Hypertension:血清尿酸会通过影响内皮功能障碍导致高血压吗?

2016-12-28 xing.T MedSci原创

在这项随机,双盲,安慰剂对照试验中,降低尿酸水平并不会影响没有高血压的超重或肥胖患者的血管内皮功能。这些数据并不支持这一假设,即尿酸与内皮功能障碍存在因果关系,并且作为高血压发生的可能机制。

血清尿酸水平升高与内皮功能障碍独立相关,是高血压的发病机制。超重/肥胖的个人比体瘦的个人更容易发生血管内皮功能障碍。然而,降低血清尿酸对这些人的内皮功能障碍所产生的效应还未被彻底阐明。近日,心血管权威期刊Hypertension上发表一篇研究文章,旨在明确这一问题。


研究人员在没有高血压、但超重或肥胖,伴有高血清尿酸(体重指数≥25 kg/m2和血清尿酸≥5mg/dL)的人群中进行了这项随机、双盲、安慰剂对照试验。研究人员将参与者随机分组,分别接受丙磺舒(500-1000mg/天)、别嘌呤醇(300-600mg/天)或匹配的安慰剂治疗。主要结果是在研究之初和第8周通过肱动脉超声测量的内皮依赖性血管舒张功能。

在研究结束后,分别有47、49和53名参与者被分配接受丙磺舒、别嘌醇和安慰剂治疗。平均血清尿酸水平在丙磺舒(从6.1降到了3.5mg/dL)和别嘌呤醇组(从6.1降到了2.9 mg/dL)治疗组明显下降,而在安慰剂组没有显著差异(6.1降至5.6 mg/dL)。

所有的干预均没有导致内皮依赖性血管舒张功能有显著变化(丙磺舒,在基础水平为7.4±5.1%,第8周为8.3±5.1%;别嘌呤醇,在基础水平为7.6±6.0%,第8周为6.2±4.8%;安慰剂,在基础水平为6.5±3.8%,第8周围7.1±4.9%)。

在这项随机,双盲,安慰剂对照试验中,降低尿酸水平并不会影响没有高血压的超重或肥胖患者的血管内皮功能。这些数据并不支持这一假设,即尿酸与内皮功能障碍存在因果关系,并且作为高血压发生的可能机制。

原始出处:

Lea Borgi, et al. Effect of Uric Acid–Lowering Agents on Endothelial Function A Randomized, Double-Blind, Placebo-Controlled Trial. Hypertension.December 27 , 2016.

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    2017-04-12 feather89
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    2016-12-28 yafeiliutjh

    新发现吗

    0

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血清中尿酸水平与绝经后妇女冠状动脉内皮功能障碍有关,并且有可能与炎症相关。这些结果可以将血清中尿酸水平与绝经后妇女早期冠状动脉粥样硬化联系在一起。

A&R:维生素C不能降低痛风患者的血清尿酸水平

维生素C是一种能从食物中获取的重要的营养物质。既往有研究报道,维生素C摄入量的增加与血清尿酸(SU)水平之间呈负相关,有降低痛风发生风险的作用,这可能与维生素C有促尿酸排泄的作用有关,同时也有认为维生素C可抑制尿酸的合成。为验证维生素C对痛风患者SU水平的影响,来自新西兰奥塔哥大学的Lisa K. Stamp博士等人进行了一项临床研究。研究结果发表于2013年6月的《关节炎与风湿病》(ARTHRI

Hypertension:血管硬化与血清尿酸相关吗?

高血清尿酸水平与男性脉搏波速度增加程度更大相关,但在女性中不存在相关性;当将血清尿酸≥6.2 mg/dL的男性排除后,这种相关性就会消失,这表明血清尿酸为6.2mg/dL是与动脉硬化存在相关性的一个阈值,这一阈值在男性中更经常达到。