体检人群血尿酸水平与肱踝脉搏波传导速度的关系研究

Relationship of Serum Uric Acid to ba-PWV of Healthy Subjects: Report of 3127 Cases

目的探讨体检人群血尿酸(SUA)水平与肱踝脉搏波传导速度(ba-PWV)之间的关系。方法选择2009年10月—2011年12月来我院体检的健康体检者3 127例为研究对象,其中男2 095例、女1 032例;年龄35～64岁。测量身高、体质量、血压;检测空腹SUA、血糖、血脂和ba-PWV。以受检者ba-PWV值<1 400 cm/s为正常,1 400～1 599 cm/s为轻度增快,1 600～1 799 cm/s为中度增快,≥1 800 cm/s为重度增快,对比不同ba-PWV组人群的SUA水平。以SUA水平男性≥420μmol/L、女性≥350μmol/L定为高尿酸血症(HUA),比较各组HUA检出率。将SUA水平与ba-PWV进行相关性分析;采用多因素逐步回归分析评价ba-PWV的影响因素。结果 ba-PWV正常组、轻度增快组、中度增快组和重度增快组的SUA水平分别为(360.7±100.1)、(394.0±97.5)、(390.4±100.1)和(414.0±118.9)μmol/L,4组间SUA水平差异有统计学意义(F=30.514,P=0.000)。男性SUA水平为(412.6±91.7)μmol/L,高于女性的(294.6±70.0)μmol/L(P=0.000)。各ba-PWV组中的男性SUA水平均高于女性(P<0.05)。4组受检者HUA的检出率分别为30.6%、40.9%、41.0%和53.1%,差异有统计学意义(P=0.000)。男性HUA检出率(43.7%)高于女性(17.2%,P=0.000)。男性SUA水平与ba-PWV无线性相关性(r=0.043,P>0.05);女性SUA水平与ba-PWV呈正相关(r=0.248,P<0.05)。以年龄、身高、体质量、收缩压、舒张压、空腹血糖、SUA、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、肌酐水平为自变量,以ba-PWV为因变量进行多因素逐步回归分析,结果显示收缩压、年龄、空腹血糖、SUA、体质量、TG、肌酐对ba-PWV的影响有统计学意义(P<0.05)。结论成年人尤其是成年女性SUA水平增高与ba-PWV增快相关,对存在心血管疾病及其危险因素的成人应重视SUA和ba-PWV的检测。

Objective To explore the relationship between serum uric acid（SUA） and brachial ankle pulse wave velocity（ba-PWV） in subjects having health examinations.Methods A total 3 127 healthy subjects,2 095 males and 1 032 females,aged between 35 and 64 years old,were enrolled in this study.Height,weight,blood pressure were measured and fasting SUA,fasting plasma glucose（FPG）,blood fat and ba-PWV were detected.The subjects were divided into groups A（ba-PWV 1 400 cm/s,normal）,B（ba-PWV = 1 400～1 599 cm/s,slightly faster）,C（ba-PWV = 1 600～1 799 cm /s,moderately faster）,D（ba-PWV 1 800 cm / s,severely faster）.SUA levels were compared among 4 groups.Males with SUA≥420 μmol / L and females with SUA≥350 μmol / L were defined as hyperuricemia（HUA）.HUA detection rates were compared in 4 groups.SUA levels and ba-PWV were analyzed correlatively and multivariate regression analysis used to evaluate the influencing factors of ba-PWV.Results The SUA levels of groups A,B,C,D were（360.7 ± 100.1） μmol / L,（394.0 ±97.5） μmol/L,（390.4 ± 100.1） μmol/L,（414.0 ± 118.9） μmol/L,respectively,the difference was significant（F = 30.514,P = 0.000）.SUA of males was（412.6 ± 91.7） μmol / L,significantly higher than that of females 〔（294.6 ± 70.0） μmol/L,P = 0.000〕.HUA detection rates of groups A,B,C,D were 30.6%,40.9%,41.0%,53.1%,respectively,the difference was significant（P = 0.000）,those of males（43.7%） higher than those of females（17.2%,P =0.000）.SUA was not correlated linearly with ba-PWV in males（r = 0.043,P〈0.05）,but positively with ba-PWV in females（r = 0.248,P〈0.05）.Taking ba-PWV as independent variables,age,height,weight,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,FPG,uric acid,TC,TG,HDL-C,LDL-C,Cr as dependent variables,multivariate stepwise regression analysis showed that there was significant difference in effects of SBP,age,FPG,uric acid,body mass,TG,Cr on ba-PWV（P〈0.05）.Conclusion Increased SUA level in adults especially in females is correlated with faster ba-PWV.Attention should be paid to SUA and ba-PWV determinations in adults having cardiovascular disease or its risk factors.