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The association and interaction analysis of hypertension and uric acid on cardiovascular autonomic neuropathy

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Abstract

Background

The purpose of this study was to evaluate associations among hypertension (HTN) and uric acid (UA) with cardiovascular autonomic neuropathy (CAN), and to estimate the extent to which synergistic effects of HTN and UA affect the outcome in a Chinese population.

Method

We conducted a large-scale, population-based study to analyze the association and interaction of the two factors for CAN in a sample of 2092 Chinese people. Univariate and multiple linear regression (MLR) analysis were employed to detect these relationships. Interaction on an additive scale can be calculated by using the relative excess risk due to interaction (RERI), the proportion attributable to interaction (AP), and the synergy index (S).

Result

After adjusting for confounding factors, MLR showed that HTN was independently associated with CAN (P < 0.001). A significant interaction effect of UA and HTN on CAN was detected (P = 0.035; RETI = 1.483, 95 % CI 0.415–2.551; AP = 0.360, 95 % CI −0.043 to 0.76 and S = 1.908, 95 % CI 0.152–3.66).

Conclusion

Our findings suggest that HTN is independently and significantly associated with CAN and offer evidence to support the hypothesis that HTN and UA have interaction effects to influence the progression of CAN.

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Abbreviations

ACEI:

Angiotensin-converting enzyme inhibitor

Alb/Cr:

Albumin/urinary creatinine ratio

AP:

Proportion attributable to interaction

BMI:

Body mass index

CAN:

Cardiovascular autonomic neuropathy

Ccr:

Creatinine clearance rate

CKD:

Chronic kidney disease

CI:

Confidence intervals

Cr:

Creatinine

DBP:

Diastolic blood pressure

DM:

Diabetes

FPG:

Fasting plasma glucose

GFR:

Glomerular filtration rate

HbAlc:

Glycosylated hemoglobin

HDL:

High-density lipoprotein cholesterol

HOMA-IR:

Homeostasis model assessment insulin resistance estimate

IDF:

International Diabetes Federation

LDL:

Low-density lipoprotein cholesterol

MetS:

Metabolic syndrome

MLR:

Multivariable logistic linear regression

OGTT:

Oral glucose tolerance test

OR:

Odds ratios

PBG:

Postprandial blood glucose

RERI:

Relative excess risk due to interaction

S :

Synergy index

SBP:

Systolic blood pressure

TC:

Serum total cholesterol

TG:

Triglyceride

WC:

Waist circumference

UA:

Uric acid

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Acknowledgments

This study was supported by the grant from China National Grant on Science and Technology (Grant Number 30570740). We thank the grant from China National Grant on Science and Technology to support the study.

Conflict of interest

All authors have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study formal consent is not required.

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Shanghai Tongji Hospital, Tongji University School of Medicine, Room 517, Building 2nd, 389 Xincun Road, Shanghai, 200063, China

    F. Zeng & Z.-H. Tang

  2. Department of Internal Medicine, Shanghai Anting Hospital, Jiading, Shanghai, China

    X.-P. Liao & H.-W. Zhu

Authors
  1. X.-P. Liao
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  2. H.-W. Zhu
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  3. F. Zeng
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  4. Z.-H. Tang
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Corresponding author

Correspondence to Z.-H. Tang.

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Liao, XP., Zhu, HW., Zeng, F. et al. The association and interaction analysis of hypertension and uric acid on cardiovascular autonomic neuropathy. J Endocrinol Invest 38, 1075–1082 (2015). https://doi.org/10.1007/s40618-015-0291-x

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  • DOI: https://doi.org/10.1007/s40618-015-0291-x

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