青岛港人群高尿酸血症患病率与心血管病危险因素的关系

Association between prevalence rate of hyperuricemia and risk factors of cardiovascular disease in the population of Qingdao port

目的:调查青岛港人群中血尿酸分布特点,分析其与心血管病危险因素的关联。方法:调查于2000-04/12完成。选择18～54岁青岛港职工11926名,从中整群抽样8640名进行了尿酸测定,均自愿参加调查。调查内容包括问卷、体格检查、实验室检查和特殊检查。通过问卷收集一般资料、个人疾病史、饮食和生活习惯和家族史等。测量职工的血压、身高及体质量。抽取空腹12h以上的静脉血,测定生化指标,血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、尿酸均用酶法测定,肌酐用苦味酸法测定。尿酸与心血管病的传统危险因素为血压、超重和肥胖、血糖、血脂。高尿酸血症为男性尿酸≥416μmol/L,女性尿酸≥357μmol/L。结果:纳入青岛港职工8640名,全部进入结果分析,无脱落。①青岛港职工尿酸水平及高尿酸血症分布:男性尿酸水平明显高于女性[(320.0±66.1),(250.6±56.3)μmol/L]。男性总高尿酸血症患病率明显高于女性[7.3%,3.3%(χ2=46.2,P<0.01)]。②血浆尿酸与传统心血管病危险因素的相关性:除了男性年龄、血糖水平与尿酸水平无显著相关外,其他各因素均与尿酸有显著相关性(r=-0.128～0.286,P<0.01)。③不同尿酸水平职工的心血管病危险因素水平比较:根据高尿酸血症评估标准,将全部职工按性别分别分为正常尿酸组和高尿酸血症组。除男性年龄、女性高密度脂蛋白胆固醇和心率外,两组间其他各危险因素水平比较,差异均有显著性意义(P<0.05～0.01)。④不同尿酸水平职工的高血压、糖尿病、血脂异常等患病率比较:无论男女,高尿酸血症组的高血糖(空腹血糖受损+糖尿病)、高血压、血脂异常和超重(包括肥胖)患病率均显著高于正常尿酸组(χ2=20.33～249.30,P<0.01)。⑤不同尿酸水平职工危险因素的个体聚集情况:无论男女2个及2个以上的危险因素的聚集比率在高尿酸血症组显著高于正常尿酸组[男:62.0%,29.2%;女:44.9%,13.2%(χ2=7.75～164.20,P<0.05～0.01)]。结论:青岛港职工中高尿酸血症患病率较高,血尿酸水平与传统心血管病危险因素紧密相关,提示尿酸可以作为中国人心血管病危险因素的标志物。

AIM： To investigate the distributive characteristics of blood uric acid in Qingdao port population and analyze the relationship with risk factors of cardiovascular disease. METHODS： The investigation was conducted from April to December 2000. 11 926 employees aged 18-54 from Qingdao port were selected. A total of 8 640 persons were surveyed on uric acid selected by cluster sampling. They all agreed to join the investigation voluntarily. The investigation included questionnaire, physical inspection, laboratory examination and special determination. General data, individual history of disease, diet, living habit and family history, etc. were collected with questionnaire. Blood pressure, height and body mass of the employees were measured. Venous blood was extracted after fasting for over 12 hours to detect biochemical index, blood sugar, total cholesterol, triacylglycerol, high-density lipoprotein （HDL） and uric acid with enzyme method. Creatinine was tested with bitter acid method. Traditional risk factors of uric acid and cardiovascular disease were blood pressure, overweight, obesity, blood sugar and blood lipid. Hyperuricemia was uric acid ≥ 416 μmol/L in males and uric acid ≥ 357 μmol/L in females. RESULTS： 8 640 included Qingdao port employees were all involved in the result analysis, without drop-out. （1） Level of uric acid and distribution of hyperuricemia in Qingdao port employees： The level of uric acid in males was higher significantly than that in the females [（320.0±66.1）, （250.6±56.3）μmol/L]. Prevalence rate of general hyperuricemia in males was higher obviously than that in the females [7.3 % ,3.3 % （χ^2=46.2,P 〈 0.01 ）]. （2） Correlation of risk factors between plasma uric acid and traditional cardiovascular disease： There was a significant correlation between factors and uric acid, except age of males, level of blood sugar and level of uric acid （r = -0.128-0.286, P 〈 0.01 ）. （3） Comparison of level of risk factors of cardiovascular disease in employees with different level of uric acid： According to the evaluation standard of hyperuricemia, all the employees were assigned into normal uric acid group and hyperuricemia group based on sex. There was significant difference on other risk factors between the two groups, except age of males, HDL of females and heart rate （P 〈 0.05-0.01 ）. （4） Comparison of prevalence rate of hypertension, diabetes and abnormal blood lipid, etc. in employees with different level of uric acid： No matter males or females, the prevalence rates of hyperglycemia （fasting glucose damage＋diabetes）, hypertension, abnormal blood lipid and overweight （including obesity） in the hyperuricemia group were all markedly higher than that in the normal uric acid group （χ^2=20.33-249.30, P 〈 0.01 ）. （5） Situation of individual aggregation of risk factors in employees with different level of uric acid： No matter male or female, the aggregation rates of 2 or over 2 in the hyperuricemia group were higher remarkably than that in the normal uric acid group [male：62.0%,29.2%;female：44.9%, 13.2%（χ^2=7.75-164.20, P 〈 0.05-0.01 ）]. CONCLUSION： The prevalence rate of hyperuricemia is high in Qingdao port population. The level of blood uric acid is closely associated with risk factors of traditional cardiovascular disease. It is indicated that uric acid can be used as a maker of risk factors of cardiovascular disease in Chinese.