尿酸水平与代谢综合征多因素的相关性研究

目的:分析尿酸水平与代谢综合征(metabolic syndrome,MS)相关因素的关联性,进一步探讨尿酸在代谢综合征中的作用?方法:调查南京医科大学第一附属医院12 249例体检群体,通过病史询问,身高体重?血压测定及血糖?血脂?血尿酸等生化指标检测,应用多因素Logistic回归模型分析尿酸水平与代谢综合征两者之间的关系,同时调整年龄?性别?总胆固醇?低密度脂蛋白胆固醇对MS的影响,并评估尿酸水平与糖脂代谢其他因素的关联性?结果:①代谢综合征组较非代谢综合征组在年龄?血压?体质指数(BMI)?血脂?血糖?尿酸等代谢相关指标方面明显升高(P < 0.01);②尿酸浓度有随BMI增加而增加的线性趋势 (P < 0.01),不同性别线性变化斜率不同(P < 0.01),女性大于男性;③男性人群的尿酸平均水平高于女性,尿酸平均水平均有随代谢综合征组份数增加而增加的线性趋势 (P < 0.01),不同性别线性变化斜率不同(P < 0.01),女性大于男性;④不同血糖状态下男性人群的尿酸水平均高于女性(P < 0.01);⑤脂代谢异常组较正常组具有更高的尿酸水平,差异具有统计学意义(P < 0.01);⑥不同年龄组 Pearson相关分析显示:男性尿酸与年龄的相关系数r = -0.07,P < 0.01,女性r = 0.24,P < 0.01,总体尿酸水平高低与年龄无关?当尿酸作为连续变量时,尿酸水平每增加1个单位,代谢综合征的风险增加0.001倍(OR=1.001,95%CI:1.000~1.003),有统计学意义(P = 0.025);当尿酸按照男性420 μmol/L,女性357 μmol/L分成二分类时发现,高尿酸患者发生代谢综合征的风险是非高尿酸患者的1.197倍(95%CI:0.765~1.872),但无统计学意义(P = 0.432);若将尿酸四等份分类,则各类与第一类相比,OR值及其95%CI分别为0.976 (0.723~1.319)?0.940 (0.697~1.268)和1.131 (0.854~1.499),各类与第一类比较均没有统计学意义(P值分别为0.876?0.685?0.391)?结论:年龄?血压?体质指数?血脂?血糖?尿酸是代谢综合征的危险因子;代谢综合征患者具有高尿酸水平;调整年龄?性别?胆固醇?低密度脂蛋白胆固醇对MS的影响后,未发现尿酸与代谢综合征有关?

The study of relevant factors in metabolic syndrome and hyperurcemia

Objective: To investigate the correlative factors of hyperuricemia and metabolic syndrome (MS) and study the role of uric acid (UA) in the development of MS. Methods: Data of 12 249 persons undergoing health examination were collected. The disease history was investigated,the biochemical indices were detected,and the general physical data were measured. Multiple stepwise by multivariate Logistic regression model were used to analysis the relationship between UA and MS,at the same time,age,sex,low density lipoprotein cholesterol,total cholesterol were adjusted,the relationship of UA and other factors related to metabolism was also analyzed. Results: Age,BMI,blood pressure,lipids,glucose and UA were higher in MS group than those in non MS group(P < 0.01). The UA level was higher in men than that in women,and increased with accompany the costitution of MS. This phenomenon was obviously in woman. The UA level was increased in man under different glucose levels. Similarly,the UA level was related to the abnormal lipid metabolism,but not related to ages. After adjusting age,sex,total cholesterol,low density lipoprotein cholesterol,the rate of MS were higher in the hyperuricemia group when the UA was analyzed as continuous variable,but when uricemia was divided into two groups,the rate of MS in hyperuricemia group was 1.197 times of that in no hyperuricemia group,but non significant difference was found between them. When uricemia was divided into four groups,there were no differences among them. Conclusion: Age,BMI,lipids,glucose,uricemia were the risk factors of MS,hyperuricemia was found in MS group,and hyperuricemia group has higher rate of MS than the non hyperuricemia group,but no direct relationship between MS and hyperurcemia was found when the uricemia was divided into two groups or four groups