健康体检人群性别和血尿酸与肱-踝脉搏波速度的关系

Influence of gender on association between serum uric acid and branchial-ankle pulse wave velocity measurement

目的探讨不同性别健康体检人群血尿酸与肱一踝脉搏波速度（baPWV）的关系。方法采用横断面研究的方法对1418例常规健康体检者收集生化指标，并测量baPWV。BaPWV≥1400cm／s定义为baPWV异常。分别根据男女性血尿酸水平的四分位数，将人群分为4组（Q1、Q2、Q3和Q4组）。Spearman相关分析不同性别血尿酸水平与baPWV的关系。在女性logistic回归分析血尿酸水平与baPWV异常的关系。结果男性和女性均有舒张压、空腹血糖、三酰甘油和体质指数随血尿酸水平增高而增高；高密度脂蛋白一胆固醇随血尿酸水平增高而降低。女性收缩压、总胆固醇和低密度脂蛋白-胆固醇水平和baPWV水平亦随血尿酸增高而升高，差异有统计学意义。相关分析显示女性血尿酸与baPWV显著正相关（r=0．18，P〈0．05），男性血尿酸与baPWV未见相关（r=-0．05，P=0．16）。对女性人群单因素logistic分析结果表明，与血尿酸最低4分位组相比，最高4分位组baPWV异常的发病相对风险OR=2．69（95％CI1．68～4．29）。在校正肌酐和估算肾小球滤过率后，血尿酸第4分位组相对第1分位组baPWV异常的相对风险OR=2．45（95％CI1．48～4．06）。进一步用年龄和MS各组分校正后血尿酸与baPWV相关性消失OR=1．15（95％CI0．56～2．37）。结论女性血尿酸水平与baPWV异常的相关依赖于年龄和MS的组分。

Objective To determine the influence of gender on the association between serum uric acid and branchial-ankle pulse wave velocity （baPWV）. Methods Cross-sectional data from 1418 adults who underwent routine laboratory tests and baPWV measurements were analyzed in a gender-specific manner. BaPWV i〉 1400 cm/s was defined as abnormality. The individuals were assigned to four groups （ Q1, Q2 ,Q3 and Q4 ） according to the gender-specific quartiles of serum uric acid. The relationship between serum uric acid and the haPWV values was assessed by Spearman＇s correlation coefficients. In female, the relationship of serum uric acid quartiles with baPWV was evaluated by logistic regression analysis. Results In male and female, diastolic blood pressure, fasting blood glucose, triglyceride and body mass index were increased with serum uric acid level, in contrast to high-density lipoprotein cholesterol. The Spearman＇s correlation coefficient for the relationship between serum uric acid and baPWV was 0. 18 in female and - 0. 05 in male （ P = 0. 16 ）. In female, univariate logistic regression analysis showed that in comparison with group Q1, odds ratio （OR） value of baPWV abnormality of group Q4 was 2.45 （95% confidence interval （CI） 1.48 to 4. 06）. In multivariate logistic regression, after adjusting for creatine and estimated glomerular filtration rate, OR value of baPWV abnormality of group Q4 was 2.45 （95% CI 1.48 to 4.06） when compared with group Q1. However, after adjustment for age and other risk factors of cardiovascular diseases, there were no significant differents in ORs among serum uric acid quartile groups. Conclusions The association between serum uric acid level and haPWV in female may depend on age and metabolic syndrome components.