文献詳細
特集 脳神経外科医が知っておくべき生活習慣病の最新治療
Ⅱ 主な生活習慣病の最新治療
文献概要
Point
・高尿酸血症は,痛風のみならず臓器障害を合併するために,尿酸代謝異常症という病態として捉える.
・脳疾患は尿酸値と臓器障害との関連から,痛風型,神経変性型,慢性腎臓病・心血管疾患型に分類される.
・高尿酸血症の治療は,病型分類に従って適切な尿酸降下薬を選択し,至適な血清尿酸値レベルにコントロールする.
・高尿酸血症は,痛風のみならず臓器障害を合併するために,尿酸代謝異常症という病態として捉える.
・脳疾患は尿酸値と臓器障害との関連から,痛風型,神経変性型,慢性腎臓病・心血管疾患型に分類される.
・高尿酸血症の治療は,病型分類に従って適切な尿酸降下薬を選択し,至適な血清尿酸値レベルにコントロールする.
参考文献
1)一般社団法人日本痛風・核酸代謝学会ガイドライン改訂委員会(編):高尿酸血症・痛風の治療ガイドライン第3版.診断と治療社,東京,2018
2)日本痛風・核酸代謝学会:腎性低尿酸血症診療ガイドライン.痛風と核酸代謝 42 suppl-1, 2018 https://doi.org/10.6032/gnam.42.suppl-1
3)久留一郎:かかりつけ医のための高尿酸血症・痛風診療 Q&A.診断と治療社,東京,2021
4)Nakayama A, et al:Dysuricemia. Biomedicines 11:3169, 2023 doi:10.3390/biomedicines11123169
5)Miake J, et al:Impact of hyper- and hypo-uricemia on kidney function. Biomedicines 11:1258, 2023 doi:10.3390/biomedicines11051258
6)西宮健介:冠動脈尿酸塩結晶に関する画像研究の最前線.痛風と尿酸・核酸 47:93-98, 2023
7)Feuchtner GM, et al:Monosodium urate crystal deposition in coronary artery plaque by 128-slice dual-energy computed tomography:an ex vivo phantom and in vivo study. J Comput Assist Tomogr 45:856-862, 2021
8)Cipolletta E, et al:Association between gout flare and subsequent cardiovascular events among patients with gout. JAMA 328:440-450, 2022
9)Strandberg TE, et al:Coronary artery disease:‘gout’ in the artery? Eur Heart J 42:2761-2764, 2021
10)Seifar F, et al:Uric acid in Parkinson's disease:what is the connection? Mov Disord 37:2173-2183, 2022
11)Boccardi V, et al:Uric acid and late-onset Alzheimer's disease:results from the ReGAl 2.0 project. Aging Clin Exp Res 33:361-366, 2021
12)Scheepers LEJM, et al:Urate and risk of Alzheimer's disease and vascular dementia:a population-based study. Alzheimers Dement 15:754-763, 2019
13)Wang L, et al:Low serum uric acid levels in patients with multiple sclerosis and neuromyelitis optica:an updated meta-analysis. Mult Scler Relat Disord 9:17-22, 2016
14)Kuwabara M, et al:Exploring the multifaceted nexus of uric acid and health:a review of recent studies on diverse diseases. Biomolecules 13:1519, 2023 doi:10.3390/biom13101519
15)Tomita M, et al:Increased levels of serum uric acid among ex-smokers. J Epidemiol 18:132-134, 2008
16)Mazza A, et al:Serum uric acid shows a J-shaped trend with coronary mortality in non-insulin-dependent diabetic elderly people. The CArdiovascular STudy in the ELderly(CASTEL). Acta Diabetol 44:99-105, 2007
17)Chaudhary NS, et al:Severity of hypertension mediates the association of hyperuricemia with stroke in the REGARDS case cohort study. Hypertension 75:246-256, 2020
18)Mentis AA, et al:Non-genetic risk and protective factors and biomarkers for neurological disorders:a meta-umbrella systematic review of umbrella reviews. BMC Med 19:6, 2021 doi:10.1186/s12916-020-01873-7
19)Seki H, et al:Relation of serum uric acid and cardiovascular events in young adults aged 20-49 years. Am J Cardiol 152:150-157, 2021
20)Chamorro A, et al:Safety and efficacy of uric acid in patients with acute stroke(URICO-ICTUS):a randomised, double-blind phase 2b/3 trial. Lancet Neurol 13:453-460, 2014
21)Seet RC, et al:Is uric acid protective or deleterious in acute ischemic stroke? A prospective cohort study. Atherosclerosis 209:215-219, 2010
22)Kuwabara M, et al:Asymptomatic hyperuricemia without comorbidities predicts cardiometabolic diseases:five-year Japanese cohort study. Hypertension 69:1036-1044, 2017
23)Sugihara S, et al:Depletion of uric acid due to SLC22A12(URAT1)loss-of-function mutation causes endothelial dysfunction in hypouricemia. Circ J 79:1125-1132, 2015
24)Kojima S, et al:Optimal uric acid levels by febuxostat treatment and cerebral, cardiorenovascular risks:post hoc analysis of a randomized controlled trial. Rheumatology(Oxford)61:2346-2359, 2022
掲載誌情報