刘淑芬;李源杰;黄程锦;王琦;秦薇;盖小荣;沈瑛;邱玲;曾学军;
LIU Shu-fen1,LI Yuan-jie2,HUANG Cheng-jin1,WANG Qi1,QIN Wei3,GAI Xiao-rong3,SHEN Ying4,QIU Ling4,ZENG Xue-jun11Department of General Internal Medicine,2Department of Internal Medicine,3Department of Physical Examination Center,4Department of Laboratory Medicine,Peking Union Medical College Hospital,Chinese Academy of MedicalSciences & Peking Union Medical College,Beijing 100730,China

• 1:中国医学科学院北京协和医学院北京协和医院普通内科
• 2:中国医学科学院北京协和医学院北京协和医院内科
• 3:中国医学科学院北京协和医学院北京协和医院健康医学部
• 4:中国医学科学院北京协和医学院北京协和医院检验科

摘要(Abstract)：

目的探讨高尿酸血症与其他代谢异常的相关性,指导临床对高尿酸血症患者的诊治。方法对2008年本院2074名健康体检人群进行横断面调查,描述高尿酸血症和其他代谢异常在健康体检人群的患病率,通过双变量分析和Logistic多元回归分析,探讨高尿酸血症和其他代谢异常的相关性。结果本组人群总高尿酸血症患病率为14.27%,男性为21.36%,女性为11.48%;其他各代谢异常的患病率分别为肥胖12.07%,高血压24.70%,空腹高血糖19.46%,高总胆固醇血症36.38%,高甘油三酯血症28.68%,低高密度脂蛋白-胆固醇血症33.80%,高低密度脂蛋白-胆固醇血症35.25%,高非高密度脂蛋白-胆固醇血症22.59%,脂肪肝40.28%;高尿酸血症组其他代谢异常的患病率均较非高尿酸血症组高,调整年龄、性别后两组比较差异仍有统计学意义;双变量相关分析显示血清尿酸值与年龄、性别、体重指数、收缩压、舒张压、高密度脂蛋白-胆固醇、低密度脂蛋白-胆固醇、总胆固醇、甘油三酯、非高密度脂蛋白-胆固醇、空腹血糖、肌酐、脂肪肝均具有显著相关性。多元Logistic回归分析发现血清尿酸水平与肥胖、高血压、低高密度脂蛋白-胆固醇、高甘油三酯、脂肪肝独立相关。结论高尿酸血症与肥胖、高血压、血脂紊乱、脂肪肝等代谢异常独立相关,其可能增加上述代谢异常的发生风险。
Objective To explore the association between hyperuricemia and other metabolism dysfunctions. Methods A cross-sectional study in 2074 health examination subjects in our hospital in 2008. We calculated the prevalences of hyperuricemia and other metabolism dysfunctions and explored the association between hyperuricemia and other metabolism dysfunctions using bivariate correlation analysis and Logistic multiple analysis. Results The prevalence were as follows:hyperuricemia is 14.27%,obesity 12.07%,hypertension 24.70%,fasting hyperglycaemia 19.46%,hypercholesteremia 36.38%,hypertriglyceridemia 28.68%,fatty liver 40.28%. The prevalences of metabolism dysfunctions were significantly higher in hyperuricemia group than in non-hyperuricemia group,and such significant differences still existed after having been adjusted with age. Bivariate correlation analysis showed that hyperuricemia was significantly correlated with age,gender,body mass index,systolic blood pressure,diastolic blood pressure,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,total cholesterol,triglyceride,non-high-density lipoprotein cholesterol,glucose,creatinine,and fatty liver. Logistic multiple regression analysis showed that the level of serum uric acid was independently associated with obesity,hypertension,low-density lipoprotein cholesterol,hypertriglyceridemia,and fatty liver. Conclusions Hyperuricemia is independently associated with obesity,hypertension,hypertriglyceridemia,and fatty liver. It can increase the risk of these metabolic disorders.

关键词(KeyWords)： 高尿酸血症;肥胖;高血压;高血糖;血脂紊乱;脂肪肝
hyperuricemia; obesity; hypertension; hyperglycaemia; hyperlipoidemia; fatty liver

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 刘淑芬;李源杰;黄程锦;王琦;秦薇;盖小荣;沈瑛;邱玲;曾学军;
LIU Shu-fen1,LI Yuan-jie2,HUANG Cheng-jin1,WANG Qi1,QIN Wei3,GAI Xiao-rong3,SHEN Ying4,QIU Ling4,ZENG Xue-jun11Department of General Internal Medicine,2Department of Internal Medicine,3Department of Physical Examination Center,4Department of Laboratory Medicine,Peking Union Medical College Hospital,Chinese Academy of MedicalSciences & Peking Union Medical College,Beijing 100730,China

Email:

DOI:

参考文献(References)：

• [1]Zorana JI,Lidija M,Vesna SK,etal.Independentassocia-tion of high serum uric acid concentration with angiographi-cally defined coronary artery disease[J].Tokoku J Exp Med,2007,211:369-377.
• [2]Verdecchia P,Schillaci G,Reboldi GP,et al.Relation be-tween serum uric acid and risk of cardiovascular disease in essential hypertension[J].Hypertension,2000,36:1072-1078.
• [3]Fang J,Alderman MH.Serum uric acid and cardiovascular mortality.The NHANES I epidemiologic follow-up study,1971-1992[J].JAMA,2000,283:2404-2410.
• [4]Liese AD,Hense HW,L wel H,et al.Associationation of serum uric acid with all-cause and cardiovascular disease mortality and incident myocardial infarction in MONICA Augsburg cohort[J].Epidemiology,1999,10:391-397.
• [5]张兴平,陈庆伟,郑陵.高血压病患者合并高尿酸血症与颈动脉粥样硬化的关系[J].重庆医学,2004,33:35-36.
• [6]张立晶,胡大一,杨进刚.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.2005,26:124-127.
• [7]方圻,游凯,林其燧,等.中国正常人血清尿酸调查及其与血脂的关系[J].中华内科杂志,1983,22:434-438.
• [8]杜蕙,陈顺乐,王元,等.上海市黄浦区社区高尿酸血症与痛风流行病学调查[J].中华风湿病学杂志,1998,2:75-78.
• [9]姜宝法,张源潮,徐晓菲,等.山东沿海地区痛风和高尿酸血症的流行病学调查[J].中国公共卫生,1999,15:205-206.
• [10]邵继红,莫宝庆,喻荣彬,等.南京市社区人群高尿酸血症与痛风的流行病学调查[J].疾病控制杂志,2003,7:305-308.
• [11]方卫纲,黄晓明,王玉,等.高尿酸血症在北京地区1997人中的患病情况及相关因素分析[J].中华医学杂志,2006,86:1764-1768.
• [12]Niskanen L,Laaksonen DE,Lindstr J,et al.Serum uric acid as a harbingerof metabolic outcome in subjects with im-paired glucose tolerance[J].Diabetes Care,2006,29:709-711.
• [13]Tseng CH.Correlation of uric acid and urinary albumin ex-cretion rate in patients with type2diabetes mellitus in Tai-wan[J].Kidney Int,2005,68:796-801.
• [14]Hovind P,Rossing P,TarnowL,etal.Serumuric acid as a predictor for development of diabetic nephropathy in type1diabetes an inception cohort study[J].Diabetes,2009,58:1668-1671.
• [15]Ioachimescu AG,Brennan DM,Hoar BM,et al.Serum u-ric acid is an independent predictor of all-cause mortality in patients at high risk of cardiovascular disease[J].Arthritis Rheum,2008,58:623-630.
• [16]Baker JF,Krishnan E,Chen L,et al.Serum uric acid and cardiovascular disease:recent developments,and where do they leave us?[J].Am J Med,2005,118:816-826.
• [17]Wannamethee SG.Serum uric acid and risk of coronary heart disease[J].Curr Pharm Des,2005,11:4125-4132.
• [18]Lai SW,Tan CK,Ng KC.Epidemiology of fatty liver in a hospital based study in Taiwan[J].South Med J,2009,95:1288-1292.
• [19]Li YM,Xu CF,Yu CH,et al.Association of serum uric acid level with non-alcoholic fatty liver disease:Across-sec-tional study[J].J Hepatol,2009,50:1029-1034.
• [20]Nakagawa T,Hu H,Zharikov S,et al.Acausal role for u-ric acid in fructose-induced metabolic syndrome[J].Am J Physiol Renal Physiol,2006,290:625-631.
• [21]张浩军,张冰,刘小青.小鼠高尿酸高脂血症复合模型初探[J].北京中医药大学学报,2001,24:29-30.
• [22]罗荣高,杨兴仁,李东升.脂肪肝与血脂的关系探讨[J].临床军医杂志,2006,34:30-31.