血尿酸与体脂分布及代谢综合征的相关性研究

目的探讨男性肥胖患者中血尿酸（SUA）与体脂分布及代谢综合征（MS）的相关性。方法选取2012—2014年门诊就诊的133例肥胖患者,体重指数（BMI）均〉25.0 kg/m2,均未经降血糖、降血脂、利尿、降压、抗尿酸药物治疗。测定血清胰岛素及生化指标,用CT在脐水平测定腹部脂肪分布。结果直线相关分析显示SUA与BMI、腰围、内脏脂肪、内脏脂肪/皮下脂肪比值、空腹血糖、HOMA-IR、甘油三酯、血肌酐、收缩压、舒张压呈正相关,相关系数分别为0.361、0.446、0.634、0.360、0.193、0.287、0.477、0.259、0.280、0.181;多元逐步回归分析显示对SUA影响最大的因素依次为内脏脂肪面积、甘油三酯,标准化回归系数分别为0.533、0.183;内脏脂肪蓄积随血尿酸水平升高明显增加,更高的4分位数血尿酸对应更高的内脏脂肪面积（P〈0.05）。MS组SUA水平高于非MS组者[（434.6±69.6）umol/L vs（367.0±104.9）umol/L,P〈0.01];Spearman秩相关分析显示SUA水平随MS组分数增加而增高（P〈0.01）。结论SUA水平与内脏脂肪蓄积相关;代谢综合征患者SUA水平更高。

Relation Between Serum Uric Acid Level and Body Fat Distribution,Metabolic Syndrome in Obesity

Objective We investigated the relationship between serum uric acid（SUA） and body fat distribution,metabolic syndrome（MS） in obese men.Methods 133 cases of obese outpatients from year 2012 to 2014,with body mass index（BMI） ≥25.0 Kg/m2,were enrolled in the study.These patients have never been given hypoglycemic,hypolipidemic,hydragogue,anti-hypertensive or anti-hyperuricemic agents.Body fat distribution was measured by computed tomography（CT） scanning at the umbilical level.Serum insulin and other biochemical parameters were also measured.Results Linear correlation analysis showed that SUA is positively correlated with BMI,waist circumference,visceral fat area,the ratio of visceral fat area with subcutaneous fat area,fasting plasma glucose,HOMA-IR,serum triglyceride,serum creatinine,systolic and diastolic blood pressure,and the above parameter of correlation coefficient was 0.361,0.446,0.634,0.360,0.193,0.287,0.477,0.259,0.280,0.181,respectively.Stepwise multiple regression analysis showed that visceral fat area,and serum triglyceride were significant explanatory variables for SUA levels,and the standardized regression coefficient was 0.533,0.183 respectively.Visceral fat accumulation increased significantly with the in-crease of uric acid.A higher quartile of SUA showed a higher visceral fat area（P 0.05）.The SUA was significantly higher in metabolic syndrome group than that in the non-metabolic syndrome group（434.6 ±69.6 umol/l vs 367.0±104.9umol/l,P〈0.01）.In Spearman rank correlation analysis,the SUA was elevated with increasing metabolic syndrome characteristics（P〈0.01）.Conclusion The present study indicated that SUA is significantly associated with visceral fat accumulation.Patients with metabolic syndrome revealed a higher SUA.