颈围与高尿酸血症发生风险的探讨

Association between neck circumference and risk of hyperuricemia

目的通过纵向研究探讨基线期的颈围(neck circumference,NC)能否预测未来高尿酸血症(hyperuricemia,HUA)的发生风险,为HUA的预防及早期治疗提供便捷的参考指标。方法本研究纳入2015年参加"中国糖尿病患者肿瘤发生风险的流行病学研究"的北京市部分社区居民共4383人(1445名男性和2938名女性,基线期均未患高尿酸血症)作为研究对象。以该研究人群2015年资料作为基线数据,随访3年,采集新发高尿酸血症的情况。采用Cox回归模型分析基线颈围与3年随访期间HUA发病风险的关系。结果在3年随访期间,男性受试者HUA的累积发病率高于女性(15.4%vs 13.1%,P=0.033)。根据基线期NC四分位数由低到高将不同性别分别分为Q1~Q4组,在男性及女性人群中,Q2~Q4组在随访期间HUA的患病率明显高于Q1组(男性HUA患病率:Q1组10.5%vs Q2组15.5%,Q3组19.1%,Q4组18.0%;女性HUA患病率:Q1组7.7%vs Q2组12.6%,Q3组14.8%,Q4组19.6%;P均<0.05)。女性受试者在调整混杂因素后,较高的基线NC与3年随访期间发生HUA的风险呈正相关(P趋势<0.001)。与Q1组相比,基线NC的Q3组和Q4组中HUA风险显著增加(HR,Q3组1.43,Q4组1.76;P<0.05)。男性受试者在调整混杂因素后,基线NC与3年随访期间发生HUA风险之间无显著相关性。结论女性基线期NC较高者未来3年患HUA的风险显著增加,而男性基线NC无法预测未来3年患HUA的风险。

Objective To investigate whether baseline neck circumference(NC)is associated with development of hyperuricemia(HUA)in future and its ability to predict HUA,so as to provide evidences for prevention and early treatment of HUA.Methods Atotal of 4383 subjects(1445 males and 2938 females)without HUA at baseline from REACTION study were included in this study,and the data collected in 2015 were used as baseline data.After 3 years of follow-up,the incidence of HUA was collected.Cox regression analysis was used to assess the correlation between baseline NC and the risk of developing HUA at follow-up.Results Thecumulative incidence of male subjects for HUA was significantly higher than that of female subjects(15.4%vs 13.1%P=0.033)during the 3-year follow-up.The sample was divided into Q1,Q2,Q3,Q4 groups according to quatiles of NC.The prevalence of HUA during the follow-up in the Q2-Q4 groups was obviously higher than that in the Q1 group(for male subjects,the prevalence was 10.5%in Q1 versus 15.5%in Q2,19.1%in Q3 and 18.0%in Q4;while for female subjects,it was 7.7%in Q1 versus 12.6%in Q2,14.8%in Q3 and 19.6 in Q4;all P<0.05).For female subjects,after adjusting for confounding factors,the higher baseline NC was positively associated with the higher risk of HUA(Pfor trend<0.001).And compared to the Q1 group of baseline NC,the risk of hyperuricemia in the Q3 and the Q4 groups significantly increased(HR was 1.43 for Q3 and 1.76 for Q4;P<0.05).For male subjects,after adjusting for confounding factors,there was no significant correlation between baseline NC and risk of HUA the following.Conclusion For female subjects,higher neck circumference is positively associated with an increased risk of HUA in following 3 years.For male subjects,higher baseline NC cannot predict HUA risk within 3 years.