대한신장학회

논문분류	춘계학술대회 초록집
제목	Sex-specific relationship of Serum Uric Acid with All-cause Mortality in Adults with Normal Kidney Function
저자	Eunjeong Kang* 1, Seung-Sik Hwang2, Dong Ki Kim1, Kook-Hwan Oh1, Kwon Wook Joo1, Yon Su Kim1, Hajeong Lee1
출판정보	2016; 2016(1):
키워드	all-cause mortality, normal kidney function, risk factor, serum uric acid, sex
초록	Background: Serum uric acid (SUA) levels are associated with cardiovascular mortality and other diseases such as hypertension, diabetes and chronic kidney disease. Although SUA possibly influence on all-cause mortality in individuals with normal kidney function, but studies are particularly lacking in normal kidney function. Methods: Participants aged over 40-years who underwent routine health check-ups at Seoul National University Hospital between 1995 and 2006 were recruited. Individuals with estimated glomerular filtrations rates <60 mL/min/1.73 m2 and who received lab study and colonoscopy on the same day were excluded. The association between SUA and all-cause mortality was evaluated using COX proportional hazard regression models with adjustment for various confounders. Results: The analysis conducted on 27,490 subjects. In general, SUA levels were higher in men than in women (5.7 ± 1.2 mg/dL for men and 4.2 ± 0.9 mg/dL for women). SUA levels had a tendency to decline as age increased in men, on the contrary in women. Total 1,402 deaths occurred during 12.3 ± 3.6 years of follow-up. The crude mortality rate was 6.9% (999 deaths of 14,468 participants) in men and 3.1% (403 deaths of 13,021 participants) in women. The crude mortality was U-shaped association with SUA in overall, J-shaped association in men, and ill-defined association in women. Interestingly, there was a significant interaction of sex for the SUA-mortality association (P for interaction = 0.049). Therefore, we examined survival analysis by sex and consequently found the different association between SUA and all-cause mortality by sex. In men, lower SUA group had higher mortality after adjustment (<4.0 mg/dL, HR 1.550, 95% CI 1.235-1.946, P < 0.001), compared with reference SUA group (6.1–8.0 mg/dL). Higher SUA tended to contribute mortality increase in men (>8.0 mg/dL, HR 1.305, 95% CI 0.904-1.884, P = 0.155) although insignificant. In contrast, women failed to show any significant association between SUA and mortality. Conclusion: This study provided a new evidence of different SUA-mortality association by sex. We demonstrated that lower as well as higher SUA was an independent risk factor for all-cause mortality in men with normal kidney function, not in women.
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