高尿酸血症和微量白蛋白尿分别与汉族女性正常高值血压相关

Associations of hyperuricemia and microalbuminuria with high-normal blood pressure in Chinese Han women

目的探讨女性人群中高尿酸血症和微量白蛋白尿与正常高值血压的关系。方法以年龄≥30岁的1773名汉族女性人群作为研究对象，采取调查问卷方式收集人口统计学特征和生活方式危险因素资料，测量身高、体质量和血压，检测血脂、血糖、尿酸和尿微量白蛋白。用有序多分类Logistic回归模型分析高尿酸血症和微量自蛋白尿与正常高值血压的关系。结果经多因素调整后，尿酸水平与正常高值血压或高血压的危险呈正相关。当微量白蛋白尿者和使用降压药物者被排除后，与尿酸最低分位者相比，其余分位者患正常高值血压的危险性明显增加[OR（95％CI）分别为1．23（O．90～1．69），1．54（1．11～2．13），2．25（1．59～3．20）]。多因素调整后，与正常血压者相比，正常高值血压中血压较高者（130～139／85～89mmHg）发生微量白蛋白尿的OR为1．85（95％ CI 1．16～2．93）。当糖尿病、高尿酸血症患者和使用降压药物者被排除后，发生微量白蛋白尿的危险随血压水平升高而增加的趋势依然存在（趋势性P〈0．01）。结论在中国汉族女性中，高尿酸血症和微量白蛋白尿分别与正常高值血压独立相关。

Objective To explore the associations of hyperuricemia and microalbuminuria with high-normal blood pressure. Methods A total of 1773 females aged over 30 from Han nationality were enrolled. Questionnaire sur vey was adopted to collect demographic characteristics and lifestyle risk factors. Height, body mass, blood pressure, lipids, blood glucose, uric acid, and microalbuminuria were measured. Multinomial and ordinal logistic re gression was used to analyze the associations of hyperuricemia and microalbuminuria with high-normal blood pressure. Results After multivariate adjustment, uric acid level was positively correlated with the incidence of high normal blood pressure or hypertension. After those with microalbuminuria or antihypertensive medication were excluded, patients with higher serum uric acid quartiles were more likely to have high-normal blood pressure than those with serum uricacidin thelowest quartile [OR（95%CI）： 1.23 （0.90-1.69）; 1.54（1.11-2.13）; 2.25（1.59-3.20）]. After multivariate adjustment, compared with normotensive population, high-normal blood pressure pa tients with higher blood pressure had evidently higher risk of microalbuminuria （OR, 95% CI 1.85, 1.16-2.93）. After subjects with diabetes, hyperuricemia and antihypertensive medication were excluded, the incidence of microalbuminuria was still positively associated with blood pressure level （P value for trend 〈0.01 ）. Conclusions Hyperuricemia and microalbuminuria are independently associated with high normal blood pressure in middle aged and elderly Han women of China.