Contribution Of Age And Sex To Serum Uric Acid Level In Subjects With Coronary Artery Disease

Objective: Uric acid is a kind of end product of purine metabolism extrinsic source and endogenous, it's dissolvability and degree of saturation in the blood is limited, the maximum degree of saturation is 416μmol/L, crystal will emerge when surpass this density. About 25% of uric acid excrete through digestive canal, the rest through kidney, the condition of it's egestion through kidney roughly as follows: (1) Almost 100% of the blood uric acid is filtered through the glomcrulus; (2)98%～100% of the uric acid which is filtered will be reabsorb in the proximate nephric tubule; (3) The nephric tubule initiatively secrete uric acid to the lumens of nephric tubule; (4) Part of the secreted uric acid will be reabsorbed to the blood around the nephric tubule. The uric acid eventually ejected though this circulation of secretion and reabsorption, this part is merely about 6%～10% of the glomerular filtration. The volume ejection of uric acid from urine is adjusted by the process of tubular secretion and resorption. Many factors can affect uric acid excretion and it's level, such as the enzymatic active, function of kidney filtration and initiative commutation, medicine, diet construction, systemic disease. Hyperuricemia suffers are mainly men and post menopause women. Most cases are due to the decrease of uric acid excretion, but the renal function is normal, we call it idio-hyperuricemia. Hyperuricemia is mainly because of the increase of purine metabolism and can be divided into two species: primarily and succeedly, the latter is common in cases who suffer from malignant tumor. In the early days of chemotherapy, the composition of uric acid increase together with the increase of cell destruction and nucleic acid decomposition. Taking some drugs such as diuretic agent can promote the reabsorption of uric acid within the renal tubule, thereby hold-back the excrete of uric acid. Serum uric acid level is concerned with factors such as age, sex, smoking, liquor taken, obesity, high blood fat, hyperinsulinemia, insulin resistance, hypertension, medicine. In this trial we mainly investigate the contribution of age and sex to serum uric acid level in subjects with coronary artery disease and the relationship between hyperuricemia and some of the coronary risk factors, then search some intervention step for hyperuricemia.Method: We select 189 coronary artery disease sufferers in cardiovascular medical department of the second hospital of Hebei medical university from January 2008 to January 2009. Among these suffers there are 133 men and 56 women, age from 40 to 84, the average age is (60.9±10.8), exclude of liquor taken, smoking, obesity, malignant tumor, gout, liver and renal disease,hematological system disease, heart failure, pulmonary embolism, phlebothrombosis of the lower limbs, thyroid disease, chronic plumbism, diabetes together with ketosis, lactic acidosis, diuretic agent, pyramide taken and of whose BUN>7. 0mmol/L,Cr>133μmol/L, patiens who suffer from coronary artery disease along with any other heart disease are not include. Inquire theire diet and medical record, collect their venous blood to survey biochemical indicators such as serum uric acid, blood fat and blood glucose, these indicators are measured on automatic equipment. Compare serum uric acid and the development of hyperuricemia between different sex and age groups; compare the incidence of hypertension, diabetes and hyperlipemia between hyperuricemia and non-hyperuricemia group; undertake Logistic regression analyse to discern the dependablity between hyperuricemia and other risk factors of coronary artery disease. Then we divide the objects into four groups according to the quartile of their uric acid(<300.5μmol/ L, 300.5-337.2μmol/L, 337.2-409.55μmol/L, >409.55μmol/L), calculate the incidence of hypertension, diabetes and hyperlipemia in each group, then draw a bar chart.Results: 189 patients who suffer from coronary artery disease are selected, among which 126 have high blood pressure, 51 have diabetes and 93 have hyperlipoidemia. The average serum uric acid level is (359.21±65.0)μmol/L in men and (331.88±50.41)μmol/L in women, the discrepancy of uric acid level is obvious between different sex(P<0.05), the discrepancy is obvious between the youngest group and the oldest group but not within the middle-aged group. The morbidity rate of hyperuricacidemia is 31.58%(42/133) in male group and 33.93%(19/56)in female group. the discrepancy of incidence of hypertension, diabetes and hyperlipemia between hyperuricemia and non-hyperuricemia group possess statistical significance, Logistic regression analyse reveals that hypertension, hyperlipemia and diabetes are independent risk factors of hyperuricemia. Among different level of uric acid, the incidence of hypertension, diabetes and hyperlipemia are different, their incidence will step up together with the ascending of uric acid level.Conclusion:①The discrepancy of uric acid level is obvious between different sex and age groups. The uric acid level step up along with the increase of age and risk factors, in the same group, the average uric acid level of male subjects is higher than that of female subjects.②Hypertension, hyperlipemia and diabetes are independent risk factors of hyperuricemia.③The incidence of hypertension, diabetes and hyperlipemia step up together with the ascending of uric acid level.