青岛市沿海社区人群高尿酸血症与痛风的流行病学调查

Epidemiological study on hyperuricemia and gout in the coastal area of Qingdao city

目的调查青岛市沿海社区10年以上居民高尿酸血症与痛风的流行情况,为治疗和预防提供临床依据。方法采用整群抽样的方法,在青岛市崂山区社区调查了5658名居民高尿酸血症与痛风的患病情况,并进行血尿酸、空腹血糖、血清胆固醇、甘油二三酯及肝肾功能的检查。结果正常人群男性血尿酸平均(288±67)μmol/L、女性平均(223±48)μmol/L;高尿酸血症患病率为5.46%(标化后4.75%),男性9.21%(标化后8.23%)、女性为1.34%(标化后1.14%);高尿酸者男性血尿酸水平平均(457±26)μmol/L,女性平均(390±30)μmol/L。男、女平均患病年龄分别为52.1岁、54.8岁;痛风患病率为0.99%(标化后0.862%),男性为1.59%(标化后1.42%),女性为0.33%(标化后0.28%)。高尿酸者中痛风的患病率为15.26%,男性为17.22%,女性为9.57%。调查发现海鲜及啤酒是诱发青岛市社区痛风的主要原因;高尿酸血症伴发疾病中以高脂血症最为常见,其次为原发性高血压、糖尿病、冠心病;痛风的首发部位常见的是第一跖趾关节,其次为足背、距小腿关节、膝关节;最常见的部位是拇趾及第一跖趾关节,其次为踝、足背、膝、腕、指、肘等关节。结论青岛市沿海社区人群高尿酸血症及痛风患病率不高于国内其他地区的调查结果。

Objective To investigate the prevalence of hyperuricemia （HUM） and gout among residents in the communities near the coast for more than 10 years in Qingdao city. Methods A stratified cluster sampling was conducted. The hyperuricemia and gout in 5658 residents living in the communities in Laoshan of Qingdao was studied, and serum uric acid （SUA）, fasting blood sugar serum cholesterol, triglyceride and liver and kidney function. Results The average SUA in normal adults was （288±67） μmol/L for men, and （223±48） μmol/L for women. The prevalence of hyperuricemia was 5.46%：9.21% in male and 1.34% in female. The average serum uric acid level was （457±26） μmol/L for male and （390±29） μmol/L for female in HUM adults. The average age for hyperuricemia was 52.1 in the male and 54.8 in the female in HUM. The prevalence of gout was 0.99%：1.59% in male and 0.33% in female. At the same time the prevalence for gout among hyperuricemic population was 15.26%：17.22% in male and 9.57% in female. We found that beer and seafood were the main predisposing factors for gout. The main concomitant disease of hyperuricemia were hyperlipemia, diabetes, coronary heart disease and hypertension. The main involved joints of gout was metatarsophalangeal joints, followed by the dorsum of foot, talocrural joints, and knee joint. The most common locations were metatarsophalangeal joints and halluces, followed by malleoli, dorsum of foot, knee joint, carpus, digits and cubiti. Conclusion The prevalence of hyperuricemia and gout in residents living near the sea in Qingdao is not higher than other districts but the prevalence of hyperuricemia and the tendeucy of gout is persistently incr easing. Extensive attention should be paid to the change of composition of diet. At the same time, doctors should monitor the Uric acid level to prevent gout. It indicates that the prevalence of HUM and gout is still rising.