2016年川西北气田体检钻井工人高尿酸血症及影响因素

Prevalence and influencing factors of hyperuricemia among natural gas drilling workers in Northwest Sichuan gas field in 2016

目的了解川西北气田钻井工人体检人群高尿酸血症现状并探讨其影响因素。方法于2016年1—12月,以工作现场位于川西北气田(平均海拔2552 m)参加健康体检且符合纳入标准的1051名男性气田钻井工人为研究对象,检测血尿酸、空腹血糖、血脂、血清肌酐及血红蛋白等指标,从中随机抽取一个作业队食堂,采用称重法和24 h回顾法进行膳食调查。比较不同血尿酸水平研究对象的生化指标水平及膳食摄入状况,用Logistic回归模型分析高尿酸血症的影响因素。结果 (1)2016年川西北气田体检钻井工人中检出高尿酸血症513人,检出率为48.8%。(2)高尿酸血症组研究对象血糖、血清总胆固醇、甘油三酯、肌酐和血红蛋白平均水平高于血尿酸正常组(P<0.05)。糖尿病、高胆固醇血症、高甘油三酯血症、血清肌酐及血红蛋白增高者发生高尿酸血症的危险度分别是血糖、血脂、血清肌酐和血红蛋白正常者的3.57(95%CI 2.45～4.67)、2.88(95%CI 1.99～4.16)、1.93(95%CI 1.30～2.86)、1.61(95%CI 1.01～2.51)和2.54(95%CI 2.11～3.36)倍(P<0.05)。(3)高尿酸血症组研究对象畜禽肉[(239.7±30.2)g]、油脂[(37.6±10.8)g]和食盐[(8.9±4.1)g]的摄入量高于血尿酸正常组[分别为(203.3±21.8)、(32.4±9.6)和(7.4±2.7)g],蔬菜[(167.7±126.8)g]、奶及奶制品[(73.6±32.9)g]、维生素B_2[(0.7±0.2)g]、维生素B_6[(0.4±0.1)g]、维生素B_(12)[(1.0±0.3)g]的摄入量低于血尿酸正常组[分别为(246.3±138.7)g、(91.4±38.1)g、(0.9±0.1)g、(0.6±0.1)g和(1.4±0.4)g](P<0.05)。蔬菜的摄入是高尿酸血症的保护因素[0.82(95%CI 0.65～0.93)],蛋白质[(1.47(95%CI 1.16～2.28)]、脂肪[2.34(95%CI 2.01～3.22)]的摄入是其危险因素。结论 2016年川西北气田钻井工人高尿酸血症患病率较高,与糖尿病、高胆固醇血症、高甘油三酯血症、血清肌酐及血红蛋白增高有关,也与脂肪摄入过多等膳食因素有关。

OBJECTIVE To investigate the prevalence and influencing factors of hyperuricemia among natural gas drilling workers in Northwest Siehuan gas field. METHODS A census of 1051 natural gas drilling workers in Northwest Sichuan gas field at an average altitude of 2552 meters was conducted in the survey,the serum uric acid,fasting blood glucose,blood lipid,creatinine and hemoglobin were detected.A staff canteen was randomly selected and the method of weighing and 24-hour dietary review were used for dietary survey.The blood biochemical level and dietary intake of subjects with different blood uric acid levels were compared,and the influencing factors of hyperuricemia were analyzed by Logistic regression model.RESULTS (1)There were 513 hyperurieemia patients in natural gas drilling workers,with a detection rate of 48.8%. (2)The levels of fasting blood glucose,total cholesterol i triglyceride,creatinine and hemoglobin in the hyperuricemia group were higher than those in the normouricemia group. The risk of hyperurieemia in patients with diabetes,hypercholesterolemia, hypertriglyceridemia,elevated serum ereatinine and hemoglobin were 3.57 (95%CI 2.45-4.67),2.88(95%CI1.99-4.16),1.93(95%CI1.30-2.86),1.61(95%CI 1.01- 2.51)and 2.54 (95%CI 2.11-3.36)times of normal fasting blood glucose,blood lipid, serum ereatinine and hemoglobin,respectively (P<0.05).(3)The intakes of meat,oil and salt in the hyperuricemia group were higher than those in the normouricemia group, while the intakes of vegetables,milk products and vitamin B were lower than those in the normouricemia group (P<0.05 ).Intake of vegetable is a protective factor for hyperuricemia (0.82 (95 %CI 0.65-0.93 )),and intakes of protein (1.47 (95 %CI 1.16 -2.28 ))and fat (2.34(95%CI 2.01-3.22))are the risk factors.CONCLUSION Drilling workers in Northwest Sichuan gas field have a high prevalence of hyperuricemia and are related to diabetes,hypercholesterolemia,hypertriglyceridemia,elevated creatinine and hemoglobin, and too much protein,fat intake and too little vegetable intake.