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Int J Cancer:CSPPT亚组分析:高尿酸血症增加癌症风险,适量补充叶酸或有益

2017-04-13 朱柳媛 中国循环杂志

血尿酸是嘌呤的代谢产物,主要通过肾脏和肠道清除。国外研究表明,血尿酸水平对癌症及癌症死亡风险有影响。但血尿酸在癌症发生中的作用存在争议,在中国人群中也很少开展相关研究。

血尿酸是嘌呤的代谢产物,主要通过肾脏和肠道清除。国外研究表明,血尿酸水平对癌症及癌症死亡风险有影响。但血尿酸在癌症发生中的作用存在争议,在中国人群中也很少开展相关研究。

近期,南方医科大学附属南方医院肾内科徐希平教授、北京大学第三医院心内科高炜教授等利用中国卒中一级预防试验(CSPPT)数据进行分析后发现,在我国高血压患者中,血尿酸水平升高与癌症、消化系统恶性肿瘤发生风险及癌症死亡风险增加独立相关,但补充叶酸可能会削弱血尿酸的影响。

研究者指出,“由于血尿酸水平在临床实践中常用且容易检测,因此是识别癌症罹患风险较高和预后较差者的一个便捷、可行的方法。”

Cox比例风险模型分析提示,在仅用依那普利的高血压患者中,血尿酸水平与癌症风险增加独立相关,血尿酸水平升高者罹患癌症的风险增加12%;与血尿酸水平处于最低三分位者相比,其余患者罹患癌症的风险增加58%。

就特定类型癌症来说,血尿酸水平与消化系统恶性肿瘤以及所有致死性癌症风险呈正相关关系(HR分别为1.18和1.15)。

有趣的是,补充叶酸似乎可以削弱血尿酸水平与癌症风险之间的关系。分析表明,在服用依那普利+叶酸的患者中,血尿酸水平与癌症风险及癌症死亡风险都没有关联。

研究者表示,目前并不清楚血尿酸影响癌症风险的方式。

在近期公布的另一项针对CSPPT的分析中,高血压患者补充叶酸并不降低癌症风险,仅基线叶酸水平较低的MTHFR C677T基因型患者癌症风险有所降低。

有Meta分析表明,每天补充153~400 μg叶酸才有预防癌症的作用。研究者推测,叶酸为许多生物反应提供必需的甲基基团,这可能有助于预防某些类型的癌症;另外,叶酸可能会降低血尿酸水平。

在这项分析中,20 577例高血压患者接受了血尿酸水平检测,平均随访4.5年期间,232例受试者罹患癌症。血尿酸水平三分位:男性由低至高依次为<5.5、5.5-6.7、≥6.7 mg/dl;女性中由低至高依次为<4.5、4.5-5.4、≥5.4 mg/dl。


原始出处:
1、Yang J, Wang Y, Zhao Q, et al. Association of Serum Uric Acid with Increased Risk of Cancer among Hypertensive Chinese. Int J Cancer. 2017 Apr 10.

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    2017-04-18 1e10c84am36(暂无匿称)

    文章不错,拜读了

    0

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    2017-04-14 九天.

    mark

    0

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随着经济发展、人口老龄化及老年性疾病增多,高尿酸血症和痛风发病率增高已成为全球问题。2016年3月19日,在第七届肥胖与糖尿病论坛上,中山大学孙逸仙纪念医院李焱教授就高尿酸血症和痛风的循证研究进展、减重治疗、降尿酸药物治疗等发表了精彩见解。 高尿酸血症(即男性血尿酸>420μmol/L,女性>360μmol/L)的危害和争议 高尿酸血症与心血管疾病、肥胖、胰岛素抵抗等密切相关,以前被视为代谢综

Hypertension:不伴合并症的无症状高尿酸血症可以预测心脏代谢性疾病!

总之,无症状高尿酸血症再无合并症的个体中发生心脏代谢疾病的风险显著。

Am J Med:别嘌呤醇可降低高尿酸血症患者发生心血管疾病的风险

背景:高尿酸血症和痛风与心血管风险增加有关。别嘌呤醇是一种有效的降尿酸药物。是否降低尿酸的别嘌呤醇能改善高尿酸血症患者发生心血管风险尚不清楚。目标:在一项观察研究中,探讨别嘌呤醇对高尿酸血症患者心血管预后的影响。方法:研究者收集了丹麦菲英郡1992年到2010年间,高尿酸水平(≥6mg/dl)的患者。研究者联系了四个登记处;所有血液样本,医院住院和门诊患者,所有报销处方及死亡原因。研究者识别应用别

高血压伴高尿酸血症的研究进展

作者:卢新政 邹花一阳单位:江苏省人民医院(南京医科大学第一附属医院、南京医科大学附属医院)[1] 高血压与高尿酸作为心血管疾病两个危险因素[1],近年在中国逐渐增多。高血压与高尿酸相互影响,两者并存时,心脑血管疾病风险明显增加。因此,高血压合并高尿酸血症的临床诊治与管理很重要。1 流行病学1870年最早发现,血尿酸与高血压的发生发展有关。早期,人们将其归因于肾血管收缩,引

隐匿性高尿酸血症,危害不止是痛风!

髙尿酸血症的高发年龄为中老年男性和绝经后女性,但近年来越来越趋于年轻化,已成为代谢性疾病、心血管疾病的重要危险因素。

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