老年人尿酸水平与颈动脉粥样硬化斑块形成的相关性研究

Correlation between uric acid level and carotid atherosclerosis plaque formation in the elderly

目的探讨老年人群血尿酸水平和颈动脉内膜厚度（IMT）增加的相关性。方法收集北京某三甲医院老年及中年体检者常规数据。对老年组（≥60岁）按照IMT正常（255例）和斑块形成（201例）分成两组，分析老年体检人群血尿酸、血糖、血脂等指标和颈动脉内膜增厚的关系。用Logistic回归和线性回归进一步分析导致IMT增厚的相关因素及影响尿酸增高的因素。结果老年组较中年组高尿酸血症发生率高，差异有统计学意义（P〈0．01）。老年组IMT正常组和斑块形成组尿酸分别为（350．6±89．6）μmol／L和（359．6±86．6）μmol／L，差异有统计学意义（t=5．19，P〈0．05）。内膜正常组和斑块形成组体质指数[（25．3±3．6）kg／m^2和（25．8±3．5）kg／m^2]、血压[收缩压（115．9±13．8）mmHg（1mmHg=0．133kPa）和（126．8±16．9）mmHg、舒张压[（74．6±11．3）mmHg和（77．8±12．1）mmHg]、血尿素[（4．9±1．2）μmol／L和（5．4±1．3）μmol／L]、胆固醇[（4．9±0．9）mmol／L和（5．0±1．0）mmol／L）、高密度脂蛋白胆固醇[（1．2±0．3）mmol／L和（1．2±0．3）mmol／L]，差异有统计学意义（均P〈0．01）。多因素相关性分析显示，内膜增厚与性别、收缩压、低密度脂蛋白胆固醇、血糖有相关性，与尿酸水平无关。血尿酸水平与性别、吸烟、体质指数、三酰甘油、血糖、C-反应蛋白、高密度脂蛋白胆固醇相关。结论IMT斑块形成组较IMT正常组的血尿酸、体质指数、血压、血脂等明显升高；但血尿酸水平不能作为IMT病变的独立危险因素。

Objective To investigate the correlation between uric acid level and increase of carotid intima media thickness （IMT） in the elderly. Methods Clinical data of elderly and middle- aged people who took health physical examination from Jan. 2013 to Dec. 2014 in a 3A-level hospital in Beijing were collected. The elderly people were divided into IMT normal group and plaque group. Logistic regression and linear regression were used to analyze the related factors for IMT thickening and uric acid level. Results The occurrence rate of hyperuricemia had a significant difference between the elderly group and the middle-aged group （P〈0.01）. There were significant differences in uric acid level 〈（350.6_±89.6） μmol/L w （359.6±86.6） μmol/L, t=5.19, P〈0.05]. Body mass index （BMI）, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, blood urea, cholesterol, high density lipoprotein levels between the IMT normal group and plaque group were [（25. 3±3. 6）kg/m^2vs.（25.8±3.5） kg/m^2, （115.9±13.8） mmHg vs. （126.8±16.9） mmHg, （74.6±11.3） mmHg vs. （77.8±12.1） mmHg, （4.9±0.9） mmol/L w （5.0±1.0） mmol/L, （1.2±0.3） mmol/L vs. （1.2±0.3） mmol/L, all P〈0.01]. Multi-factor correlation analysis showed that the IMT thickening was correlated with gender, SBP, low density lipoprotein, blood glucose, while had no correlation with uric acid level. Blood uric acid level was related with gender, smoking, BMI, triglycerides, blood glucose, C-reactive protein, high-density lipoprotein. Conclusions Blood uric acid level, BMI, blood pressure and lipids are increased in the plaque group as compared with the IMT normal group. However, blood uric acid level can not be used as an independent risk factor for IMT lesions.