中老年汉族妇女中维生素Ｄ 不足与血清尿酸的关系

摘要：目的　探讨中国汉族妇女中维生素Ｄ 不足与血清尿酸升高的关系。方法　以苏州市金阊区１７２６名
３０岁以上女性常住居民为研究对象，将年龄＜５５ 岁定义为绝经前妇女，年龄≥５５ 岁定义为绝经后妇女，
对其进行血压、身高、体重和腰围的测量，生活习惯、疾病史等情况的调查，血、尿样本采集，２５ 羟基
维生素Ｄ、血糖、血脂、血尿酸的检测。运用ｌｏｇｉｓｔｉｃ回归模型分别在绝经前和绝经后妇女中分析维生素Ｄ
不足与尿酸升高的关系，犘＜０．０５表示差异有统计学意义。结果　在绝经后妇女中，尿酸升高者维生素Ｄ
水平明显低于尿酸正常者［中位数（四分位间距）：３５ （２８～５７）狏狊４０ （３２～５８）ｍｇ／Ｌ；Ｋｒｕｓｋａｌ Ｗａｌｌｉｓ
ｔｅｓｔχ
２＝７．５１２，犘＝０．００６］，维生素Ｄ 不足者中尿酸升高的比例显著高于维生素Ｄ 正常者（１６．５０％ 狏狊
８．０８％；χ
２＝１２．０８９，犘＜０．００１）。在绝经前妇女中，未发现维生素Ｄ 不足与尿酸升高的关联性。但是在
绝经后妇女中，与维生素Ｄ 正常者相比， 维生素Ｄ 不足者更容易发生尿酸升高（犗犚＝２．３８，９５％ 犆犐：
１．４７～３．８７），此外，排除糖尿病和／或高血压患者后，维生素Ｄ 不足与尿酸升高的关系仍有统计学意义
（犗犚＝ ２．４８，９５％犆犐：１．１４～５．２６）。结论　在中国汉族绝经后妇女中，维生素Ｄ不足与尿酸升高显著相关。
关键词：维生素Ｄ；尿酸；女性
中图分类号：Ｒ５８９　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１４）０４ ０３１４ ０６

Association of vitamin D deficiency with serum uric acid among middle-aged and elderly women of Han nationality

Objective To explore the relationship between vitamin D deficiency and serum uric acid among middle-aged and elderly Chinese women of han nationality. Methods 1 726female residents aged 30years and over from Jinchang district of Suzhou were randomly enrolled in the study.Blood pressure,height,weight and waist circumference were measured,and blood and urine samples were also collected to determine the level of25-hydroxy vitamin D,blood glucose,blood lipid and uric acid.Logistic regression model was applied to analyze the association of vitamin D deficiency and elevated serum uric acid among premenopausal and postmenopausal women. Results Among postmenopausal women,serum 25-hydroxy vitamin D level was significantly lower in subjects with elevated uric acid compared to those with normal uric acid（median interquartile range]：35 28-57]vs 40 32-58],μg/L;P=0.006）.More women with vitamin D deficiency had higher level of uric acid compared to those with sufficient vitamin D（16.50%vs 8.08%;P＆lt;0.001）.However,the above association was not identified among premenopausal women.However postmenopausal women with vitamin D deficiency were more likely to have elevated uric acid（OR,95%CI：2.38,1.47-3.87）.Moreover,after excluding individuals with diabetes and/or hypertension,the association was still significant（OR,95%CI：2.48,1.17-5.44）. Conclusions Vitamin D deficiency is closely associated with elevated uric acid among postmenopausal Chinese Han women.