Relationship between hyperuricemia and cardiovascular risk factors among middle-aged and elderly persons
-
摘要: 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。Abstract: 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.
-
-
[1] Conen D, Wietlisbach V, Bovet P, et al.Prevalence of hyperuricemia and relation of serum uric acid with cardiovascular risk factors in a developing country[J].BMC Public Health, 2004, 4:9.
[2] Nagahama K, Iseki K, Inoue T, et al.Hyperuricemia and cardiovascular risk factor clustering in a screened cohort in Okinawa, Japan[J].Hypertens Res, 2004, 27(4):227-233.
[3] 刘力生.中国高血压防治指南2010[J].中华高血压杂志, 2011, 19(8):701-743. [4] 卫生部疾病控制司, 中华医学会糖尿病学分会.《中国糖尿病防治指南》(试行本)(节选)[J].中国慢性病预防与控制, 2004, 12(6):283-285. [5] 中国医师协会心血管内科医师分会, 中国医师协会循证医学专业委员会.无症状高尿酸血症合并心血管疾病诊治建议中国专家共识[J].中国全科医学, 2010, 13(11):1145-1149. [6] 中国肥胖问题工作组.中国成人超重和肥胖症预防与控制指南(节录)[J].营养学报, 2004, 26(1):1-4. [7] 脑卒中综合危险度评估及干预国家十五攻关冠心病.国人缺血性心血管病发病危险的评估方法及简易评估工具的开发研究[J].中华心血管病杂志, 2003, 31(12):893-901. [8] 陈宗遒.广州中老年人群膳食因素与代谢综合征关系的初步研究[D].广州:中山大学, 2009. [9] 中华医学会心血管病学分会中华心血管病杂志编辑委员会.中国心血管病预防指南[J].中华心血管病杂志, 2011, 39(1):3-22. [10] 广东统计年鉴2010[M].中国统计出版社, 2010. [11] 袁智敏, 张丽崧, 杨丽芳.广州地区人群高尿酸血症的调查分析[J].营养学报, 2004, 26(3):201-203. [12] 文育锋, 许静, 叶冬青, 等.芜湖市中老年人群高尿酸血症影响因素分析[J].中国公共卫生, 2010, 26(3):332-333. [13] 余俊文, 陆锦波, 张小娟, 等.1320名老年人血尿酸与血脂、血糖和血压的分析[J].中华流行病学杂志, 2005, 26(6):455-457. [14] Lippi G, Montagnana M, Luca SG, et al.Epidemiological association between uric acid concentration in plasma, lipoprotein(a), and the traditional lipid profile[J].Clin Cardiol, 2010, 33(2):76-80.
[15] 张立晶, 胡大一, 杨进刚, 等.有心血管疾病危险因素人群中高尿酸血症的发生率及其相关因素[J].首都医科大学学报, 2005(2):124-127. [16] Perlstein TS, Gumieniak O, Williams GH, et al.Uric acid and the development of hypertension:the normative aging study[J].Hypertension, 2006, 48(6):1031-1036.
[17] 陈慧, 杨柳青, 俞玲, 等.噻嗪类利尿剂、氯沙坦及其复方制剂对高血压患者的血清尿酸水平的影响[J].中华心血管病杂志, 2008, 36(6):523-526. [18] Mcadams DM, Maynard JW, Baer AN, et al.Diuretic use, increased serum urate levels, and risk of incident gout in a population-based study of adults with hypertension:the Atherosclerosis Risk in Communities Cohort Study[J].Arthritis Rheum, 2012, 64(1):121-129.
[19] Liu PW, Chang TY, Chen J D.Serum uric acid and metabolic syndrome in Taiwanese adults[J].Metabolism, 2010, 59(6):802-807.
[20] 金善姬, 朴鲜女, 熊英环, 等.成人血尿酸分布与代谢综合征及其各组分关系[J].中国公共卫生, 2012, 28(2):163-165.
计量
- 文章访问数: 1325
- HTML全文浏览量: 173
- PDF下载量: 113
下载: