| Objective:The purpose of this study was to analyze the effect of serum uric acid(SUA)levels on left ventricular mass index(LVMI)in patients with chronic kidney disease(CKD)without dialysis to further investigate the relationship between SUA levels and left ventricular hypertrophy(LVH),and then to identify the relationship between hyperuricemia(HUA)and cardiovascular disease(CVD)in patients with CKD.Methods:Using the method of retrospective study,we selected 189 patients with CKD who were hospitalized in the Department of Nephrology from July 2017 to January 2018 in the China-Japan Union Hospital of Jilin University,all patients were not treated with hemodialysis,including 126 patients with hyperuricemia as HUA group and 63 patients without hyperuricemia as control group.The general data,laboratory tests,and echocardiographic indicators were collected and compared between the two groups,and the correlation between SUA levels and statistically significant differences among the groups was analyzed.Using multiple linear stepwise regression analysis to compare the effects of each variable index on LVMI.According to the SUA level,the HUA group was divided into SUA<480μmol/L(8mg/dL)group,SUA 480-600μmol/L(8-10mg/dL)group,SUA>600μmol/L(10mg/dL)group,and the index of the echocardiography was compared among the groups.The data was analyzed with SPSS 21.0 statistical software and P<0.05 was considered statistically significant difference.Results:The average systolic blood pressure(SBP)was higher in the HUA group than in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the data of gender,age,diastolic blood pressure,height,weight,body mass index,smoking,drinking and chronic kidney disease between the two groups of patients(P<0.05).2.The serum creatinine(Scr),blood urea nitrogen(BUN),phosphorus(P),calcium-phosphorus product index was higher in the HUA group than in the control group,while the glomerular filtration rate(eGFR)and hemoglobin(Hb)index were lower than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in fasting blood glucose(FBG),calcium(Ca),total cholesterol(TC),total triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)between the two groups(P>0.05).3.The left ventricular diastolic diameter(LVDd),diastolic interventricular septum thickness(IVST)and LVMI index of the HUA group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the ratio of left ventricular ejection fraction(LVEF),early diastolic transmural flow velocity/late diastolic mitral flow velocity(E/A),diastolic posterior wall thickness(PWT)in the two groups(P>0.05).The proportion of LVH in the HUA group was 37.3%,and the proportion of LVH in the control group was 28.6%.4.The correlation of SUA with SBP,SCR,eGFR,BUN,P,Ca-P product,LVDd,IVST and LVMI was statistically significant(P<0.05).SUA was positively correlated with SBP,Scr,BUN,P,Ca-P product,LVDd,IVST,LVMI,and negatively correlated with eGFR.There was no statistically significant correlation between SUA and Hb(P>0.05).5.In the multiple linear stepwise regression analysis,eGFR and systolic blood pressure had a statistically significant effect on LVMI(P<0.05),the effect of eGFR was negative,and the effect of systolic blood pressure was positive,indicating that the smaller the eGFR,the higher the systolic blood pressure,the greater the LVMI.6.The differences of IVST and LVMI in three groups of patients with different SUA levels were statistically significant(P<0.05).Further comparison shows that the “SUA>600 group’”IVST and LVMI are significantly higher than the “SUA<480 group”.The difference was statistically significant(P<0.05).There was no significant difference between the “SUA<480 group” and the “SUA 480-600 group”,the “SUA 480-600 group” and the “SUA>600 group”(P>0.05).There was no significant difference in the proportions of LVDd,EF,E/A,PWT among the three groups(P>0.05).The proportion of LVH in the “SUA <480 group” was 31.9%,The proportion of LVH in the “SUA was 480-600 group” was 34.8%,The proportion of LVH in the “SUA> 600 group” was 44.4%.Conclusions:1.There is no direct correlation between SUA levels and LVMI in CKD patients with HUA.2.There was a negative correlation between SUA levels and eGFR,The higher the SUA,the lower the eGFR.The SUA levels and systolic blood pressure were positively correlated,The higher the SUA,the higher the systolic blood pressure.The SUA levels was positively correlated with the level of P and calcium-phosphorus product,The higher the SUA,the higher the P levels and calcium-phosphorus product.3.There is a negative correlation between eGFR and LVMI,The lower the eGFR,the greater the LVMI.The systolic blood pressure is positively correlated with LVMI,The higher the systolic blood pressure,the greater the LVMI.The higher the P level and the product of calcium and phosphorus,the higher the risk of CVD such as vascular calcification may be caused.4.In patients with CKD,the higher the SUA level,the greater the LVMI.SUA may have an indirect effect on the left ventricular mass index by leading to decreased glomerular filtration rate,elevated blood pressure and disturbance of calcium and phosphorus metabolism.Therefore,CKD patients with HUA should pay attention to control SUA levels to lower blood pressure,delay deterioration of renal function,reduce P levels and product of calcium and phosphorus to prevent CVD occurrence. |
