山东内陆地区高尿酸血症的流行现状及影响因素分析

Prevalence and risk factors of hyperuricemia in Shandong Province

目的研究山东内陆地区≥20岁居民血尿酸（血清尿酸,SUA）水平、高尿酸血症（hyperuricemia,HUA）的流行及其影响因素。方法采用随机、分层抽样方法选取2012年1月-2012年12月期间11 234例健康查体人群,询问既往史和个人史,测量身高、体质量和血压,检测肝功、肾功和生化等指标。多元线性回归分析相关变量对SUA的影响程度,logistic回归分析HUA的危险因素。结果 HUA的患病率为15.71%,男、女性患病率分别为18.89%、6.31%。男性年龄〉50岁组SUA水平和HUA患病率均低于男性〈50岁组,女性HUA患病率随着年龄增加而升高,各年龄组内男性SUA水平均高于女性（P〈0.001）,20-34岁、35-49岁、50-64岁3个年龄组男性HUA的患病率均高于女性,〉64岁组女性HUA的患病率高于男性。血肌酐（SCr）对男女性SUA影响最大（β男=0.229、β女=0.200）。饮酒、甘油三酯（TG）、肥胖、高血压、BCr、血尿素氮（BUN）、丙氨酸转氨酶（ALT）和谷氨酰转肽酶（GGT）是男性HUA患病的独立危险因素,高血压、TG、低密度脂蛋白、BCr、BUN、ALT与女性HUA密切相关。结论山东内陆地区居民HUA患病率较高,饮酒、肥胖、高血压、血脂异常、肝功和肾功指标异常等都增加HUA发病风险,因此减少饮酒,控制体质量、血压等对预防HUA极为重要。

Objective To analyze the prevalence and risk factors of the hyperuricemia （HUA）in the adult population （aged ≥20）in Shandong Province. Methods A cross-sectional survey was conducted among 11 234 subjects（ 8399 males and 2835 females）selected in a randomized, stratified study between January and December of 2012. The serum samples were collected and some biochemical indicators were assayed including serum uric acid（SUA） , glucose, blood lipids, liver function and renal function. The body height, body mass and blood pressure were also measured, and the body mass index （BMI） was calculated. Multiple linear regression was used to clarify the contributions of different variables to SUA. The risk factors of HUA were analyzed using univariate and multivariate logistic regression analysis. Results The overall incidence of HUA was 15.71% , and was 18. 89% in men and 6.31% in women, respectively. After age 35, the level of SUA declined with age in males. However, the opposite was true in women. Our results also indicated that drinking, obesity, hyper-triglyeeridemia, hypertension, serum creatinine （ SCr ）, blood urea nitrogen （ BUN ）, alanine aminotransferase （ALT）, serum gamma-glutamyltransferase （GGT） were associated with HUA in men while hypertension, low-density lipoprotein, hyper-triglyceridemia,ALT,SCr and BUN were related to HUA in women. Conclusion HUA is prevalent in Shandong Province. Drinking, obesity, hypertension, abnormal liver and renal functions might increase the risk of HUA while changing lifestyle by decreasing alcohol consumption, adopting a proper diet and controlling hypertension and obesity might decrease the risk of HUA.