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中国矮小儿童和青少年尿酸与高密度脂蛋白胆固醇之比和收缩压的关系
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Abstract:
目的：本研究旨在探讨身材矮小的儿童和青少年尿酸与高密度脂蛋白胆固醇比值(UHR)和收缩压(SBP)的关系。方法：在这项横断面分析中，选择了2013年3月1日至2021年12月31日在济宁医学院附属医院内分泌科接受评估的1510名矮小症儿童和青少年的临床数据，收集其基线临床资料，分析UHR与SBP之间的关系。结果：单因素分析结果显示，UHR与SBP呈正相关(β 0.75, P < 0.0001)。此外，在调整了可能的混杂因素后，通过平滑曲线拟合发现UHR和SBP之间存在非线性关系，经多元分段线性回归分析，拐点为6.33%。当UHR大于6.33%时，SBP随UHR升高而增加(β 0.33, 95% CI 0.12, 0.54; P = 0.0019)，然而，当UHR小于6.33% (P = 0.0736)时，我们没有观察到显著的相关性。结论：我们的研究发现，在身材矮小的儿童和青少年中，UHR和SBP之间存在非线性关系，并表明当UHR达到拐点时，SBP水平与UHR的升高呈正相关。这一发现表明UHR可能与SBP水平的调节有关，这种关系值得进一步研究。
Objective: This study aims to investigate the relationship between the uric acid to high density lip-oprotein cholesterol ratio (UHR) and systolic blood pressure (SBP) in children and adolescents with short stature. Methods: In this cross-sectional analysis, clinical data of 1510 children and adoles-cents were evaluated in the Department of Endocrinology, Affiliated Hospital of Jining Medical Col-lege from 1 March 2013 to 31 December 2021, their baseline clinical data were collected and the relationship between UHR and SBP was analyzed. Results: In the univariate analysis, UHR was posi-tively associated with SBP (β 0.75, P < 0.0001). Furthermore, after adjusting for possible confound-ers, a non-linear relationship between UHR and SBP was found by smoothing curve fitting, and the inflection point was 6.33% by multiple piecewise linear regression analysis. When the UHR is greater than 6.33%, SBP increases with increasing UHR (β 0.33, 95% CI 0.12, 0.54; P = 0.0019). However, we did not observe a significant correlation when the UHR was less than 6.33% (P = 0.0736). Conclusions: Our study found a nonlinear relationship between UHR and SBP in short stat-ure children and adolescents, and showed that SBP levels are positively associated with increased UHR when UHR reaches an inflection point. This finding suggests that the UHR may be related to the regulation of SBP levels, and this relationship warrants further investigation.
| [1] | Ji, Y.T., Li, L.L., Cai, S.Z., et al. (2022) Body Composition in Preschool Children with Short Stature: A Case-Control Study. BMC Pediatrics, 22, Article No. 98. https://doi.org/10.1186/s12887-022-03159-8 |
| [2] | Aryayev, M., Sen-kivska, L. and Lowe, J.B. (2021) Psycho-Emotional and Behavioral Problems in Children with Growth Hormone Defi-ciency. Frontiers in Pediatrics, 9, Article ID: 707648. https://doi.org/10.3389/fped.2021.707648 |
| [3] | Nelson, C.P., Hamby, S.E., Saleheen, D., et al. (2015) Genetically Determined Height and Coronary Artery Disease. The New England Journal of Medicine, 372, 1608-1618. https://doi.org/10.1056/NEJMoa1404881 |
| [4] | Onat, A., Ornek, E., Can, G., et al. (2012) Short Stature Is an Independent Risk Marker for Mortality and Incident Coronary Heart Disease Only in Women: A Structural Relationship? Anadolu Kardiyoloji Dergisi, 12, 289-297.
https://doi.org/10.5152/akd.2012.091 |
| [5] | Park, C.S., Choi, E.K., Han, K.D., et al. (2018) Association between Adult Height, Myocardial Infarction, Heart Failure, Stroke and Death: A Korean Nationwide Population-Based Study. International Journal of Epidemiology, 47, 289-298. https://doi.org/10.1093/ije/dyx175 |
| [6] | Moon, J., Hwang, I.C. and Han, S.H. (2020) Short Stature Is Associated with Higher Pulse Wave Velocity in Subjects without Overt Cardio-vascular Disease. Medicine (Baltimore), 99, e22219.
https://doi.org/10.1097/MD.0000000000022219 |
| [7] | Karhunen, P.J. and Meinander, T. (2015) Coronary Artery Disease: Complex Association between Height and CHD- Size Matters. Nature Reviews Cardiology, 12, 385-386. https://doi.org/10.1038/nrcardio.2015.80 |
| [8] | Reges, O., Ning, H., Wilkins, J.T., et al. (2021) Association of Cu-mulative Systolic Blood Pressure with Long-Term Risk of Cardiovascular Disease and Healthy Longevity: Findings from the Lifetime Risk Pooling Project Cohorts. Hypertension, 77, 347-356. https://doi.org/10.1161/HYPERTENSIONAHA.120.15650 |
| [9] | Yan, Y., Hou, D., Liu, J., et al. (2017) Childhood Body Mass Index and Blood Pressure in Prediction of Subclinical Vascular Damage in Adulthood: Beijing Blood Pres-sure Cohort. Journal of Hypertension, 35, 47-54.
https://doi.org/10.1097/HJH.0000000000001118 |
| [10] | Hao, G., Wang, X., Treiber, F.A., et al. (2017) Blood Pres-sure Trajectories from Childhood to Young Adulthood Associated with Cardiovascular Risk: Results from the 23-Year Longitudinal Georgia Stress and Heart Study. Hypertension, 69, 435-442. https://doi.org/10.1161/HYPERTENSIONAHA.116.08312 |
| [11] | Urbina, E.M., Khoury, P.R., Bazzano, L., et al. (2019) Relation of Blood Pressure in Childhood to Self-Reported Hypertension in Adulthood. Hypertension, 73, 1224-1230. https://doi.org/10.1161/HYPERTENSIONAHA.118.12334 |
| [12] | Azegami, T., Uchida, K., Arima, F., et al. (2021) Association of Childhood Anthropometric Measurements and Laboratory Parameters with High Blood Pressure in Young Adults. Hypertension Research, 44, 711-719.
https://doi.org/10.1038/s41440-021-00615-3 |
| [13] | Kosekli, M.A., Kurtkulagii, O., Kahveci, G., et al. (2021) The Association between Serum Uric Acid to High Density Lipoprotein-Cholesterol Ratio and Non-Alcoholic Fatty Liver Disease: The Abund Study. Revista da Associa？？o Médica Brasileira (1992), 67, 549-554. https://doi.org/10.1590/1806-9282.20201005 |
| [14] | Zhang, Y.N., Wang, Q.Q., Chen, Y.S., et al. (2020) Association between Serum Uric Acid to HDL-Cholesterol Ratio and Nonalcoholic Fatty Liver Disease in Lean Chinese Adults. In-ternational Journal of Endocrinology, 2020, Article ID: 5953461. https://doi.org/10.1155/2020/5953461 |
| [15] | Aktas, G., Kocak, M.Z., Bilgin, S., et al. (2020) Uric Acid to HDL Cholesterol Ratio Is a Strong Predictor of Diabetic Control in Men with Type 2 Diabetes Mellitus. Aging Male, 23, 1098-1102.
https://doi.org/10.1080/13685538.2019.1678126 |
| [16] | Yazdi, F., Baghaei, M.H., Baniasad, A., et al. (2022) Inves-tigating the Relationship between Serum Uric Acid to High-Density Lipoprotein Ratio and Metabolic Syndrome. Endo-crinology, Diabetes & Metabolism, 5, e311.
https://doi.org/10.1002/edm2.311 |
| [17] | Kocak, M.Z., Aktas, G., Erkus, E., et al. (1992) Serum Uric Acid to HDL-Cholesterol Ratio Is A Strong Predictor of Metabolic Syndrome in Type 2 Diabetes Mellitus. Revista da Associ-a？？o Médica Brasileira, 65, 9-15.
https://doi.org/10.1590/1806-9282.65.1.9 |
| [18] | Safar, M.E., Balkau, B., Lange, C., et al. (2013) Hypertension and Vascular Dynamics in Men and Women with Metabolic Syndrome. Journal of the American College of Cardiology, 61, 12-19.
https://doi.org/10.1016/j.jacc.2012.01.088 |
| [19] | Palmu, J., Watrous, J.D., Mercader, K., et al. (2020) Eicosanoid In-flammatory Mediators Are Robustly Associated with Blood Pressure in the General Population. Journal of the American Heart Association, 9, e17598.
https://doi.org/10.1161/JAHA.120.017598 |
| [20] | Aktas, G., Khalid, A., Kurtkulagi, O., et al. (2022) Poorly Con-trolled Hypertension Is Associated with Elevated Serum Uric Acid to HDL-Cholesterol Ratio: A Cross-Sectional Cohort Study. Postgraduate Medicine, 134, 297-302.
https://doi.org/10.1080/00325481.2022.2039007 |
| [21] | Kou, S., Zhang, M., Ji, B., et al. (2021) Association between Systolic Blood Pressure and Uric Acid in Chinese Children and Adolescents with Idiopathic Short Stature: A Cross-Sectional Study. Journal of Human Hypertension, 35, 472-478. https://doi.org/10.1038/s41371-020-0362-0 |
| [22] | Hwang, Y.C., Fujimoto, W.Y., Kahn, S.E., et al. (2019) Higher High Density Lipoprotein 2 (HDL2) to Total HDL Cholesterol Ratio Is Associated with a Lower Risk for Incident Hy-pertension. Diabetes & Metabolism Journal, 43, 114-122. https://doi.org/10.4093/dmj.2018.0053 |
| [23] | Jang, I. (2021) Pre-Hypertension and Its Determinants in Healthy Young Adults: Analysis of Data from the Korean National Health and Nutrition Examination Survey VII. International Journal of Environmental Research and Public Health, 18, Article No. 9144. https://doi.org/10.3390/ijerph18179144 |
| [24] | Li, H., Ji, C.Y., Zong, X.N., et al. (2009) Height and Weight Standardized Growth Charts for Chinese Children and Adolescents Aged 0 to 18 Years. Chinese Journal of Pediatrics, 47, 487-492. |
| [25] | Marshall, W.A. and Tanner, J.M. (1970) Variations in the Pattern of Pubertal Changes in Boys. Archives of Disease in Childhood, 45, 13-23. https://doi.org/10.1136/adc.45.239.13 |
| [26] | Marshall, W.A. and Tanner, J.M. (1969) Variations in Pattern of Pubertal Changes in Girls. Archives of Disease in Childhood, 44, 291-303. https://doi.org/10.1136/adc.44.235.291 |
| [27] | Syrenicz, A., Garanty-Bogacka, B., Syrenicz, M., et al. (2006) Rela-tion of Low-Grade Inflammation and Endothelial Activation to Blood Pressure in Obese Children and Adolescents. Neu-ro Enocrinology Letters, 27, 459-464. |
| [28] | Jung, J.Y., Oh, C.M., Choi, J.M., et al. (2019) Levels of Systolic and Dias-tolic Blood Pressure and Their Relation to Incident Metabolic Syndrome. Cardiology, 142, 224-231. https://doi.org/10.1159/000499867 |
| [29] | Katsimardou, A., Imprialos, K., Stavropoulos, K., et al. (2020) Hyperten-sion in Metabolic Syndrome: Novel Insights. Current Hypertension Reviews, 16, 12-18. https://doi.org/10.2174/1573402115666190415161813 |
| [30] | Lurbe, E. and Ingelfinger, J.R. (2016) Blood Pressure in Children and Adolescents: Current Insights. Journal of Hypertension, 34, 176-183. https://doi.org/10.1097/HJH.0000000000000790 |
| [31] | Wang, Y., Hu, J.W., Lv, Y.B., et al. (2017) The Role of Uric Acid in Hypertension of Adolescents, Prehypertension and Salt Sensitivity of Blood Pressure. Medical Science Monitor, 23, 790-795. https://doi.org/10.12659/MSM.899563 |
| [32] | Tang, O., Miller, E.R., Gelber, A.C., et al. (2017) DASH Diet and Change in Serum Uric Acid over Time. Clinical Rheumatology, 36, 1413-1417. https://doi.org/10.1007/s10067-017-3613-x |
| [33] | Lin, K.H., Yen, F.S., Chen, H.S., et al. (2021) Serum Uric Acid and Blood Pressure among Adolescents: Data from the Nutrition and Health Survey in Taiwan (NAHSIT) 2010-2011. Blood Pressure, 30, 118-125.
https://doi.org/10.1080/08037051.2020.1848417 |
| [34] | Mazzali, M., Hughes, J., Kim, Y.G., et al. (2001) Elevated Uric Acid Increases Blood Pressure in the Rat by a Novel Crystal-Independent Mechanism. Hypertension, 38, 1101-1106. https://doi.org/10.1161/hy1101.092839 |
| [35] | Park, B., Lee, H.A., Lee, S.H., et al. (2017) Association between Serum Levels of Uric Acid and Blood Pressure Tracking in Childhood. American Journal of Hypertension, 30, 713-718. https://doi.org/10.1093/ajh/hpx037 |
| [36] | Ouimet, M., Barrett, T.J. and Fisher, E.A. (2019) HDL and Re-verse Cholesterol Transport. Circulation Research, 124, 1505-1518. https://doi.org/10.1161/CIRCRESAHA.119.312617 |
| [37] | Nagao, M., Nakajima, H., Toh, R., et al. (2018) Cardio-protective Effects of High-Density Lipoprotein beyond Its Anti-Atherogenic Action. Journal of Atherosclerosis and Thrombosis, 25, 985-993. https://doi.org/10.5551/jat.RV17025 |
| [38] | Manandhar, B., Cochran, B.J. and Rye, K.A. (2020) Role of High-Density Lipoproteins in Cholesterol Homeostasis and Glycemic Control. Journal of the American Heart Association, 9, e13531.
https://doi.org/10.1161/JAHA.119.013531 |
| [39] | Kunutsor, S.K., Kieneker, L.M., Bakker, S., et al. (2017) The In-verse Association of HDL-Cholesterol with Future Risk of Hypertension Is Not Modified by Its Antioxidant Constituent, Paraoxonase-1: The PREVEND Prospective Cohort Study. Atherosclerosis, 263, 219-226. https://doi.org/10.1016/j.atherosclerosis.2017.06.353 |
