| Objective: Recent studies in both humans and experimental animals have led to renewed interest in uric acid and its association with vascular function. Various lines of evidence suggest that uric acid may have a direct role in the pathogenesis of hypertension , vascular disease and renal disease. it is apparent that serum uric acid levels serve as a independent predictor of prognosis and outcome in certain renal, cardiovascular and cerebrovascular. Some documents have reported that the uric acid,as an anti-oxidant have the effect of anti-oxidative stress, it's a protective factor. But much more studies show that hyperuricemia has a adverse effect on vascular function, it relates to many vascular diseases'process of generation and development. So far, we put much more attention to the relationship between hyperuricemia and IMT, but there is little researches on the relationship of different levels of uric acid that in normal range and myeloperoxidase and the carotid intima-media thickness. This study will make a T-sect research on the high risk group of atherosclerosis—metabolic syndrome patients .After correcting risk factors that affecting vascular function, detect the level of myeloperoxidase and the carotid intima-media thickness in different levels of serum uric acid .So to study the effect that different levels of uric acid make on vascular endothelial function.Methods: According to the 2005 IDF criteria for the diagnosis of metabolic syndrome, chosed 120 patients without hematological system disease, hepatic and kidney disease, gout, cancer and thyroid diseases and so on.The blood pressure, body mass index, smoking history and family history of all subjects were collected . Mensurate blood glucose, blood fat, hepatic and renal function and myeloperoxidase with venous blood drawed on an empty stomach. Measure the carotid intima-media thickness by doppler ultrasound. According to the different levels of uric acid ,the subjects were divided into four groups : 30 subjects in each group .Group A ( lower level in normal range uric acid): uric acid 176～260μmol/l. Including 16 men and 14 women with the age range from 46 to 75(62.17±9.46); Group B( model level in normal range uric acid): uric acid 261~340μmol/l. Including 17 men and 13 women with the age range from 44 to 79(63.07±12.92); Group C(higher level in normal range uric acid ):uric acid 341~416μmol/l . Including 17 men and 13 women with the age range from 42 to 74(60.10±11.84); Group D(hyperuricacidemia ): uric acid > 417μmol/l. Including 18 men and 12 women with the age range from 42 to 74(58.90±12.76).Results: 1.After adjustment for possible influencing factors, the results of the comparison of MPO and IMT among the four groups are as follows:①From group A to group D ,the blood MPO has a tendency to increasing gradually . MPO in group D is the highest(102.03±13.88μg/L), in sequence from high to low , MPO of the other three groups in orders is the group C(98.27±16.21μg/L),group B(89.36±13.57μg/L)and group A(88.76±13.58μg/L), MPO in group C and group D are both significantly higher than it in group A and group B(p<0.05) respectively, but there are no significant difference between group A and B and group C and D(P >0.05).②From group A to group D ,the IMT has a tendency to increasing gradually .The carotid intima-media thickness in group D is the highest(1.07±0.30m/s), in sequence from high to low , IMT of the other three groups in orders is the group C(1.06±0.42 m/s),group B(0.81±0.25 m/s)and group A(0.80±0.30m/s), IMT in group C and group D are both significantly higher than it in group A and group B(p<0.05) respectively, but there are no significant difference between group A and B and group C and D(P >0.05).③The incidence rate of carotid artery artherosclerosis in group D is the highest 63.3%(19/30),in sequence are group C 50.0%(15/30)and group B 26.7%(8/30) , the rate in group A is the lowest 20.0%(6/30). After chi square test, we can see the four groups have a significantly different(P<0.01) . The incidence of carotid atherosclerosis in group C and group D are both significantly higher than it in group A and group B(p<0.05) respectively, but there are no significant difference between group A and B and group C and D(P >0.05)④By doing Pearson correlation analysis to analyze the correlation of uric acid to MPO and IMT, we can see that uric acid both has positive correlation to both of MPO and IMT , their coefficient of correlation are 0.3529 and 0.22 respectively. And MPO also has a positive correlation to IMT ,the coefficient is 0.0213.Both of them have statistical significance (p<0.05).⑤To analyze the influence factors of MPO in metabolic syndrome patients by stepwise regression, make MPO to be the dependent variable and age,body mass index,fasting plasma glucose and so on which can also affect on MPO to be the independent variable. It is suggested that uric acid is an independent influence factor to the augmentation of MPO in metabolic syndrome patients(P<0.001).⑥Make IMT to be the dependent variable and age,body mass index,fasting plasma glucose and so on which can also affect on IMT to be the independent variable. It is suggested that the independent influence factors to the augmentation of IMT in metabolic syndrome patients conclude age,uric acid and MPO(P<0.05).Conclusion:⑴To the metabolic syndrome patients , in the range of normal level uric acid to high level uric acid ,the level of blood MPO has a tendency to inceasing gradually. And the level of blood uric acid is an independent influence factor of blood MPO. It is suggested that to the metabolic syndrome patients , in the range of normal level uric acid to high level uric acid ,the increasing of blood uric acid is the risk factor to the impairment of vascular function. (2) To the metabolic syndrome patients , in the range of normal level uric acid to high level uric acid ,the level of IMT has a tendency to inceasing gradually, and the number of carotid artery sclerosis is also higher.The level of blood uric acid is an independent influence factor of IMT. It is suggested that to the metabolic syndrome patients , in the range of normal level uric acid to high level uric acid , the increasing of blood uric acid is the risk factor of atherosclerosis.⑶To the metabolic syndrome patients ,even though the level of uric acid is in the normal range, there is an increasing of the blood MPO and IMT in the high level of normal range. It is suggested that to the metabolic syndrome patients, the vascular dysfunction even atherosclerosis have already existed in the high level of normal range uric acid .
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