尿液pH值与代谢综合征的相关性研究

Correlation between urinary pH value and metabolic syndrome

目的:探讨中老年人群尿液pH水平与代谢综合征的相关性。方法:对上海市嘉定社区2 322名40岁以上居民进行问卷调查和体格检查,空腹采血检测肝功能、肾功能、血糖、血脂及胰岛素,收集晨尿检测尿pH值。采用多元线性回归分析代谢综合征与尿液pH值的相关性,Logistic回归分析代谢综合征和低尿液pH水平的相对风险度。代谢综合征采用按亚洲人特点改良的美国国家胆固醇教育计划成人治疗组第3次报告诊断标准。结果:与正常人群相比,代谢综合征患者腰围、体质量指数、血压、空腹血糖、糖化血红蛋白、低密度脂蛋白胆固醇、三酰甘油等指标偏高(P<0.000 1),高密度脂蛋白胆固醇和尿液pH值显著低下(P<0.000 1)。Pearson相关性分析显示,尿液pH值与腰围、三酰甘油、胰岛素抵抗指数呈负相关,与高密度脂蛋白胆固醇呈正相关。随着代谢综合征组分的增加,尿液pH水平呈现下降趋势(趋势P<0.000 1)。Logistic回归分析显示,腹型肥胖、高三酰甘油血症、高血压、高血糖均是低尿液pH值的影响因素。与非代谢综合征人群相比,代谢综合征患者尿液pH≤5.5的风险增加42%[比值比(OR)=1.42,95%可信区间:1.19～1.70]。结论:中老年人群中,代谢综合征患者尿液pH值低于正常人群,更易伴发肾结石。

Objective To investigate the correlation between urinary pH value and metabolic syndrome in middle-aged and elderly Chinese people. Methods Two thousand three hundred and twenty-two subjects aged 40 years or older from Jiading community, Shanghai, were enrolled in this study. Questionnaire interview, physical examination, and blood biochemical tests including blood glucose, lipids, insulin, liver function tests, renal function tests and urinary pH value were performed or measured. Multivariate linear regression analyses was performed to investigate the correlation between urinary pH value and metabolic syndrome. Logistic multiple regression analysis was performed to explore the risk of metabolic syndrome for decreased urinary pH value. The metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel Ⅲ （NCEP ATP Ⅲ） criteria with modification appropriate for Asian population. Results Subjects with metabolic syndrome had higher waist circumference, body mass index, systolic blood pressure, serum fasting glucose, low- density lipoprotein-cholesterol,triglyeerides and lower high-density lipoprotein-cholesterol, urinary pH value than subjects without metabolic syndrome. Pearson＇s correlation analysis indicated that urinary pH value was negatively correlated with waist circumference, triglyeerides, insulin resistance index and positively correlated with high-density lipoprotein-cholesterol. With the increase in components of metabolic syndrome, urinary pH value decreased both in men and women （P for trend〈0.001）. Logistic regression analysis indicated that central obesity, hypertriglyeerides, hypertension and hyperglycemia were the influencing factors of low urinary pH value. Subjects with metabolic syndrome had higher risk of having decreased urinary pH value [odds ratio （OR）=1.42;95% confidence interval （CI）： 1.19-1.70]. Conclusions Metabolic syndrome is associated with decreased urinary pH value in middle-aged and elderly people, predisposing the development of nephrolithiasis.