Association Between Serum Uric Acid And Carotid Intima-media Thickness

Objective:To analyze the association between serum uric acid（SUA）level and carotid intima-media thickness（CIMT）,and to explore the relationship between SUA and carotid atherosclerosis.Method:This study consisted of a meta-analysis and a clinical research.For Meta analysis,Pub Med、Cochrane Library、Embase、CNKI、Wanfang Database,and Chinese Biomedical Database were searched from self-built databases to March 2021（See attachment for detailed search strategy）.Stata 15.1 was used for statistical analysis,NOS scale was used to evaluate the quality of the included literature,I~2value was used for inter-study heterogeneity test,Egger test was used to evaluate publication bias,and sensitivity analysis was used to evaluate the stability of the results.In clinical study,general data,clinical biochemical parameters and imaging data of included subjects were collected,and uric acid levels were measured by uricase-peroxidase assay.Cervical vascular lesions were defined based on endometrial and medial thickness and plaque formation as indicated by ultrasound imaging results.Multifactor regression analysis was used to evaluate the relationship between correlation factors and carotid intima-media thickness（CIMT）.Results:一.Meta-analysis:1.A total of 24 studies were included,involving 8594 subjects,including 1896 in the hyperuricemia group and 6698 in the normuricemia group.2.CIMT in hyperuricemia group was higher than that in normuricemia group[SMD=0.53,95%CI（0.47,0.59）,P<0.001].3.We performed subgroup analysis based on study population,age,body mass index（BMI）and systolic blood pressure（SBP）,and the results showed that in the general population（I~2=62.20%,P=0.003）,in patients with disease（I~2=89.50%,P<0.001）;in patients with age<60 years（I~2=78.60%,P<0.001）,in patients with age≥60 years（I~2=88.10%,P<0.001）;in patients with BMI<24 kg/m~2（I~2=0.00%,P=0.369）;in patients with BMI≥24 kg/m~2（I~2=55.80%,P=0.007）;in patients with SBP<140 mm Hg（I~2=88.90%,P<0.001）,SBP≥140 mm Hg（I~2=0.00%,P=0.897）.二.Clinical research:1.A total of 304 subjects were included in the clinical research,including 152subjects in normuricemia group and 152 subjects in the hyperuricemia group.2.CIMT in hyperuricemia group was significantly higher than that in normuricemia group[(0.19（0.13,0.25）vs 0.12（0.11,0.14）cm,P<0.001].The serum uric acid level of male[449.76（363.71,507.28）vs 358.47（284.45,415.84）umol/L,P<0.001]and CIMT[0.14（0.12,0.22）vs 0.13（0.11,0.19）cm,P<0.05]was higher than that of female.3.The CIMT of the third and fourth quartiles was significantly higher than that of the first and second quartiles（P<0.01）.4.The detection rate of carotid plaque in hyperuricemia group was 64.47%,which was significantly higher than that in normuricemia group（24.34%）（P<0.001）.5.Correlation analysis results showed that age（r=0.334,P<0.001）,gender（r=0.136,P=0.018）,systolic blood pressure（r=0.272,P<0.001）,diastolic blood pressure（r=0.231,P<0.001）,SUA（r=0.338,P<0.001）and serum creatinine（r=0.164,P=0.004）were correlated with CIMT.6.Multivariate regression analysis showed that age[B=0.691,95%CI（0.467,0.915）,P<0.001],and SUA[B=0.464,95%CI（0.279,0.650）,P<0.001]were risk factors for CIMT thickening.Conclusion:1.The increase of serum uric acid level was closely related to the increase of carotid intima-media thickness.2.Serum uric acid could be an independent risk factor for cervical atherosclerosis.