老年人高尿酸血症调查及影响因素分析

目的了解老年人(≥60岁)发生高尿酸血症的情况及其临床特点,并探讨出现老年高尿酸血症的相关因素。方法以2003年在我院进行查体的1500名老年人为研究对象,采用酶法在Bek-m anCx—9全自动生化分析仪上测定血尿酸,以血尿酸440μm ol/L为界限,比较分析高尿酸血症组与尿酸正常组的临床指标。对影响高尿酸水平的诸多因素进行Logistic多因素回归分析。结果血尿酸增高患者的比例为17.6%(264/1500)。尿酸增高组的男女比例为256∶8。随各年龄组年龄的增大,血尿酸增高患者的比例、血尿酸、尿素氮、肌酐及甘油三酯平均值均逐渐增高。与尿酸正常组相比,高尿酸血症组的脂肪肝、肥胖症及糖耐量异常的发生率明显增高(P均<0.05),代谢综合征、高血压、氮质血症或肾功能不全及痛风关节炎的发生率明显增高(P均<0.01),平均体重、体重指数、腰围、臀围及腰/臀比也明显增高(P均<0.01),血清胆固醇、尿素氮、肌酐和餐后2h血糖水平明显增高(前者P<0.05,后三者P均<0.01)。Logistic多因素回归分析显示,腰/臀比、体重指数、血清胆固醇和肌酐水平是影响血尿酸的主要相关因素。结论老年高尿酸血症与多种心血管或代谢性疾病相关,腰/臀比、体重指数、血清胆固醇和肌酐水平是影响老年人血尿酸升高的重要相关因素。

The investigation and multivariable statistical analysis of hyperuricemia in 1500 elderly people

Objective To explore the prevalence and clinical features of hyperuricemia in elderly people and to analyze the influencing factors of hyperuricemia in elderly people. Methods Serum uric acid (SUA) levels in 1500 elderly people were examined by the uricase-peroxidase enzymatic method .Clinical parameters of hyperuricemia group and normal SUA group were comparatively analyzed. Logistic regression was used to analyze the influencing factors of SUA in elderly people. Results In 264 out of 1500 (17.6%) the SUA level were increased. The ratio of male to female in the hyperuricemia group was 256:8. The proportion of the patients with increased SUA levels, mean level of SUA, serum urea nitrogen, serum creatinine and serum triglyceride were all increased with age. As compared with the normal SUA group, the hyperuricemia group were more prone to have adiposis hepatica (P<0.05),obesity(P<0.05),abnormal carbohydrate tolerance(P<0.05),metabolic syndrome(P<0.01),hypertension(P<0.01),azotemia or renal inadequacy(P<0.01)and gouty arthritis(P<0.01). The mean weight(P<0.01),body mass index(P<0.01),waistline(P<0.01) and waist-to-hip ratio(P<0.01) were significantly higher in the hyperuricemia group compared with normal SUA group. The serum cholesterol(P<0.05),urea nitrogen(P<0.01),creatinine(P<0.01)and 2 h postprandial blood sugar level(P<0.01) were also significantly higher in the hyperuricemia group. Logistic regression analysis revealed a significant association between SUA and waist-to-hip ratio,body mass index, serum cholesterol and serum creatinine level. Conclusion Hyperuricemia in elderly people is related to various cardiovascular or metabolic diseases. Waist-to-hip ratio, body mass index, serum cholesterol and serum creatinine are major related factors of hyperuricemia in elderly people.