中老年人群高尿酸血症与心血管危险因素关系

目的探讨中老年人群高尿酸血症与心血管危险因素及聚集性之间的关系，为高尿酸血症的防治提供有效的策略和依据。方法采用随机整群抽样方法抽取在广州军区广州总医院健康管理体检中心接受长期定期体检的14个体检单位1 176名45~75岁人群进行问卷调查、体格检查和实验室检测。结果中老年人群男性高尿酸血症患病率为55.7%，标化患病率为37.7%，女性高尿酸血症患病率为46.5%，标化患病率为40.7%；男女性高尿酸血症组年龄、甘油三酯、血肌酐、体质指数、腰臀比及高血压患病率均高于非高尿酸血症组，高密度脂蛋白胆固醇低于非高尿酸血症组，女性高尿酸血症组糖尿病患病率高于非高尿酸血症组，差异均有统计学意义（P<0.05）；多因素logistic回归分析显示，调整年龄和饮酒后，甘油三酯含量较高（OR=1.923，95%CI=1.304~2.834）、腹型肥胖（OR=1.482，95%CI=1.001~2.194）是中老年男性高尿酸血症患病的危险因素；血肌酐含量较高（OR=1.061，95%CI=1.037~1.086）、肥胖（OR=6.345，95%CI=2.524~15.952）是中老年女性高尿酸血症患病的危险因素，高密度脂蛋白胆固醇含量较高（OR=0.387，95%CI=0.222~0.676）是中老年女性高尿酸血症患病的保护因素；随着心血管危险因素的增多，高尿酸血症患者所占比例也随之增多（P<0.05）；校正年龄、饮酒、性别等混杂因素后，随着个体存在心血管危险因素的增多，高尿酸血症的患病风险也随之升高，具有1、2、≥3个心血管危险因素的个体患高尿酸血症的危险性分别是无危险因素个体的1.557、1.688、2.666倍。结论中老年男性高尿酸血症的影响因素为甘油三酯、腰臀比，中老年女性高尿酸血症的影响因素为血肌酐、体质指数、高密度脂蛋白胆固醇；高尿酸血症患者具有心血管危险因素聚集性。

Relationship between hyperuricemia and cardiovascular risk factors among middle-aged and elderly persons

ObjectiveTo investigate the relationship between hyperuricemia and cardiovascular risk factors and the clustering of the risk factors among middle-aged and elderly physical examinees,and to provide basis for effective prevention of hyperuricemia.MethodsA cross-sectional clustering sampling survey was conducted in physical examinees registered in the Department of Healthy Management of General Hospital of Guangzhou Military Region.Totally 1 176 valid subjects aged from 45 to 75 years taking annual physical examination at 14 medical examination centers were required to complete a questionnaire survey,physical examination and laboratory detection.ResultsMean age,the level of triglyceride and creatinine,body mass index,waist-hip ratio,and the prevalence rate of hypertension in the hyperuricemia group were higher than those the non-hyperuricemia group,and the mean level of high-density lipoprotein cholesterol(HDL) of hyperuricemia group was lower than that of the non-hyperuricemia group in both men and women.In addition,the prevalence rate of diabetes was higher in the hyperuricemia group among women.After adjusting for sex and alcohol drinking habit,the results of multivariate analyses showed that factors associated with hyperuricemia(odds ratio[OR]) (95% confidence interval[95%CI],) were high density lipoprotein cholesterol(OR=1.923,95%CI:1.304-2.834),abdominal obesity(OR=1.482,95%CI:1.001-2.194) in the men,HDL(OR=0.387,95%CI:0.222-0.676),creatinine(OR=1.061,95%CI:1.037-1.086),obesity(OR=6.345,95%CI:2.524-15.952) in the women.With the increasing number of cardiovascular risk factors,the proportion of hyperuricemia patients increased significantly.After adjusting for age,sex and alcohol drinking,the risk of hyperuricemia increased significantly along with the increased number of risk factors.ConclusionAmong the middle-aged and elderly populations,the prevalence rate of hyperuricemia is higher in women than in men.The level of high density lipoprotein cholesterol,abdominal obesity are significantly associated with hyperuricemia in men.The level of HDL and creatinine,and obesity are significantly associated with hyperuricemia in women.Hyperuricemia subjects tend to have a clustering of cardiovascular risk factors.