Hyperuricemia increases the risk of cardiovascular mortality associated with very high HdL-cholesterol level

被引：12

作者：

Palatini, Paolo ^{[1
]}

Virdis, Agostino ^{[4
]}

Masi, Stefano ^{[4
]}

Mengozzi, Alessandro ^{[4
]}

Casiglia, Edoardo ^{[16
]}

Tikhonoff, Valerie ^{[16
]}

Cicero, Arrigo F. G. ^{[6
]}

Ungar, Andrea ^{[8
,9
]}

Parati, Gianfranco ^{[2
,3
]}

Rivasi, Giulia ^{[5
,8
,9
]}

Salvetti, Massimo ^{[7
]}

Barbagallo, Carlo M. ^{[17
]}

Bombelli, Michele ^{[14
]}

Dell'Oro, Raffaella ^{[14
]}

Bruno, Berardino ^{[12
]}

Lippa, Luciano ^{[13
]}

D'Elia, Lanfranco ^{[15
]}

Masulli, Maria ^{[15
]}

Verdecchia, Paolo ^{[18
]}

Reboldi, Gianpaolo ^{[8
,9
]}

Angeli, Fabio ^{[19
,29
]}

Mallamaci, Francesca ^{[20
]}

Cirillo, Massimo ^{[21
]}

Rattazzi, Marcello ^{[22
]}

Cirillo, Pietro ^{[23
]}

Gesualdo, Loreto ^{[23
]}

Mazza, Alberto ^{[24
]}

Giannattasio, Cristina ^{[25
]}

Maloberti, Alessandro ^{[25
]}

Volpe, Massimo ^{[26
,30
]}

Tocci, Giuliano ^{[26
,30
]}

Iaccarino, Guido ^{[27
]}

Nazzaro, Pietro ^{[28
]}

Galletti, Ferruccio ^{[15
]}

Ferri, Claudio ^{[12
]}

Desideri, Giovambattista ^{[12
]}

Viazzi, Francesca ^{[10
,11
]}

Pontremoli, Roberto ^{[10
,11
]}

Muiesan, Maria Lorenza ^{[7
]}

Grassi, Guido ^{[14
]}

Borghi, Claudio ^{[6
]}

机构：

[1] Univ Padua, Dept Med, Studium Patavinum, Padua, Italy

[2] S Luca Hosp, Ist Auxol Italiano, Milan, Italy

[3] Univ Milano Bicocca, Milan, Italy

[4] Univ Pisa, Dept Clin & Expt Med, Pisa, Italy

[5] Univ Perugia, Dept Med & Surg Sci, Perugia, Italy

[6] Alma Mater Studiorum Univ Bologna, Bologna, Italy

[7] Univ Brescia, Dept Clin & Expt Sci, Brescia, Italy

[8] Careggi Hosp, Dept Geriatr & Intens Care Med, Florence, Italy

[9] Univ Florence, Florence, Italy

[10] Univ Genoa, Dept Internal Med, Genoa, Italy

[11] Policlin San Martino, Genoa, Italy

[12] Univ Laquila, Dept Life Hlth & Environm Sci, Laquila, Italy

[13] Italian Soc Gen Med SIMG, Avezzano, Laquila, Italy

[14] Univ Milano Bicocca, Dept Cardiovasc Neural & Metab Sci, Dept Med & Surg, Clin Med, Monza, Italy

[15] Federico II Univ Naples, Med Sch, Dept Clin Med & Surg, Naples, Italy

[16] Univ Padua, Dept Med, Padua, Italy

[17] Univ Palermo, Biomed Dept Internal Med & Specialist, Palermo, Italy

[18] Hosp S Maria Misericordia, Perugia, Italy

[19] Univ Insubria, Dept Med & Surg, Varese, Italy

[20] CNR IFC, Reggio Cal Unit, Clin Epidemiol Renal Dis & Hypertens, Reggio Di Calabria, Italy

[21] Federico II Univ Naples, Dept Publ Hlth, Naples, Italy

[22] Univ Padua, CaFoncello Univ Hosp, Dept Med DIMED, Med Interna 1, Treviso, Italy

[23] Aldo Moro Univ Bari, Dept Emergency & Organ Transplantat Nephrol, Dialysis & Transplantat Unit, Bari, Italy

[24] Gen Hosp, Dept Internal Med, Hypertens Unit, Rovigo, Italy

[25] Milano Bicocca Univ, Niguarda Ca Granda Hosp, A Gasperis Dept, Hlth Sci Dept,Cardiol 4, Milan, Italy

[26] Univ Rome Sapienza, Sant Andrea Hosp, Fac Med & Psychol, Dept Clin & Mol Med,Hypertens Unit,Div Cardiol, Rome, Italy

[27] Federico II Univ Naples, Dept Adv Biomed Sci, Naples, Italy

[28] Univ Bari, Dept Med Basic Sci Neurosci & Sense Organs, Med Sch, Bari, Italy

[29] IRCCS Tradate, Maugeri Care & Res Inst, Dept Med & Cardiopulm Rehabil, Varese, Italy

[30] IRCCS Neuromed, Pozzilli, IS, Italy

来源：

NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES | 2023年 / 33卷 / 02期

关键词：

HDL-Cholesterol; Uric acid; Cardiovascular; Mortality; HURRAH; HIGH-DENSITY-LIPOPROTEIN; ALL-CAUSE MORTALITY; URIC-ACID; EFFLUX CAPACITY; DISEASE; DYSFUNCTION; WOMEN; MEN;

D O I：

10.1016/j.numecd.2022.11.024

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background and aims: Whether the association between very high HDL-cholesterol levels and cardiovascular mortality (CVM) is modulated by some facilitating factors is unclear. Aim of the study was to investigate whether the risk of CVM associated with very high HDL-cholesterol is increased in subjects with hyperuricemia.Methods and results: Multivariable Cox analyses were made in 18,072 participants from the mul-ticentre URRAH study stratified by sex and HDL-cholesterol category. During a median follow-up of 11.4 years there were 1307 cases of CVM. In multivariable Cox models a J-shaped association was found in the whole population, with the highest risk being present in the high HDL-cholesterol group [>80 mg/dL, adjusted hazard ratio (HR), 1.28; 95%CI, 1.02-1.61; p = 0.031)]. However, a sex-specific analysis revealed that this association was present only in women (HR, 1.34; 95%CI, 1.02-1.77; p = 0.034) but not in men. The risk of CVM related to high HDL-cholesterol was much greater in the women with high uric acid (>0.30 mmol/L, HR 1.61; 95% CI, 1.08-2.39) than in those with low uric acid (HR, 1.17; 95%CI, 0.80-1.72, p for interaction = 0.016). In women older than 70 years with hyperuricemia the risk related to high HDL-cholesterol was 1.83 (95%CI, 1.19-2.80, p < 0.005). Inclusion of BMI in the models weakened the strength of the associations.Conclusion: Our data indicate that very high HDL-cholesterol levels in women are associated with CVM in a J-shaped fashion. The risk of CVM is increased by concomitant hyperuricemia suggest-ing that a proinflammatory/oxidative state can enhance the detrimental cardiovascular effects associated with high HDL-cholesterol. 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Ital-ian 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

页码：323 / 330

页数：8

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