诊断学理论与实践

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2019 , Vol. 18 >Issue 1: 44 - 50

DOI: https://doi.org/10.16150/j.1671-2870.2019.01.009

论著

上海社区中老年人群血尿酸/肌酐比值与代谢综合征关联性的流行病学调查

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  • 1. 国家代谢性疾病临床医学研究中心 上海市内分泌代谢病研究所上海交通大学医学院附属瑞金医院内分泌代谢病科，上海 200025
    2. 上海市宝山区淞南镇社区卫生服务中心，上海 200441

收稿日期: 2018-09-30

  网络出版日期: 2019-02-25

基金资助

国家重点研发计划“重大慢性非传染性疾病防控研究”重点专项(2018YFC1311800)

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Epidemiological study on association of uric acid to creatinine ratio with metabolic syndrome in middle-aged and elderly populationin Shanghai

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  • 1. Shanghai Clinical Medicine Center for Endocrine and Metabolic Di-seases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai 200025, China
    2. Songnan Community Health Service Center, Baoshan District, Shanghai 200441, China

Received date: 2018-09-30

  Online published: 2019-02-25

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摘要

目的 探讨上海市嘉定区中老年人群血尿酸/肌酐比值（uric acid to creatinine ratio, UA/Cr）与代谢综合征（metabolic syndrome，MS）间关联性的流行病学趋势。方法 采取整群抽样的方法，对2014年上海市嘉定区6 570名40岁以上居民进行标准化问卷调查、体格检查、生化检测等。根据国际糖尿病联盟的标准定义MS。按照UA/Cr四分位数分组，采用多因素logistic回归模型，分析UA/Cr与MS间相关性，以明确UA/Cr是否可作为MS的独立风险因素。结果 本研究纳入6 414 名研究对象，其中MS患者3 313例（52.7%）。血Cr水平为77（70~87） mmol/L，血UA水平为314（267~372） mmol/L，UA/Cr水平为4.01（3.46~4.65）。根据UA/Cr四分位数将研究人群分为4组，第1组UA/Cr <1.0，第2组1.0≤UA/Cr<1.5，第3组1.5≤UA/Cr<2.0，第4组UA/Cr≥2.0。从第1组到第4组，随着UA/Cr水平的增加，受试者的体质量指数（body mass index, BMI）、腰围、血压、三酰甘油、低密度脂蛋白胆固醇、总胆固醇、C反应蛋白及胰岛素抵抗水平逐渐增加（P<0.01）;MS及其组分的患病率也呈现显著增加的趋势（P<0.01）。logistic回归分析显示，UA/Cr水平与MS、高血压病、中心性肥胖、高三酰甘油血症、低高密度脂蛋白血症及胰岛素抵抗呈正相关性，以第1组作为参照，第2、3、4组MS患病风险OR值及95%CI分别为1.15（0.96~1.38）、1.36（1.14~1.64）、1.96（1.62~2.37）;高血压病为1.04（0.86~1.25）、1.22（1.01~1.48）、1.33（1.09~1.62）;中心性肥胖为1.06（0.86~1.31）、1.26（1.02~1.56）、1.33（1.09~1.62）;高三酰甘油血症为1.29（1.08~1.54）、1.74（1.46~2.07）、2.81（2.35~3.36）;低高密度脂蛋白血症为0.93（0.77~1.13）、1.35（1.12~1.61）、1.50（1.25~1.80）;胰岛素抵抗为0.96（0.77~1.19）、1.14（0.92~1.40）、1.81（1.48~2.22）（均P趋势<0.01）。结论 社区中老年人群UA/Cr 与MS患病间呈独立正相关，UA/Cr可作为MS的早期生物标志物，为MS的早期发现、高危人群的干预及心血管疾病的逆转提供新的科学依据。

关键词： 血尿酸/肌酐比值; 代谢综合征; 中老年人群

本文引用格式

侯亚楠, 禤立平, 赵志云, 李勉, 陈宇红, 戴蒙, 徐敏, 毕宇芳, 王卫庆, 高金丽 . 上海社区中老年人群血尿酸/肌酐比值与代谢综合征关联性的流行病学调查[J]. 诊断学理论与实践, 2019 , 18(1) : 44 -50 . DOI: 10.16150/j.1671-2870.2019.01.009

Abstract

Objective: To undertake an epidemiological study onassociation between serum uric acid to creatinine ratio (UA/Cr) and metabolic syndrome (MS) in middle-aged and elderly populationin Shanghai. Methods: A cross-sectional study was conducted in 6 570 residents aged 40 years or older in Jiading District of Shanghai in 2014. All participants received standard questionnaire, anthropometric measurements, biochemical evaluation. MS was defined according to the international Diabetes Federation (IDF) criteria. Participants were divided into 4 groups according to the quartiles of UA/Cr, and the associations of UA/Cr with MA were investigated by multivariate logistic regression analysis. Results: A total of 6 414 participants were included in this study, of which 33 135 (52.7%) participants were diagnosed with MS. The blood Cr level was 77（70-87） mmol/L, bloodUA level was 314（267-372） mmol/L, UA/Cr level was 4.01（3.46-4.65）. The UA/Cr of 1st quartile group was <1.0, the 2ndquartile group was 1.0≤ to<1.5, the 3rd quartile group was 1.5≤ to<2.0, the 4th quartile group was ≥2.0. From 1st UA/Cr quartile to 4th UA/Cr quartile, the body mass index (BMI), waist circumference, blood pressure, serum triglyceride, total cholesterol, low-density lipoproteincholesterol, HOMA-IR level, and serum C-reactive protein level increased with the increase of UA/Cr level（P<0.01）; the prevalence of MS and its components also showed a trend of increase (P<0.01). The multivariate logistic regression analysis revealed that serum UA/Cr was positively associated with MS, hypertension, dyslipidemia, hyperglycemia, central obesity, and insulin resistance. Compared with 1st quartile group, the risk of MS in 2nd quartile group, 3rd quartile group and 4th quartile group 4 were 1.15(0.96-1.38),1.36(1.14-1.64）,1.96(1.62-2.37）; the risk of hypertension were 1.04(0.86-1.25), 1.22(1.01-1.48), 1.33(1.09-1.62); the risk of central obesity were 1.06(0.86-1.31),1.26(1.02-1.56), 1.33(1.09-1.62); the risk of high TG were 1.29(1.08-1.54), 1.74(1.46-2.07), 2.81(2.35-3.36); the risk of low HDL were 0.93(0.77-1.13),1.35(1.12-1.61), 1.50(1.25-1.80); the risk of insulin resistance were 0.96(0.77-1.19),1.14(0.92-1.40), 1.81(1.48-2.22) (all P<0.01). Conclusions: Serum UA/Cr is significantly associated with MS in middle-aged and elderly populationin Shanghai. Serum UA/Cr could serve as a biomarker of MS, which contributes to early detection and thereby the intervention of metabolic syndrome and its associated diseases.

Key words： Serum uric acid to creatinine ratio; Metabolic syndrome; Middle-aged and elderly population

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