中国儿童青少年代谢综合征定义和防治建议

  目的  了解天津市学龄前儿童血尿酸（SUA）水平，分析其升高的影响因素，探求SUA与体质指数（BMI）、血糖（FPG）、血脂的关系。  方法  采用随机抽样方法，于2015年3 — 6月在天津市市区26所幼儿园对4 073名3～6岁儿童进行健康体检，收集基本信息，测量身高、体重，检测空腹SUA、FPG、总胆固醇（TC）和甘油三酯（TG），分析SUA水平与肥胖、FPG、血脂的关系。  结果  SUA平均水平为（243.02 ± 53.25）μmol/L，其中SUA > 310 μmol/L占10.14 %；男童SUA水平为（247.26 ± 53.68）μmol/L，高于女童的（238.33 ± 52.37）μmol/L（P < 0.001）。肥胖组和超重组儿童SUA、FPG、TG水平均高于正常体重组，差异均有统计学意义（均P < 0.05）。全人群线性回归分析结果显示，在调整了年龄和性别后，SUA与BMI和TG均呈正相关（均P < 0.05），BMI每增加1 kg/m²，SUA增加4.092 μmol/L。亚组线性回归结果显示，只有在肥胖组儿童中，SUA与FPG和TG均呈正相关（均P < 0.05），FPG和TG每升高1 mmol/L，SUA分别增加15.932和13.809 μmol/L。  结论  天津市区3～6岁学龄前儿童群体中SUA异常率较高，且SUA水平与BMI、FPG和TG密切相关；尤其是肥胖儿童，SUA水平与FPG、TG水平的关联更强。

Prevalence of gout and hyperuricemia in the US general population:the National Health and Nutrition Examination Survey 2007-2008

  Objective  To explore serum uric acid (SUA) level, its potential influencing factors, and its association with body mass index (BMI), serum glucose and lipids among preschool children in Tianjin city.  Methods  A total of 4 073 children aged 3 – 6 years were selected from 26 kindergartens in urban Tianjin, China with cluster sampling for a cross-sectional survey from March to June 2015. Height, weight, fasting plasma glucose (FPG), total cholesterol (TC), triglycerides (TG), and SUA were measured.  Results  The mean SUA level was 243.02 μmol/L (standard deviation [SD]:53.25 μmol/L) for all the children and the proportion of the children with the SUA of higher than 310 μmol/L was 10.14 % . The mean SUA was significantly higher among the small boys than among the small girls (247.26 μmol/L [SD:53.68 μmol/L]vs. 238.33 μmol/L[SD:52.37 μmol/L]) (P < 0.001). The mean SUA, FPG, and TG were significantly higher among the overweight or obese children than among those with normal body weight (P < 0.05 for all). The results of linear regression showed that the SUA was significantly associated positively with BMI and TG after adjusting for age and gender (both P < 0.05), with an increased BMI of 1 kg/m² for the increased SUA of 4.092 μmol/L. The linear regression analyses on data of subgroups revealed significantly positive associations of SUA with FPG and TG only among obese children (both P < 0.05), with the increased FPG of 15.932 μmol/L and TG of 13.809 μmol/L for one mmol/L increment of SUA.  Conclusion  The prevalence of hyperuricemia among urban Tianjin children aged 3 – 6 years was relatively high. BMI, FG, and TG levels are associated with higher SUA levels among the children, especially in the obese children.