The combination of high uric acid and high C-reactive protein increased the risk of cardiovascular disease: A 15-year prospective cohort study

被引:4
作者
Li, Na [1 ,2 ]
Wu, Shouling [3 ]
Shu, Rong [2 ]
Song, Haicheng [2 ]
Wang, Jierui [2 ]
Chen, Shuohua [3 ]
Yang, Wenhao [4 ]
Wang, Guodong [3 ]
Yang, Jingtao [5 ]
Yang, Xuemei [5 ]
Tse, Gary [1 ,6 ,7 ]
Zhang, Nan [1 ]
Cui, Liufu [2 ]
Liu, Tong [1 ]
机构
[1] Tianjin Med Univ, Hosp 2, Tianjin Inst Cardiol, Dept Cardiol,Tianjin Key Lab Ion Mol Funct Cardiov, 23 Pingjiang Rd, Tianjin 300211, Peoples R China
[2] North China Univ Sci & Technol, Kailuan Gen Hosp, Dept Rheumatol & Immunol, Tangshan, Peoples R China
[3] Kailuan Gen Hosp, Dept Cardiol, Tangshan, Peoples R China
[4] North China Univ Sci & Technol, Affiliated Hosp, Dept Rheumatol & Immunol, Tangshan, Peoples R China
[5] North China Univ Sci & Technol, Sch Clin Med, Tangshan, Hebei, Peoples R China
[6] PowerHealth Ltd, Cardiovasc Analyt Grp, Epidemiol Res Unit, Hong Kong, Peoples R China
[7] Hong Kong Metropolitan Univ, Sch Nursing & Hlth Studies, Hong Kong, Peoples R China
基金
中国国家自然科学基金;
关键词
Uric acid; C-reactive protein; Cardiovascular disease; Combined exposure; Mediation analysis; NITRIC-OXIDE PRODUCTION; CORONARY-HEART-DISEASE; GENERAL-POPULATION; INFLAMMATORY MARKERS; CELL-PROLIFERATION; MEDIATION ANALYSIS; FAILURE; HEALTH; PREDICTION; HYPERTENSION;
D O I
10.1016/j.numecd.2024.01.027
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background and aims: Uric acid (UA) and C-reactive protein (CRP) may interact synergistically to accelerate the initiation and progression of cardiovascular disease (CVD). This study investigated the effects of a combination of high UA and high CRP on the risks of CVD. Methods and results: A total of 90,270 participants recruited from the Kailuan study were included, who were divided into four groups according to the presence/absence of hyperuricemia and inflammation. Cox regression was applied to evaluate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) of CVD. C-statistics, net classification index (NRI), and integrated discrimination improvement (IDI) were used to compare the incremental predictive of UA, CRP, and their combined effects on CVD. Mediation analysis was to explore the impact of CRP on the association between UA and CVD. Over a median follow-up of 14.95 years, we identified 11398 incident CVD cases. Compared to the low UA/low CRP group, the high UA/low CRP, low UA/high CRP and high UA/high CRP groups showed progressively higher risks of CVD, HR (95% CI): 1.18(1.10-1.27), 1.27(1.21-1.33) and 1.50 (1.33-1.69), respectively. The incorporation of UA and CRP into the traditional China-PAR model led to improvement in the C-statistic, NRI, and IDI, and was better than incorporation of either UA or CRP alone. Mediation analysis showed that CRP mediated the association between UA and CVD, accounting for 11.57% of the total effects. Conclusions: High UA/high CRP is associated with increased risks of CVD. Incorporation of both UA and CRP provided additional value for risk stratification. (c) 2024 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:1508 / 1517
页数:10
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