Txo lub raum ua haujlwm tuaj yeem piav qhia qhov muaj ntau dua ntawm Hyperuricemia hauv cov neeg laus

Txoj kev tshawb no tsom los tshawb xyuas qhov kev koom tes ntawmlub raumkev ua haujlwm tsis zootxhawm rau txhim kho hyperuricemia hauv cov neeg laus. Ib pawg ntawm 13,288 tus neeg Suav hnub nyoog nruab nrab ntawm 40 thiab 95 xyoo tau raug xaiv txij lub Ib Hlis Ntuj txog Lub Tsib Hlis 2019. Serum uric acid concentration thiab kwv yees glomerular fltration rate [eGFR] raug ntsuas. Kev sib koom ua ke ntawm hnub nyoog lossis eGFR thiab cov ntshav uric acid lossis hyperuricemia tau txheeb xyuas siv cov kab los yog binary logistic regression hloov kho rau cov xwm txheej txaus ntshai. Uric acid concentration thiab prevalence ntawm hyperuricemia yog ntau dua nyob rau hauv cov neeg laus. Kev kho kom txo qislub raummuaj nuj nqi(eGFR< 60="" ml/min/1.73="" m2)="" eliminated="" the="" associations="" between="" older="" age="" and="" higher="" uric="" acid="" concentration="" and="" between="" older="" age="" and="" higher="" prevalence="" of="" hyperuricemia="" diagnosis,="" whereas="" adjustment="" for="" other="" risk="" factors="" did="" not="" change="" those="" associations.="" lower="" egfr="" was="" associated="" with="" higher="" uric="" acid="" concentration="" both="" before="" (β="−" 0.296,="">< 0.001)="" and="" after="" adjustment="" for="" age="" (β="−" 0.313,="">< 0.001).="" reduced="">lub raummuaj nuj nqitau txuam nrog kev kuaj mob hyperuricemia ob qho tib si ua ntej (qhov sib txawv, OR, 3.64; 95 feem pua ​​​​CI 3.10–4.28; P< 0.001)="" and="" after="" adjustment="" for="" age="" (adjusted="" or,="" 3.82;="" 95%="" ci="" 3.22="" 4.54;="">< 0.001).="" mean="" serum="" uric="" acid="" and="" prevalence="" of="" hyperuricemia="" were="" higher="" in="" people="" with="">< 60="" ml/min/1.73="" m2="" than="" those="" with="" egfr≥="" 60="" ml/="" min/1.73="" m2.="" the="" prevalence="" of="" reduced="">lub raummuaj nuj nqince nrog lub hnub nyoog laus (P< 0.001).="" this="" study="" suggests="" that="" reduced="">lub raummuaj nuj nqituaj yeem piav qhia txog qhov nce qib uric acid thiab kev kuaj mob hyperuricemia hauv cov neeg laus.

Cistanche yog tshuaj ntsuab zoo tshaj plaws rau lub raum ua haujlwm

Feem ntau ntawm cov kws tshawb fawb txog kev kho mob thaum ub nyob rau ntau thaj tsam paub txog Cistanche los ntawm kev paub. Txhawm rau kom nkag siab zoo dua cov txiaj ntsig ntawm Cistanche, cov kws tshawb fawb niaj hnub no kuj tau ua ntau qhov tob thiab ntau qhov kev tshawb fawb thiab kev sim ntawm Cistanche. Tom qab xyoo ntawm kev tshawb fawb, cov kws tshawb fawb tau tshawb pom tias cov khoom xyaw tseem ceeb tshaj plaws hauv Cistanche yog:Echinacoside, Verbascoside, thiabFlavonoid. Nyob rau tib lub sijhawm, cov kws tshawb fawb tau tshawb nrhiav kev siv ethanol los rho tawm cov ntsiab lus ntawm Cistanche thiab tsim cov Cistanche extracts nrog cov ntsiab lus siab dua ntawm cov khoom xyaw nquag.Cov kws tshawb fawb faib Cistanche rau peb hom tseem ceeb:CistancheTubulosa, CistanchedeserticolathiabCistancheSalsa. Txawm li cas los xij, tsuas yog Cistanche Tubulosa muaj cov ntsiab lus siab tshaj plaws ntawm peb cov khoom xyaw nquag saum toj no. Dab tsi nthuav yog tias cov khoom xyaw no muaj cov nyhuv antioxidant, txo cov cell apoptosis thiab txhawb kev loj hlob ntawm tes.

Cistanche tuaj yeem txhawb kev loj hlob ntawm cov qog adrenal thiab txo qis adrenal cell apoptosis.Cistanchekuj txhawbtestosteronezais cia. Cov no yog vim li cas Cistanche yog qhov zoo tshaj plaws adrenal-boosting tshuaj ntsuab.

Nyem rau cov txiaj ntsig ntawm cistanche thiab bioflavonoids ntsiav tshuaj rau lub raum ua haujlwm

Uric acid yog qhov khoom kawg ntawm kev ua kom cov metabolism hauv purine compounds 1. Nws cov concentration hauv cov ntshav yog qhov sib npaug ntawm nws cov khoom, uas yog catalyzed los ntawm xanthine oxidase2, thiab excretion feem ntau ntawm cov zis 3. High circulating uric acid (hyperuricemia) tau tshaj tawm tias muaj feem xyuam nrog ntau yam teeb meem kev noj qab haus huv xws li kub siab 4,5, metabolic syndrome6, kab mob coronary artery7, stroke8 thiab preeclampsia9, thiabraumkab mob10-12 uas tej zaum yuav txuam nrog pro-inflammatory nyhuv ntawm uric acid13.

Ntau yam tuaj yeem cuam tshuam rau qib uric acid hauv cov ntshav. Piv txwv li,lub raumkev ua haujlwm tsis zootuaj yeem cuam tshuam qhov kev tso tawm ntawm uric acid thiab yog li tuaj yeem nce qib uric acid hauv cov ntshav ua rau hyperuricemia14. Kev noj zaub mov thiab kev coj tus cwj pwm suav nrog kev noj nqaij ntau dua, haus dej haus, haus luam yeeb, tsaug zog tsawg, thiab kev ua neej nyob tsis muaj zog tuaj yeem nce qib uric acid qib 14-18. Tsis tas li ntawd, txiv neej poj niam txiv neej, siab BMI, siab dua tag nrho cov roj cholesterol, siab dua triglyceride, ntshav siab, thiab ntshav qab zib yog qhov muaj feem cuam tshuam rau hyperuricemia14-17.

Nws tau raug tshaj tawm tias cov ntshav uric acid thiab qhov tshwm sim ntawm hyperuricemia nce hauv cov neeg Suav hnub nyoog 19,20. Cov kev tshawb pom zoo sib xws kuj tau tshaj tawm hauv cov neeg los ntawm lwm lub tebchaws xws li Austria21 thiab United States22. Txawm li cas los xij, vim li cas hauv qab cov kev soj ntsuam no tsis paub 23. Txoj kev tshawb no tsom los tshawb xyuas qhov kev koom tes ntawmlub raumkev ua haujlwm tsis zookom siab dua uric acid thiab txhim kho hyperuricemia prevalence nyob rau hauv cov neeg laus siv ib tug loj Suav pawg (N=13,288). Peb pom zoo tias cov hnub nyoog laus yog txuam nrog ob qho tib si uric acid ntau dua thiab ntau dua ntawm hyperuricemia thiab qhov kev hloov kho rau lub raum ua haujlwm txo qis yuav tshem tawm cov kev koom tes zoo.

Cov txiaj ntsig

Cov yam ntxwv ntawm pawg. Tag nrho ntawm 13,288 tus neeg koom nrog 7782 tus txiv neej thiab 5506 tus poj niam hnub nyoog 40-95 xyoo tau suav nrog (Table 1). Ntawm cov neeg koom no, 13.9 feem pua ​​​​yog hyperuricemic thiab 5.5 feem pua ​​​​tau txo lub raum ua haujlwm (eGFR<60 ml/min/1.73="" m2="" ).="" no="" participants="" were="" on="" uric="" acid="" lowering="" or="" dialysis="">

Uric acid concentration thiab prevalence ntawm hyperuricemia yog ntau dua rau cov neeg laus. Cov hnub nyoog laus tau cuam tshuam nrog cov ntshav uric acid ntau dua (=0.026, P=0.003, Table 2) thiab ntau dua ntawm kev kuaj mob hyperuricemia (OR, 1.007; 95 feem pua ​​​​CI 1.002–1.011; P<0.005, table="" 3).="" a="" 10-year="" increase="" in="" age="" +of="" participants="" was="" associated="" with="" a="" mean="" increase="" in="" uric="" acid="" of="" 0.03="" mg/dl="" and="" with="" a="" 7%="" increased="" risk="" of="" hyperuricemia.="" mean="" serum="" uric="" acid="" increased="" from="" 5.28="" mg/dl="" in="" 40–49="" years="" of="" age="" to="" 5.47="" mg/dl="" in="" the="" 80–95="" years="" age="" group="" (fig.="" 1a)="" and="" the="" prevalence="" of="" hyperuricemia="" increased="" from="" 13.5%="" in="" the="" 40–49="" years="" of="" age="" group="" to="" 18.6%="" in="" the="" 80–95="" years="" age="" group="" (fig.="">

Cov nyhuv ntawm lub raum ua haujlwm ntawm kev sib koom ua ke ntawm hnub nyoog nrog uric acid concentration thiab hyperuricemia. Tom qab kho kom txo lub raum ua haujlwm, lub hnub nyoog laus tsis cuam tshuam nrog cov ntshav uric acid ntau dua; es nws tau txuam nrog qis qis hauv cov ntshav uric acid ( {{0}}}-0.018, P=0.048, Table 2). Lub ntsiab lus uric acid hauv cov neeg uas tsis muaj lub raum ua haujlwm txo qis los ntawm 5.26 mg / dL hauv pawg hnub nyoog 40–49 xyoo mus rau 5.11 mg / dL hauv pawg hnub nyoog 80–95 xyoo (Fig. 1a). Kev hloov kho rau lwm yam kev pheej hmoo rau hyperuricemia tsis hloov pauv kev sib raug zoo ntawm cov hnub nyoog laus thiab cov ntshav uric acid ntau dua (Table 2). Tsis tas li ntawd, tom qab kho qhov txo qis hauv lub raum ua haujlwm, cov hnub nyoog laus dua tsis cuam tshuam nrog kev pheej hmoo siab rau hyperuricemia (P=0.114, Table 3). Tom qab tshem tawm ntawm lub raum tsis ua haujlwm, qhov tshwm sim ntawm hyperuricemia tsis nce ntxiv nrog cov hnub nyoog laus dua (Fig. 1b). Kev hloov kho rau lwm yam kev pheej hmoo rau hyperuricemia tsis hloov pauv kev sib raug zoo ntawm cov hnub nyoog laus thiab kev txhim kho ntawm kev kuaj mob hyperuricemia (Table 3). Cov txiaj ntsig no qhia tias txo qis rau lub raum ua haujlwm piav qhia txog kev nce ntshav hauv cov ntshav uric acid thiab qhov tshwm sim ntawm hyperuricemia hauv cov neeg laus.

Txo lub raum ua haujlwm yog txuam nrog ntau dua uric acid concentration thiab siab dua hyperuricemia kuaj tsis muaj hnub nyoog. eGFR tau cuam tshuam tsis zoo nrog uric acid concentration thoob plaws txhua tus neeg koom ( {{0}}}−0.296, P<0.001). a="" 10="" ml/min/1.73="" m2="" decrease="" in="" egfr="" of="" participants="" was="" associated="" with="" a="" mean="" increase="" of="" 0.28="" mg/dl="" in="" uric="" acid.="" the="" association="" was="" independent="" of="" age="" alone="" (β="−0.313,"><0.001) or="" age="" together="" with="" other="" risk="" factors="" for="" hyperuricemia="" including="" sex,="" fasting="" glucose,="" hypertension,="" body="" mass="" index,="" total="" cholesterol,="" and="" triglycerides="" (β="−0.243,"><0.001). consistently,="" people="" with="" reduced="" renal="" function="" had="" higher="" serum="" uric="" acid="" compared="" to="" those="" with="" preserved="" renal="" function="" (median="" [interquaricle="" range],="" 6.15="" [5.15–7.14]="" mg/dl="" versus="" 5.17="" [4.32–6.12]="" mg/dl,=""><>

Thaum eGFR raug kho raws li qhov sib txawv tsis tu ncua, eGFR siab dua tau cuam tshuam nrog kev pheej hmoo qis rau kev kuaj mob hyperuricemia (OR, {{0}}}.956; 95 feem pua ​​​​CI 0.952–0.959; P<0.001), such="" that="" a="" 10="" ml/min/1.73="" m2="" increase="" in="" egfr="" was="" associated="" with="" a="" 44%="" decreased="" risk="" of="" hyperuricemia.="" the="" association="" between="" higher="" egfr="" and="" lower="" prevalence="" of="" hyperuricemia="" diagnosis="" remained="" after="" adjusting="" for="" age="" alone="" (or,="" 0.987;="" 95%="" ci="" 0.982–0.992;=""><0.001) or="" age="" together="" with="" other="" risk="" factors="" for="" hyperuricemia="" including="" sex,="" fasting="" glucose,="" hypertension,="" body="" mass="" index,="" total="" cholesterol,="" and="" triglycerides="" (or,="" 0.955;="" 95%="" ci="" 0.950–0.959;=""><0.001). when="" egfr="" was="" treated="" as="" a="" categorical="" variable="">< 60="" or="" ≥="" 60="" ml/min/1.73="" m2="" ),="" reduced="" renal="" function="">< 60="" ml/min/1.73="" m2="" )="" was="" associated="" with="" higher="" prevalence="" of="" hyperuricemia="" diagnosis="" (or,="" 3.64;="" 95%="" ci="" 3.10–4.28;="" p="" <="">

Lub koom haum tseem nyob tom qab hloov kho rau lub hnub nyoog ib leeg (LOSSIS, 3.82; 95 feem pua ​​​​CI 3.22–4.54; P < 0.001) lossis hnub nyoog ua ke nrog lwm yam kev pheej hmoo rau hyperuricemia suav nrog kev sib deev, yoo mov qabzib, kub siab, lub cev qhov hnyav. , tag nrho cov roj cholesterol, thiab triglycerides (OR, 3.37; 95% CI 2.82–4.04; P<0.001), meaning="" that="" reduced="" renal="" function="" increased="" the="" prevalence="" of="" hyperuricemia="" diagnosis="" independent="" of="" age.="" further="" sub-analysis="" was="" conducted="" in="" which="" egfr="" was="" divided="" into="" three="" categories,=""><60 and≥30,="" and="" <="" 30="" ml/min/1.73="" m2.="" compared="" to="" people="" with="" an="" egfr="" ≥="" 60="" ml/min/1.73="" m2="" ,="" people="" with="" an="" egfr="" between="" 30="" to="" 60="" ml/min/1.73="" m2="" had="" an="" increased="" risk="" of="" hyperuricemia="" (or,="" 3.57;="" 95%="" ci="" 3.03–4.21;=""><0.001), and="" people="" with="" an="">< 30="" ml/min/1.73="" m2="" had="" a="" much="" higher="" risk="" of="" hyperuricemia="" (or,="" 7.74;="" 95%="" ci="" 2.98–20.09;="" p="" <="">

Cov koom haum tseem nyob tom qab hloov kho rau hnub nyoog, poj niam txiv neej, yoo mov qabzib, kub siab, lub cev qhov hnyav, tag nrho cov cholesterol, thiab triglycerides. Kev soj ntsuam ntawm poj niam txiv neej raws li kev txheeb xyuas tau pom tias eGFR (raws li qhov sib txawv tsis tu ncua) tau cuam tshuam tsis zoo nrog uric acid concentration hauv cov txiv neej thiab poj niam ua ntej ( =−0.285, P<0.001 for="" men;="" β="−0.308,"><0.001 for="" women)="" and="" after="" adjustment="" for="" age,="" fasting="" glucose,="" hypertension,="" body="" mass="" index,="" total="" cholesterol,="" and="" triglycerides="" (β="−0.283,"><0.001 for="" men;="" β="−0.271,"><0.001 for="" women).="" reduced="" renal="" function=""><60 ml/min/1.73="" m2="" )="" increased="" both="" serum="" uric="" acid="" and="" the="" prevalence="" of="" hyperuricemia="" in="" both="" men="" and="" women="" (fig.="" 2).="" binary="" logistic="" regression="" analysis="" confirmed="" that="" reduced="" renal="" function="" was="" associated="" with="" a="" higher="" prevalence="" of="" hyperuricemia="" diagnosis="" in="" both="" men="" and="" women="" before="" (men:="" or,="" 3.02;="" 95%="" ci="" 2.47–3.68;=""><0.001. women:="" or,="" 5.46;="" 95%="" ci="" 4.12–7.28;=""><0.001) and="" after="" adjustment="" for="" age,="" fasting="" glucose,="" hypertension,="" body="" mass="" index,="" total="" cholesterol,="" and="" triglycerides="" (men:="" adjusted="" or,="" 3.49;="" 95%="" ci="" 2.81–4.35;="" p=""><0.001. women:="" adjusted="" or,="" 2.84;="" 95%="" ci="" 2.06–3.92;=""><>

Feem ntau ntawm kev txo lub raum ua haujlwm nce nrog cov hnub nyoog laus. Feem ntau ntawm kev txo lub raum ua haujlwm tau nce nrog lub hnub nyoog hauv tag nrho pawg neeg thiab hauv txhua tus poj niam txiv neej (Table 4).

Kev sib tham

Txoj kev tshawb no qhia tau hais tias cov qib ntshav uric acid thiab qhov tshwm sim ntawm hyperuricemia yog txuam nrog cov hnub nyoog laus thiab cov koom haum zoo no ploj mus tom qab kev kho kom txo qis lub raum ua haujlwm, tab sis tsis yog rau lwm yam kev pheej hmoo rau hyperuricemia. Cov txiaj ntsig no qhia tias txo qis rau lub raum ua haujlwm piav qhia txog qib uric acid ntau dua thiab txhim kho qhov kev kuaj mob hyperuricemia hauv cov neeg laus. Lub raum tsis ua haujlwm tuaj yeem ua rau tsis zoo rau kev tso tawm ntawm uric acid thiab nce nws cov qib ntshav ua rau hyperuricemia14. Txoj kev tshawb fawb tam sim no pom tias qis dua eGFR cuam tshuam nrog cov ntshav uric acid ntau dua thiab ntau dua kev kuaj mob hyperuricemia, tsis muaj hnub nyoog thiab lwm yam kev pheej hmoo. Raws li cov ntaub ntawv tshaj tawm 24, txoj kev tshawb no pom tias feem pua ​​​​ntawm cov neeg muaj lub raum tsis ua haujlwm tau nce ntxiv thaum muaj hnub nyoog. Yog li, kev nce ntxiv ntawm kev txo lub raum ua haujlwm zoo nkaus li yog lub hauv paus txheej txheem ntawm kev nce ntxiv ntawm hyperuricemia hauv cov neeg laus. Feem ntau nws tau xav tias qhov nce hauv uric acid yuav ua rau muaj kev cuam tshuam ntawm lub raum ua haujlwm tsis zoo.

Txawm li cas los xij, cov pov thawj tsis ntev los no tau qhia tias kev kho mob uric acid-txo qis tsis ua rau lub raum tsis ua haujlwm qeeb hauv cov neeg mob uas muaj uric acid.mob ntevraumkab mob25 lossis nrog hom 1 mob ntshav qab zib hom 26, thiab nws tsis tsim txiaj ntsig rauraumua tsis tiav27, qhia tias hyperuricemia tsis yog ua raumob ntevraumkab mob. Hloov chaw, cov ntawv ceeb toom no thiab peb txoj kev tshawb fawb qhia tias kev nce qib ntawmmob ntevraumkab mobyog qhov ua rau nce hauv circulating uric acid. Txoj kev tshawb no qhia tau hais tias circulating uric acid theem nyob rau hauv cov neeg uas muaj lub raum kev ua hauj lwm tau pom ib tug poj niam-dependent qauv: ib tug maj mam txo nyob rau hauv lub sij hawm ntawm cov txiv neej hnub nyoog tshaj 40 xyoo piv rau ib tug nce ntawm cov poj niam thaum lub sij hawm hloov ntawm 40-49 xyoo mus rau 50-59 xyoo. . Lub hauv paus mechanism tsis paub. Kev hloov pauv ntawm cov tshuaj hormones poj niam txiv neej nyob rau lub sijhawm yuav ua rau muaj tus qauv ntawm poj niam txiv neej. Estradiol tuaj yeem inhibit xanthine oxidase28, enzyme tseem ceeb hauv txoj kev tsim cov uric acid; thaum testosterone tuaj yeem txhawb nqa enzyme29. Uric acid inhibitory estradiol txo qis hauv cov poj niam thaum cev xeeb tub thiab uric acid-stimulatory testosterone hauv cov txiv neej txo qis tom qab 40 xyoo 30.

Cov qauv ntawm kev hloov pauv ntawm cov tshuaj hormones poj niam txiv neej zoo li tsom iav cov qauv ntawm kev hloov pauv hauv uric acid pom hauv peb txoj kev tshawb fawb. Txawm li cas los xij, seb qhov kev piav qhia no puas muaj tseeb yuav tsum tau tshawb xyuas yav tom ntej. Lub zog ntawm txoj kev tshawb no yog cov qauv loj loj uas suav nrog cov kev kawm txuas ntxiv mus rau ntau xyoo ntawm cov neeg laus uas tau tso cai rau kev soj ntsuam ntawm qhov cuam tshuam ntawm lub raum ua haujlwm tsis zoo ntawm kev sib koom ntawm cov hnub nyoog laus thiab hyperuricemia. Txoj kev tshawb no muaj ntau yam kev txwv. Ua ntej, peb tsis tau tshawb xyuas txog kev noj zaub mov lossis kev coj tus cwj pwm xws li kev noj nqaij ntau dua, haus dej haus cawv, haus cawv ntau dua, haus luam yeeb, tsaug zog tsawg, thiab kev ua neej nyob sedentary 14-18 uas tuaj yeem nce qib uric acid ntawm cov neeg koom nrog. Qhov thib ob, cov txiaj ntsig ntawm txoj kev tshawb no cuam tshuam rau cov neeg nyob hauv sab hnub tuaj thiab nruab nrab Asia, thiab cov kev tshawb fawb yav tom ntej yuav qhia meej seb peb cov txiaj ntsig siv rau cov neeg ntawm lwm haiv neeg, xws li Caucasians. Hauv kev xaus, qhov kev tshawb fawb no pom tau tias ntau dua ntawm kev txo lub raum ua haujlwm zoo li yuav muaj feem cuam tshuam rau kev nce hauv cov ntshav uric acid hauv cov neeg laus.

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