Epidemiology of blood transfusion

BACKGROUND: Earlier investigations of the epidemiologic attributes of blood transfusion were not based on total community populations. To calculate incidence rates of the transfusion of blood and blood components in the general population and in age- and gender-specific groups, all residents of a United States county who received transfusion(s) from 1989 through 1992 were studied. STUDY DESIGN AND METHODS: The study was a prevalence survey (cross-sectional study) of a well-defined population at a specified time. RESULTS: There was no significant change in blood and blood component utilization from the beginning of 1989 through 1992. The incidence of red cell transfusion was 42.88 units per 1000 population per year in both men and women and varied from 12.08 units per 1000 population per year in those less than 41 years old to 245.24 units per 1000 population per year in the group aged more than 65. A random resident's probability of receiving transfusion(s) in any year was 0.89 percent (0.83% for men and 0.94% for women) and varied from 0.26 to 5.17 percent among the three age groups. The incidence of platelet and fresh-frozen plasma transfusion was 21.24 units per 1000 population per year and 8.64 units per 1000 population per year, respectively. CONCLUSION: Incidence rates of blood transfusion for "causal" planning of blood collections are presented here for the first time. The probability of receiving a transfusion of RBCs in any year rises by 20-fold from the rate in those less than 40 years old to that in those more than 65 years old, who receive 53.3 percent of the red cell units transfused.     

云南大理白族血清尿酸与代谢综合征及危险因素相关性研究

目的探讨云南大理白族血尿酸的分布特点与代谢综合征（MS）及其危险因素的相关性。方法对5 444例包括城市、农村、城乡结合部居住5年以上的大理白族人群进行问卷调查、体格检查和生化指标进行分析。结果①随着血尿酸水平升高,研究对象收缩压、舒张压、甘油三酯、低密度脂蛋白胆固醇、体质量指数、腰臀比逐渐上升,高密度脂蛋白胆固醇逐渐下降（P<0.01）;随着血尿酸的升高,空腹血糖、糖化血红蛋白男性差异无统计学意义（P>0.05）,女性呈逐渐升高趋势（P<0.01）;②高尿酸血症（HUA）及MS患病率男性高于女性;随着年龄增加,患病率逐渐升高（P<0.01）;农民、城镇居民、城乡结合部居民患病率逐渐升高（P<0.01）。吸烟史、饮酒史、代谢病家族史男性高于女性（P<0.01）;农民、城镇居民、城乡结合部居民所占比例逐渐升高（P<0.01）;随着年龄的增加,吸烟史所占比例逐渐下降,饮酒史呈中年增高趋势而代谢疾病家族史呈中年下降趋势（P<0.01）。③随着血尿酸升高,男女性MS患病率逐渐升高（P<0.01）。④MS患病与UA水平有关。在同一年龄组,随着UA水平的增加,MS患病风险呈增加趋势,特别是中、老年女性。结论云南大理白族HUA患病率高,血尿酸水平与MS有关,血尿酸升高是MS的独立危险因素。     

Biological factors affecting concentrations of serum LpAI lipoprotein particles in serum, and determination of reference limits

We used an electroimmunoassay to measure LpAI lipoprotein particles (lipoproteins containing apolipoprotein AI but not apolipoprotein AII) in serum of a presumably healthy population of about 1000 subjects, noting sex- and age-related variations for the age interval four to 70 years. Results were higher for women than men. For males, the value for the 50th percentile of the distribution was highest in the 10- to 14-year subgroup, 0.69 g/L, decreasing to 0.60 g/L in adults. For females, the values increased regularly, from 0.59 g/L at ages four to 10 years to 0.79 g/L after age 55 years. The influence of puberty, menopause, oral contraceptives, alcohol consumption, and morphometric characteristics was studied. Only being overweight by more than 20% statistically influenced LpAI values in men and in women. We used these results to select a reference population and to establish reference limits of LpAI at ages 25 to 35 years: 0.40-0.95 g/L for men and 0.46-1.05 g/L for women.     

Soluble transferrin receptor (sTfR): biological variations and reference limits.

The aim of this study was to establish soluble serum transferrin receptor (sTfR) reference limits. sTfR was measured in 885 healthy subjects from 3 to 91 years old (433 men, 409 women), without hematological abnormalities, using an immunonephelometric assay. The sTfR median concentrations in our population decreased gradually from the group aged 3-10 years to the group aged 21-40 years, then there were no changes in the older groups except for the females >60 years of age. The interindividual variability ranged from 12.6% to 30.3% among different age groups, and the analytical variability was 5%. Biological factors and other factors associated with sTfR concentration variation were examined and accounted for 35% of the sTfR variability in men aged 20 years or less, and 18% in those older than 20 years. Also, they accounted for 45% of the variability in women aged 20 years or less and 14% in those older than 20 years. The main factors statistically associated with sTfR concentration in males were ferritin, orosomucoid, hemoglobin, and tobacco in all age groups and only mean corpuscular volume (MCV) in males less than 20 years old. In the females the main factors were age, orosomucoid, and hemoglobin in all age groups, MCV and tobacco in females less than 20 years old, and ferritin and physical activity in females more than 20 years old. These factors were used to define the exclusion and partition criteria for obtaining the reference samples. Medians for reference values were: 1.60 mg/l in the 3-10-year old group (males and females); 1.42 mg/l in males between 11 and 20 years of age, and 1.33 mg/l in females of the same age. In the other age groups, the median of the reference values was 1.16 mg/l, except in females over 60 years old, for whom it was 1.26 mg/l.     

The Troms? Heart Study: distribution of, and determinants for, gamma-glutamyltransferase in a free-living population

Gamma-glutamyltransferase (GGT) was measured in 1579 men, aged 20-54 years, and 1654 women, aged 20-49 years, screened for coronary risk factors. The distribution was right-skewed with medians 15 and 10 U/l for men and women, respectively. Less than 3.8% of the men and 0.8% of the women had GGT greater than or equal to 50 U/l. The low level of GGT matched well with the low mortality of cirrhosis and the modest use of alcohol in Norway. Multiple regression analysis for each sex showed a strong positive association with body mass index, use of alcohol and, unexpectedly, a negative association with coffee consumption, whereas serum triglycerides and the time since the last meal showed a weaker positive association. In women, use of oral contraceptives was positively associated with GGT.     

中国正常成人步行时空参数分析

目的:探讨中国正常成人的步行特征,为临床步态分析提供科学参考依据。方法:365名正常受试者,按性别、年龄分为20—29岁组、30—39岁组、40—49岁组、50—59岁组、60—75岁组共10组。应用人体步态垫测量与分析系统,测试受试者自由行走时的步速、步长、步幅、步长时间、摆动时间、支撑时间、单足支撑时间、双足支撑时间等时空参数,并对每位受试者的身高、体重进行测试。结果:年龄组内平均步速,除30—39岁组、60—75岁组外,男性均大于女性(P<0.05),50岁以后,男、女步速均减慢,与50岁以前相比差异具有显著性(P<0.01);各年龄组步长,男性均大于女性(P<0.05),女性步长在50岁以后减小,与50岁以前相比差异具有显著性(P<0.01),男性步长在60岁以后减小,明显小于60岁以前步长(P<0.01)。结论:应用人体步态垫测量与分析系统,首次建立中国正常成人步行时空参数值参考范围,初步揭示中国正常成人的步行时空特征。     

邯郸市健康献血人群丙氨酸氨基转移酶参考值范围调查

目的 调查邯郸市健康献血人群丙氨酸氨基转移酶(ALT)的参考值范围.方法 采用速率法检测ALT值,对邯郸市2010-01-2010-02 10844名18～55周岁健康献血者的ALT检测结果进行统计学分析.结果 ALT水平为对数正态分布,本地区健康献血者95％参考值范围是小于51.7 U/L,其中男7512例,女3332例,几何均数分别为21.5 U/L、13.8 U/L,认为男女间有差异(P＜0.0001),男性高于女性,95％参考值范围分别为小于:57.1、34.3 U/L.各年龄分组中,18～岁人群的ALT值低于其他年龄组(每5岁一组,最后一组为48～55岁),各年龄组几何均数分别为:14.9、17.9、20.9、20.4、20.4、18.8、19.6 U/L,95％参考值范围分别小于:40.1、51.0、58.9、52.8、55.1、50.7、44.9 U/L.结论 该调查反映了邯郸地区健康献血人群的ALT平均水平,男性95％参考值范围高出国家规定≤40 U/L的标准,女性95％参考值范围低于国家规定≤40 U/L的标准;各年龄组的ALT值95％参考值范围均＞40 U/L,18～岁年龄组最低.供有关单位参考.     

安徽39 824例健康体检者高尿酸血症流行病学分析

目的 了解安徽城镇居民高尿酸血症流行现状。方法 选择安徽15城市的39824例健康体检者的血尿酸测定资料，在各年龄、性别间进行统计、分析。结果 39824例健康体检者的高尿酸血症患病率为8.77%，男、女性分别为11.06%和4.43%，血尿酸值在各年龄组男、女性间和女性各年龄组间差别明显，≤39岁和40～55岁年龄组的男性间及整体人群间比较无明显差别；在患病率比较中，除了男性三年龄组间、≥56岁组男女间(p=0.075)无明显差异外，其余各组间差异明显，均有统计学意义（p＜0.05）。 结论 高尿酸血症的发病率男性高于女性，男女间的差异随年龄增加而逐渐变小，男性发病率与年龄关系不明显。     

Some determinants of whole-gut transit time: a population-based study

Slow whole-gut transit time may be associated with an increasedrisk of gallstones, and possibly bowel cancer, but its determinantsare unknown. We looked for these determinants in a community-basedstudy of 884 women aged 25–69 years and 677 men aged 40–69years. Transit time was estimated using prospective examinationof three stools and a questionnaire about bowel habit. Dietand alcohol intake were assessed using a validated food frequencyquestionnaire. In women <50 years not taking oral contraceptives,mean transit time was relatively constant across 10-year agebands (62 to 63 h). In older women it was also relatively constant,but was significantly shorter (58 to 59 h), suggesting an effectof female sex hormones. In women taking oral contraceptives,mean transit-time was 6 h longer than in women of the same agenot taking them (95% Cl 1.4 to 10.6 h). In men drinking >40 g alcohol/day, mean transit time was 49 h compared with 54h in those drinking <20 g/day (p<0.0001). In alcohol-abstainingmen, an effect of dietary NSP (non-starch polysaccharide orfibre) intake was clearly apparent. Alcohol consumption quickenedtransit in both sexes; oral contraceptive usage slowed it inwomen. Body mass index in both sexes, soluble NSP in men, andinsoluble NSP in women also significantly and negatively affectedtransit time. The food groups which were related to transittime were potatoes and cooked fruit in men, and pulses and breadin women. Alcohol and sex hormones had a stronger associationwith transit time than did NSP in people eating an English diet.     

江苏省常州地区自然人群人体测量指标与血压、血脂关系的研究

目的调查常州地区自然人群的高血压和血脂紊乱的发病率,探讨并比较3种人体测量指标包括体重指数(BMI)、腰臀比(WHR)和体脂肪率(FAT%)及其与血压、血脂的关系。方法在常州市社区自然人群中采用临床横断面研究通过整群抽样抽取研究样本,采用格式化调查表收集人群信息,并检测血糖、血脂、血压、BMI、WHR、FAT%、尿酸、肝肾功能等指标。结果常州地区自然人群血脂紊乱、高血压、糖尿病的发病率分别为41.6%、28.2%和10.7%。调整年龄差异后男女的BMI、WHR和FAT%均有显著差异,其中男性的BMI、WHR高于女性,女性的FAT%显著高于男性。在自然人群中BMI和WHR在预测血脂紊乱和高血压的能力上没有显著差异,并都显著高于FAT%的预测能力,但在男女分层后无差别。3种人体测量指标的的独立影响因素包括SBP、HDL、LDL、UA。年龄是BMI和WHR的影响因素。结论常州地区自然人群高血压和血脂紊乱的发病率呈现高发趋势;BMI、WHR和FAT%不仅是肥胖的指标,对潜在的心血管疾病危险因素—血脂紊乱和高血压发生的危险性亦有预报作用。超重和肥胖的早期发现,指导人群改变生活习惯,控制BMI、WHR和FAT%的上升发展趋势的工作迫在眉睫。     

健康体检者血尿酸结果分析及对策

分析33 742例健康体检人群的血尿酸水平,指导健康教育。方法对33 742名健康体检者血尿酸浓度测定,分析比较各年龄段及男女性别间血尿酸水平及高尿酸血症检出率。结果血尿酸水平男性为（349±73）μmol/L,女性为（257±59）μmol/L。高尿酸血症检出率：男性15.5%,女性6.7%,男性明显高于女性（P〈0.01）。血尿酸水平峰值和高尿酸血症峰值男性在30~39岁组,女性峰值≥70岁组。结论该33 742名健康体检人群的高尿酸血症检出率11.7%,并高发于中年男性,应对健康人群进行高尿酸血症相关知识的普及,改变不良生活习惯,加强血尿酸监测,有效预防和减少高尿酸血症的患病率。     

西双版纳州健康人群血清丙氨酸氨基转移酶参考区间调查

目的建立西双版纳州健康人群血清丙氨酸氨基转移酶（ALT）丙酮酸氧化酶法参考区间。方法对3167名健康者血清ALT活性在不同性别、不同年龄组间的分布进行统计分析。结果ALT活性男性明显高于女性（P〈0.001）。ALT参考区间上限：男性为42 U/L,女性为37 U/L。男性血清ALT活性在30-59岁组较高（其中40-49岁组最高）,〈20岁组最低;ALT参考区间上限：〈20岁为34 U/L,20-29岁为46 U/L,30-59岁为47 U/L,≥60岁为39 U/L。女性≥40岁者血清ALT活性较高（其中50-59岁组最高）,≤29岁者较低;ALT参考区间上限：≤29岁为34 U/L,30-39岁为35 U/L,≥40岁为40 U/L。结论ALT活性在不同性别、不同年龄组间有明显差异,各实验室应按不同性别、不同年龄建立本地区、本实验室血清ALT参考区间。     

Comparative study of the effect of basic risk and nutritional factors on the development of ischemic heart disease in a population

Altogether 39 CHD new cases were detected in a representative random sample of 556 men aged 40-59 in the course of 5 yrs. The patients had a high AP, consumed more alcohol, were more well-fed, older and consumed more refined carbohydrates per 1 kg bw and less cholesterol and vegetable protein. A high density lipoprotein cholesterol level was lower. 50% of all CHD new cases originated from the upper sextile of distribution (17% of values). Risk of CHD development compared to the lower sextile increased 9.5-fold. In considering logistic function 46% of CHD new cases originated from the first four informative characteristics of the upper sextile. Risk of CHD development in the upper sextile was 6 times as high as in the lower sextile. An acute drop of the informative value of the set of 3 characteristics occurred after excluding from the analysis values of the consumption of carbohydrates per 1 kg bw, and differences between values of theoretically anticipated and empirical risk became statistically significant. The study showed the interrelationship of alimentary factors and risk factors in CHD development. A raised consumption of refined carbohydrates and alcohol consumption enhanced the effect of such risk factors as overweight, arterial hypertension and disorders of the blood lipid spectrum regarded as the main causes of CHD development in males aged 40-59.     

Clearance of triglycerides from the circulation and its relationship to serum lipoproteins: influence of age and sex

In this study of a randomly selected population from 20 to 70 years of age, the clearance of triglycerides from the blood was studied after i.v. injection of an artificial triglyceride emulsion Intralipid. In women, the triglyceride clearance from the blood decreases with increasing age, but for men there was no change with age. Women had faster fractional removal rates of i.v. injected triglycerides than men in all age-groups. The triglyceride clearance showed a negative correlation to Broca index (obesity), serum triglyceride, serum cholesterol, triglycerides in very low density lipoproteins, and to cholesterol in very low density lipoproteins and in low density lipoproteins, but showed a strong positive correlation to cholesterol in high density lipoproteins.     

The features of uric acid metabolism in women in climacterium

The purpose of the study was to establish the prevalence of uric acid (UA) metabolism disturbances as a possible risk factor of urate nephropathy in women of various age groups. The authors carried out a retrospective analysis of 757 case histories and performed uricemia and uricosuria screening in women aged 18 to 69 years. The study revealed significant age-dependent elevation of uricemia, with hyperuricemia (HUE) at the age of 60 to 69 years old. The study also found age-dependent increase of HUE rate with its significant elevation in postmenopausal women (older than 50 years), compared with HUE rate in reproductive age women (18 to 49 years old) -37.9% vs. 11.4%. For the first time the researchers established UA excretion level and found a significant tendency of uricosuria to decrease with age (p < 0.016 between the groups of 40 to 49 and 50 to 59 years old). The highest rate of hyperuricosuria was revealed in women of 40 to 49 years old (22.2%), while in women of 18 to 29 and 60 to 69 years old it was 10.1% to 12.1%. For the first time the authors established the rate of hypouricosuria in women, which culminated in women older than 50 (22% of cases). The increase of HUE rate, which is most prominent in postmenopausal women, is associated with the decrease in UA excretion, accompanied by the decrease of hyperuricosuria rate and increase of hypouricosuria rate. Taking into account high prevalence of UA metabolism disturbances in women older than 50, menopause may be considered a risk factor of HUE and urate nephropathy.     

天津大港地区3752例健康体检者血尿酸水平分析

目的：探讨大港地区人群血尿酸水平与年龄性别的相关性。方法对2014年9月1日到2015年9月1日天津市滨海新区大港医院3752名健康体检者的血尿酸水平进行普查。结果80岁以下各年龄段男性血尿酸水平显著高于女性（ P＜0．05）;男性19岁—29岁组血尿酸水平显著高于60岁—69岁组（ P＜0．05）;30岁—39岁组及40岁—49岁组血尿酸水平显著高于50岁—59岁组、60岁—69岁组及70岁—79岁组（ P＜0．05）;50岁—59岁组、60岁—69岁组及70岁—79岁组显著低于80岁—89岁组。差异均有显著性（ P＜0．05）。其余组间比较差异无显著性（ P＞0．05）。女性19岁—29岁组和30岁—39岁组显著高于40岁—49岁组（ P＜0．05）,却显著低于60岁—69岁组及70岁—79岁组（ P＜0．05）;40岁—49岁组显著低于50岁—59岁组、60岁—69岁组、70岁—79岁组及80岁—89岁组（ P＜0．05）;70岁—79岁组显著低于50岁—59岁组及60岁—69岁组（ P＜0．05）;其余组间比较差异无显著性（ P＞0．05）。60岁以下各年龄组男性高血尿酸比率均高于女性（ P＜0．05）;60岁以上各年龄组男性与女性高血尿酸比率无显著性差异（ P＞0．05）。女性70岁—89岁组显著高于其他5组（ P＜0．01）,其余各组两两比较差异无显著性（P＞0．05）。而男性不同年龄组 HUA患病率两两比较无显著性差异（P＞0．05）。结论天津大港地区人群血尿酸水平与年龄、性别及饮食习惯有关。     

四川省遂宁地区表观健康成年人群血浆FMN,FMN/TP比值及FMN/ALB比值参考区间的建立

目的 建立四川省遂宁地区表观健康成年人群血浆果糖胺(fructosamine,FMN)、果糖胺/总蛋白比值(fructosamine to total protein ratio,FMN/TP)及果糖胺/清蛋白比值(fructosamine to albumin ratio,FMN/ALB)的参考区间。方法 选取2017年1～12月遂宁市中心医院健康管理中心14 639例20～79岁的表观健康成年人作为研究对象,其中男性4 811例,女性9 828例,通过问卷调查、体格检查、超声及实验室检查排除呼吸系统、血液系统、内分泌系统、炎症和肿瘤等疾病,检测其血浆FMN、总蛋白(total protein,TP)和清蛋白(albumin,ALB)的浓度并计算该人群FMN/TP及FMN/ALB的浓度水平。根据性别和年龄将研究对象分组(男女各6组:20～29岁组,30～39岁组,40～49岁组,50～59岁组,60～69岁组和70～79岁组),对各组检测结果进行统计学分析,浓度水平差异无统计学意义的各组数据进行合并后,呈正态分布则以均值±1.96标准差((-overx)&#177;1.96s)建立该地区表观健康人群血浆中FMN,FMN/TP及FMN/ALB的参考区间; 呈偏态分布以百分位数法(P_2.5～P_97.5)建立其参考区间。结果 男性血浆FMN,FMN/TP及FMN/ALB浓度水平依次为1.7(1.6～1.8)mmol/L,22.0(20.7～23.5)μmol/g和37.1(34.5～39.8)μmol/g; 女性则依次为1.7(1.6～1.8)mmol/L,22.4(21.1～23.9)μmol/g和38.5(36.2～41.2)μmol/g。男性和女性血浆FMN,FMN/TP及FMN/ALB浓度水平均呈偏态分布(P<0.05),且两组间比较差异均具有统计学意义(P<0.01)。进一步分析,男性和女性各年龄组血浆FMN,FMN/TP及FMN/ALB浓度水平的中位数与其总体区间中位数的差异均<25%,故不建议按年龄段分组建立参考区间,可仅按性别分组建立其参考区间。 FMN的参考区间:男性为1.4～2.0 mmol/L,女性为1.5～2.0 mmol/L; FMN/TP的参考区间:男性为18.2～26.4 μmol/g,女性为18.9～26.8 μmol/g; FMN/ALB的参考区间:男性为30.4～46.1 μmol/g,女性为32.1～46.9 μmol/g。结论 初步建立了遂宁地区20～79岁表观健康人群血浆FMN,FMN/TP及FMN/ALB的参考区间,为临床应用其作为糖尿病患者的诊断及疗效评估指标提供依据。     

延安市宝塔区40岁以上常住人口随机抽样筛查脑卒中高危人群血清Hcy水平与性别及年龄差异

目的 分析延安地区不同性别及年龄脑卒中筛查的高危人群血清同型半胱氨酸(Hcy)水平,为脑卒中的防治提供指导。方法 按照卫生部的要求,连续六年对延安市宝塔区40岁以上常住人口随机进行卒中的问卷调查、体格检查达54 209例,筛出伴高血压的脑卒中高危人群3 427例,其中男性1 324例,占38.63%; 女性2 103例,占61.37%; 50岁以上占78.79%,男女比63:100; 选取健康体检者104例,应用AU-2700全自动生化分析仪对血清进行血脂、血糖、Hcy水平检测,采用t检验和LSD-t检验,比较各指标组间差异的显著性。结果 脑卒中高危人群血脂、血糖、Hcy水平均高于对照组,男性40～49岁组Hcy水平为21.82±15.53 μmol/L,50～59岁组Hcy水平为25.45±20.42 μmol/L,60～69岁组Hcy水平为24.70±18.90 μmol/L,>70岁组Hcy水平为23.85±15.75 μmol/L。女性40～49岁组Hcy水平为16.61±11.60 μmol/L,50～59岁组Hcy水平为18.40±12.92 μmol/L,60～69岁组Hcy水平为18.35±12.88 μmol/L,>70岁组Hcy水平为18.18±12.63μmol/L。各年龄组男性的Hcy水平均高于女性,经t检验,差异有统计学意义(t=4.569,6.742,5.732,4.286,均P<0.01); 男女Hcy水平较高人群均分布在50～59岁年龄段。结论 延安地区脑卒中高危人群血清Hcy水平明显升高,男女在50～59岁年龄段Hcy水平达高峰,应对该年龄段人群进行脑卒中重点防护与干预,以期减低卒中发生的风险。     

Prevalence of known and previously unknown diabetes mellitus and impaired glucose tolerance in an adult Norwegian population. Indications of an increasing diabetes prevalence. the Nord-Trøndelag diabetes study

Objective - To establish the prevalence of known and undiagnosed diabetes mellitus and impaired glucose tolerance in a representative Norwegian adult population according to the 1980 World Health Organization Expert Committee diagnostic criteria.

Design - Screening survey applying questionnaire and non-fasting blood glucose followed by a fasting and an oral glucose tolerance test. Setting - the county of Nord-Trøndelag, Norway, 1984-86.

Subjects - All inhabitants aged >20 years (85 100); 90.3% participated. for previously unknown diabetes: all inhabitants >40 years (53 001) - participation rate 84.7%.

Main outcome measure - Prevalence.

Results - the prevalence of previously known diabetes was 2.6% in men and 3.2% in women. Total diabetes prevalence >40 years was 4.8% in men and 5.6% in women. the prevalence increased continuously with age until 90 years. One patient in five was previously undiagnosed. Impaired glucose tolerance in those with an abnormal non-fasting value was rare; only 0.9% in men and 0.2% in women. the prevalence of known diabetes was three times higher than 20-30 years ago and four times higher than 50 years ago. Except for known diabetes in the very old the prevalence corresponded well with recent Nordic studies.

Implications - the present diabetes prevalence was so high that interested general practitioners will get sufficient experience in follow-up of diabetic patients to facilitate a good quality of the care.     

中老年高尿酸血症人群发生微量清蛋白尿风险的前瞻性研究

目的 考察中老年人群血尿酸水平和微量清蛋白尿水平,探讨其在肾脏病发生发展过程中的相关性.方法 检测2010年1月～2013年12月在湘雅健康管理中心体检的40岁以上的984例高尿酸血症患者和1 020例健康体检者的血压、血糖、体质指数、总胆固醇、三酰甘油、糖化血红蛋白、血尿酸、尿微量清蛋白/尿肌酐和血肌酐水平;同时在三年里随访192例尿微量清蛋白正常的中老年高尿酸血症患者,每年检测尿微量清蛋白/尿肌酐2次.结果 高尿酸组尿和尿酸正常组微量清蛋白水平（ln（ACR））分别为3.67±4.02和2.88±3.58,差异有统计学意义（t=4.393,P＜0.001）.多元线性回归模型分析和非条件logistic回归分析结果显示中老年人群血清尿酸是发生微量清蛋白尿的独立危险因素,COX回归结果显示在校正其它影响因素后,血尿酸每升高100 μmol/L,发生微量清蛋白尿的风险增加2.41倍（RR=4.82,95％CI为4.111～5.932,P=0.009）.结论 中老年人群血尿酸水平与微量清蛋白尿发生关系密切,是其独立危险因素.