体检职工血尿酸水平及相关危险因素分析

Risk factors for hyperuricemia in active and retired employees underwent physical examination

目的了解体检职工的血清尿酸（UA）水平及其相关危险因素。方法2010年3月至2011年9月，安排某单位在职职工和离退休职工（不含家属）21700名进行体检，其中实际体检职工16416名，符合研究要求且资料完整者14044名。体检内容包含体格检查和实验室检查。采用专用体检记录软件录入体检者资料，体检结束后导出数据，分析UA水平、分布特征及UA和高尿酸血症（HUA）的危险因素。结果体检职工HUA的患病率为11．2％（1571／14044），男性HUA患病率是女性的3．9倍。UA水平、HUA患病率在不同性别、年龄、体质指数职工之间差异有统计学意义（P均〈0．01）。UA水平、HUA患病率随年龄增长呈“J”形曲线变化。Pearson相关分析显示：UA水平与收缩压、舒张压、体质指数、年龄、甘油三酯、低密度脂蛋白胆固醇（LDL-C）、总胆固醇、空腹血糖呈正相关，与高密度脂蛋白胆固醇（HDL．C）、性别呈负相关（P均〈0．05）。多元线性回归分析显示：收缩压、体质指数、空腹血糖、甘油三酯、LDL-C是UA水平的危险因素，而HDL-C、女性是其保护因素（P均〈0．01）。年龄、舒张压是女性UA水平的危险因素（P均〈0．05），而LDL-C是男性UA水平的危险因素（P〈0．05）。logistic回归分析显示：高龄、超重、收缩压升高、高甘油三酯、低HDL-C是HUA的危险因素（P均〈0．05），而女性是其保护因素（P〈0．01）。结论职工UA水平随年龄增长呈“J”形曲线变化。收缩压、体质指数、空腹血糖、甘油三酯、LDL．C是UA水平的危险因素，而HDL-C、女性是尿酸水平的保护因素。

Objective To observe serum uric acid （UA） level distribution and explore risk factors of hyperuricemia （HUA） in a large cohort of active and retired employees underwent physical examination. Methods Physical examination was arranged for 21 700 active and retired employees from May 2010 to September 2011, 16 416 employees were examined and complete examination data were obtained in 14 044 subjects. The distribution characteristics of UA level and correlations of UA level and HUA prevalence rate with gender, age, body mass index （BMI）, systolic pressure （SBP）, diastolic pressure （ DBP ） , fasting blood-glucose （ FPG ） , serum total cholesterol （ TC ） , triglyceride （ TG ） , low-density lipoprotein cholesterol （ LDL-C ）, high-density lipoprotein cholesterol （ HDL-C ） were analyzed. Results HUA prevalence rate was 11.2% in this cohort, which was significantly higher in males （ 15.8% ） than in females （4. 1% , P 〈 0. 05 ）. The UA level and the HUA prevalence rate presented a ＂J＂ curve relationship with aging and positively correlated with BMI, SBP, DBP, TG, LDL-C, TC and FPG while negatively correlated with HDL-C. Multiple linear regression analysis showed that SBP, BMI, FPG, TG, and LDL-C were independent risk factors while HDL-C and female gender were the protective factors of HUA （ all P 〈 0. Ol ）. Aging and high DBP were independent risk factors of HUA for females（ all P 〈 0. 05 ）and LDL-C was risk factor of HUA for males （ P 〈 0. 05 ）. Conclusions Serum UA level presents a ＂J＂ wave relationship with aging. The risk factors of HUA are increased SBP, BMI, FPG, TG, LDL-C while the protective factors of HUA are female gender and high HDL-C.