中国农村高血压患者高尿酸血症患病率及相关因素分析

Prevalence and associated risk factors of hyperuricemia in rural hypertensive patients

目的探讨中国农村高血压患者中高尿酸血症的患病率及其影响因素。方法通过阶段性随机整群抽样入选河南信阳7个社区5235例40～75岁高血压患者，进行问卷、体检、生化指标测定等检查。高尿酸血症定义为血尿酸水平男性≥420μmol／L，女性≥360μmol／L。结果高血压患者高尿酸血症患病率14．1％，男性显著高于女性（21．5％比10．2％，P〈0．01）。高尿酸血症患病率随体重指数（BMI）增加显著升高，在BMI〈25和≥30的男性中分别为14．4％、30．4％，女性中分别为7．2％、17．0％。血尿酸水平在男、女性中均随BMI增加显著升高[男性（328±83）、（383±86）μmol／L；女性（251±70）、（293±75）μmol／L；均P〈0．01]，高尿酸血症患病率仅在女性中随年龄增加显著升高（40—70岁以上：5．8％～18．0％，P〈0．01）。降压药物、血脂异常、吸烟、饮酒均显著增加高尿酸血症患病率及血尿酸水平（均P〈0．01），但Ⅰ、Ⅱ、Ⅲ级高血压各组间差异无统计学意义（均P〉0．05）。多元Logistic回归分析发现男性中BMI、饮酒和应用利尿剂，女性中年龄、BMI、血脂异常、吸烟和应用降压药物是高尿酸血症的独立危险因素。结论农村高血压患者高尿酸血症患病率相对较低，性别、年龄、BMI、降压药物、血脂异常、吸烟、饮酒等均可影响血尿酸水平和高尿酸血症患病率，不同性别的影响因素不同。

Objective To investigate the prevalence of hyperuricemia and its associated risk factors in treated and untreated hypertensive patients in Chinese rural area. Methods This cross-section study was performed in 5235 hypertensive patients aged 40 - 75 years old at Xinyang, Henan by using a multistage cluster sampling method. All patients underwent an investigation composed of a standardized questionnaire, physical and biochemieal examination. Hyperurieemia was defined as serum uric acid levels ≥420 μmol/L in men or ≥360 μmol/L in women. Results The overall prevalence of hyperurieemia was 14. 1%, and it was higher in men than in women（21.5% vs 10. 2%, P 〈0. 01 ）. With an increase of body mass index （BMI）, the prevalence of hyperuricemia and serum uric acid level increased significantly in both sexes [BMI 〈25, ≥30： 14.4% ,30.4%, （328 ±83） μmol/L, （383±86） μmol/L in males; and 7.2% , 17.0%, （251 ±70） μmol/L, （293 ±75） μmol/L in females, respectively, all P 〈 0. 01 ]. So did that with increase of age only in female patients （40 -49 years vs ≥70 years： 5. 8% - 18.0%, respectively, P 〈 0. 01 ）. Antihypertensive treatment, lipid disorder, smoking and alcohol consumption also significantly increased the incidence of hyperuricemia and the serum uric acid level （ all P 〈 0. 01 ） . However, no significant differences were found among patients with Ⅰ , Ⅱ , and Ⅲ blood pressure levels （ all P 〉 0.05 ）. After adjustment for age and other conventional risk factors by using multiple logistic regression analysis, hyperurieeraia was significantly associated with BMI, alcohol consumption and diuretics in males as well as BMI, lipid disorder, age, smoking, and antihypertensive treatment in females. Conclusions Hyperurieemia is relatively less common in rural hypertensive patients. The associated risk factors of hyperuricemia and elevated serum uric acids include sex, age, BMI, antihypertensive medicines, lipid disorder, smoking and alcohol consumption. The effect of these factors is different between sexes.