尿酸水平对银屑病合并心血管疾病的影响

Effect of serum uric acid levels on cardiovascular diseases in patients with psoriasis

  • 摘要: 目的 探讨银屑病患者的高尿酸血症及低尿酸血症的发生情况,及其对银屑病合并心血管疾病(CVD)的影响。方法 选择2022年1月至2023年9月在喀什地区第一人民医院皮肤科住院的银屑病患者,收集其临床资料和实验室检查结果。分析银屑病患者合并低尿酸血症、高尿酸血症及CVD情况,比较合并CVD和无CVD者的临床特征,并应用多因素Logistic回归分析其血尿酸浓度与CVD发生风险的关系。结果 共纳入206例银屑病患者,患者年龄为(52.0±13.7)岁,男性130例(63.1%),合并CVD 33例(16.0%),伴高尿酸血症、低尿酸血症者的比例分别为26.2%、10.2%。高尿酸血症与正常尿酸的银屑病患者相比,合并CVD者的比例升高(27.8% vs. 9.2%,P = 0.011);低尿酸血症与正常尿酸的银屑病患者相比,合并CVD者的比例也升高(28.6% vs. 9.2%,P = 0.001);合并CVD与无CVD的银屑病患者相比,合并高尿酸血症者(45.5% vs.22.5%)、低尿酸血症者(18.2% vs. 8.8%)、高血压者(63.3% vs. 13.3%)、糖尿病者(30.3% vs. 8.1%)、总胆固醇浓度≥5.2 mmol/L者(39.4% vs. 20.8%)和高敏C反应蛋白质量浓度>5 mg/L者(57.6% vs. 27.7%)的比例均升高(均P < 0.05)。多因素Logistic回归分析显示,与正常尿酸患者相比,高尿酸血症(OR=1.668,95%CI 1.022~2.722,P = 0.041)、低尿酸血症(OR=4.520,95%CI 1.210~16.877,P = 0.025)均为银屑病患者合并CVD的危险因素。结论 高尿酸血症及低尿酸血症均可能为银屑病患者合并CVD的潜在风险因素。

     

    Abstract: Objective To explore the prevalence of hyperuricemia and hypouricemia in patients with psoriasis and explore their potential impact on the occurrence of cardiovascular disease(CVD). Methods Patients with psoriasis who were hospitalized in the Department of Dermatology at the First People’s Hospital of Kashi Prefecture from January 2022 to September 2023 were enrolled. Clinical data and laboratory test results were collected. The occurrence of hypouricemia,hyperuricemia,and cardiovascular disease(CVD)among these patients was analyzed. Clinical characteristics were compared between patients with and without CVD. Multivariate logistic regression analysis was performed to assess the associations between serum uric acid levels and the risk of CVD. Results A total of 206 psoriasis patients were included in the study. The mean age was(52.0±13.7)years and 130 patients(63.1%)were male. 33 patients(16.0%)had comorbid cardiovascular disease(CVD). The prevalence of hyperuricemia and hypouricemia was 26.2% and 10.2%,respectively. Compared with patients with normal uric acid levels,those with hyperuricemia had a higher prevalence of CVD(27.8% vs. 9.2%,P = 0.011),and similarly,patients with hypouricemia also had an increased prevalence of CVD(28.6% vs. 9.2%,P = 0.001),even without higher traditional cardiovascular risk factors. Compared with psoriasis patients without CVD,those with CVD showed higher proportions of hyperuricemia(45.5% vs. 22.5%),hypouricemia(18.2% vs. 8.8%),hypertension(63.3% vs. 13.3%),diabetes(30.3% vs. 8.1%),total cholesterol ≥ 5.2 mmol/L(39.4% vs. 20.8%),and hsCRP> 5 mg/L(57.6% vs. 27.7%)(all P < 0.05). Multivariate logistic regression analysis indicated that,compared with patients with normal uric acid levels,both hyperuricemia(OR=1.668,95%CI 1.022-2.722,P = 0.041)and hypouricemia(OR=4.520,95%CI 1.210-16.877,P = 0.025)were independent risk factors for CVD in patients with psoriasis. Conclusions Both hyperuricemia and hypouricemia may be potential risk factors of CVD in patients with psoriasis.

     

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