血尿酸水平与某干部人群发生慢性肾功能不全风险的相关性研究--以人群为基础的前瞻性研究

Association between serum uric acid and early kidney damage in an sample of office workers——apopulationbased prospective study

目的观察血尿酸（SUA）与发生慢性肾功能不全（CRF）风险的相关性。方法选取2009年3月于我院健康查体中显示血肌酐（Scr）水平正常,且完成3年随访者1181名为研究对象。根据SUA水平分为C1（480μmol/L）组79例。比较各组CRF发病情况,并分析发生CRF的危险因素。结果与C1组比较,其他各组TC[（4.91±0.93）vs（5.81±1.01）,（5.28±0.83）,（5.25±1.22）mmol/L]和TG[（1.11±0.58）vs（2.97±1.06）,（2.13±1.26）,（1.65±1.19）mmol/L]升高（P〈0.05）。男性新发CRF患者在C1~C4组中所占比例分别为4.47%、12.13%、13.31%和14.72%;女性分别为2.17%、4.96%、18.21%和36.43%。多因素Logistic回归分析结果显示,校正年龄、BMI、SBP、DBP等因素影响后,SUA升高是CRF发病的独立危险因素。结论 SUA升高是该研究中某干部人群发生CRF的独立危险因素。

Objective To investigate the association between serum uric acid（SUA）and the risk of chronic renal insufficiency（CRF）. Methods A population of office employees underwent medical examination in March 2009 in our hospital.1,181 with normal serum creatinine（Scr）completed three years of follow-up.All these subjects were divided into four groups according to the levels of SUA：C1group（n=726,SUA360μmol/L）,C2group（n=253,SUA 360~420μmol/L）,C3group（n=123,SUA420~480μmol/L）,C4group（n=79,SUA480μmol/L）.eGFR was calculated according to MDRD（modification of diet in renal disease）equation.Early kidney damage was defined as eGFR ≤ 89[ml/（min·1.73m2）].The incidence of CRF in each group and the risk factors were compared and analyzed. Results Compared with C1 group,the levels of TG[（1.11±0.58）vs（2.97±1.06）,（2.13±1.26）,（1.65±1.19）mmol/L]and TC [（4.91±0.93）vs（5.81±1.01）,（5.28±0.83）,（5.25±1.22）mmol/L]were higher than those in C2,C3 and C4group（P〈0.05）.Newly diagnosed CRF in men of C1,C2,C3 and C4groups were 4.47%,12.13%,13.31% and 14.72% respectively.Newly diagnosed CRF in women of 4groups were 2.17%,4.96%,18.21% and 36.43% respectively.Logistic regression analysis with adjustment for age,gender,waist,and body mass index showed that hyperuricemia was an independent risk factor of CRF. Conclusion SUA is an independent risk factor of early kidney damage in this population of office workers.