不同性别居民尿酸水平与代谢综合征相关性

Serum uric acid level as an additional component for identifying metabolic syndrome in male and female

目的了解不同性别居民尿酸水平与代谢综合征(MS)相关性,判断最合适诊断MS的尿酸切点,为MS的干预提供科学依据。方法于2011年3月采取整群随机抽样方法对江苏省昆山市玉山镇和锦溪镇的4个小区共1 172名常住居民进行问卷调查、体格检查和实验室检测。结果偏相关分析结果表明,男性尿酸水平与腰围、收缩压、舒张压、甘油三酯均呈正相关(P<0.001),与高密度脂蛋白胆固醇呈负相关(r=-0.141,P<0.001),与血糖无相关(P>0.05);女性尿酸水平与腰围、收缩压、舒张压、血糖、甘油三酯均呈正相关(P<0.01),与高密度脂蛋白胆固醇呈负相关(r=-0.180,P<0.001);对不同性别居民尿酸水平进行四分位划分,调整吸烟史、饮酒史、胆固醇、体质指数和年龄等混杂因素后,随着尿酸水平升高,女性发生MS的危险性增大,其中尿酸水平在P25～P50女性居民发生MS的风险性是尿酸水平在<P25女性居民的7.94倍(OR=7.94,95%CI=2.17～29.00),尿酸水平在>P50女性居民发生MS的风险性是尿酸水平在<P25女性居民的13.20倍(OR=13.20,95%CI=3.35～51.80);男性居民尿酸水平对MS的发生无明显影响;ROC曲线分析结果表明,女性居民诊断MS的最佳截点为284.0μmol/L。结论血清中的尿酸水平可作为诊断女性MS的一个组分。

Objective To explore the relationship between serum uric acid level and metabolic syndrome in male and female. Methods A total of 1 173 residents from 4 communities in Yushan and Jingxi district, Kunshan city were selected with cluster random sampling. Data on demographic information, smoking, alcohol consumption, family history of disease were collected and blood pressure, height, weight, waist circumference, blood glucose, blood lipids, and uric acid were detected. Univariate and multivariate logistic regression models were used to evaluate serum uric acid and the metabolic syndrome. Receiver operation characteristic （ROC） curve was used to determine the cut-off point for predicting metabolic syndrome. Results Partial correlation analysis found that serum uric acid level was related to waist circumference, systolic blood pressure, diastolic blood pressure, blood glucose, triglycerides, and high-density lipid chdesterol both in males and females. However, there was no significant relationship between serum uric acid level and blood glucose in males. The risks of the metabolic syndrome increased with serum uric acid levels. Furthermore, there was a dose-response relationship between serum uric acid and the risk of metabolic syndrome. Compared to those with a serum uric acid level 〈25% ,the women with a serum uric acid level of 25%-50% were more likely to have metabolic syndrome （odds ratio[OR] ,95% confidence interval [CI]：7.94,2.17 - 29.0）, as well as those with a serum uric acid of 〉 50% （13.2,3.35 - 51.8）. However, we did not find significant association between serum uric acid level and the metabolic syndrome. Additionally ,284μmol/L is the most appropriate cut-off point to diagnose metabolic syndrome in the women. Conclusion Elevated serum uric acid level can be treated as a component of the metabolic syndrome in females.