國家衛生研究院 NHRI:Item 3990099045/11030
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    Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/11030


    Title: U-shaped association between serum uric acid levels with cardiovascular and all-cause mortality in the elderly: The role of malnourishment
    Authors: Tseng, WC;Chen, YT;Ou, SM;Shih, CJ;Tarng, DC;Yang, CY;Lin, YP;Chuang, YF;Chen, LK;Wang, KY;Chen, YH;Tsai, MT;Lin, YS;Hung, SC;Kuo, KL;Hung, TP;Hu, FH;Chen, NJ;Chen, YC;Lin, CH;Tsai, TH;Hsieh, SL;Wei, YH;Hsu, CC;Liu, JS;Chang, YK;Chiang, MH
    Contributors: Institute of Population Health Sciences
    Abstract: Background--The link between elevated serum uric acid (SUA) levels and cardiovascular disease (CVD)-related mortality in the elderly population remains inconclusive. Nutritional status influences both SUA and CVD outcomes. Therefore, we investigated whether SUA-predicted mortality and the effect-modifying roles of malnourishment in older people. Methods and Results--A longitudinal Taiwanese cohort including 127 771 adults 65 years and older participating in the Taipei City Elderly Health Examination Program from 2001 to 2010 were stratified by 1-mg/dL increment of SUA. Low SUA (<4 mg/dL) strata was categorized by malnourishment status defined as Geriatric Nutritional Risk Index < 98, serum albumin < 38 g/L, or body mass index < 22 kg/m2. Study outcomes were all-cause and CVD-related mortality. Cox models were used to estimate hazard ratios (HRs) of mortality, after adjusting for 20 demographic and comorbid covariates. Over a median follow-up of 5.8 years, there were 16 439 all-cause and 3877 CVD-related deaths. Compared with the reference SUA strata of 4 to < 5 mg/dL, all-cause mortality was significantly higher at SUA < 4 mg/dL (HR, 1.16; 95% confidence interval, 1.07-1.25) and ≥8 mg/dL (HR, 1.13; confidence interval, 1.06-1.21), with progressively elevated risks at both extremes. Similarly, increasingly higher CVD-related mortality was found at the SUA level < 4 mg/dL (HR, 1.19; confidence interval, 1.00-1.40) and ≥7 mg/dL (HR, 1.17; confidence interval, 1.04-1.32). Remarkably, among the low SUA (< 4 mg/dL) strata, only malnourished participants had greater all-cause and CVD-related mortality. This modifying effect of malnourishment remained consistent across subgroups. Conclusions--SUA ≥ 8 or < 4 mg/dL independently predicts higher all-cause and CVD-related mortality in the elderly, particularly in those with malnourishment.
    Date: 2018-02
    Relation: Journal of the American Heart Association. 2018 Feb;7(4):Article number e007523.
    Link to: http://dx.doi.org/10.1161/JAHA.117.007523
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=2047-9980&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000426644000032
    Cited Times(Scopus): http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85042151633
    Appears in Collections:[Chih-Cheng Hsu] Periodical Articles

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