上海市浦东新区高尿酸血症流行状况及其危险因素研究

Prevalence and risk factors of hyperuricemia in Pudong new district of Shanghai

目的了解上海市浦东新区高尿酸血症(HUA)的患病率,探讨影响该地区人群血尿酸水平因素。方法于2013年1-7月采用多阶段分层随机抽样方法抽取9 294名20~80岁常住居民,并对其进行横断面调查,收集空腹静脉血检测血尿酸、血脂、血糖、肾功能等指标,同时进行问卷调查和体格检查。采用SPSS 22.0统计软件进行t检验、χ~2检验和logistic回归分析。结果调查对象HUA患病率为15.54%,其中男性为18.83%,明显高于女性(13.64%),差异有统计学意义(P<0.05)。男性在20~29岁年龄段HUA患病率最高(25.81%),之后随年龄增加患病率逐渐降低,50岁之后略有升高;女性HUA最高患病率出现在70~80岁年龄段(24.37%),40岁之后患病率明显升高;小学及以下学历者HUA患病率最高(18.62%),其次为高中教育程度者(16.22%);与生活行为习惯良好者相比,经常夜班、有吸烟和饮酒习惯的调查对象HUA患病率较高,差异均有统计学意义(P<0.01);有糖尿病、高血压、血脂异常、慢性肾病或向心性肥胖的调查对象HUA患病率分别为20.10%、22.46%、20.87%、21.43%和21.24%,明显高于无上述疾病状态的调查对象(分别为14.47%、10.81%、10.57%、14.12%和8.85%),差异均有统计学意义(P<0.01);肥胖者HUA患病率最高(29.17%),其次为超重者(16.71%),差异有统计学意义(P<0.01)。多因素分析显示,饮酒(OR=1.370,95%CI:1.151~1.631)、患高血压(OR=1.708,95%CI:1.512~1.930)、血脂异常(OR=1.712,95%CI:1.514~1.935)、慢性肾病(OR=1.546,95%CI:1.346~1.776)、超重和肥胖[OR值分别为1.461(95%CI:1.233~1.732)和2.498(95%CI:2.045~3.051)]以及向心性肥胖(OR=1.495,95%CI:1.273~1.755)为HUA的危险因素,女性(OR=0.768,95%CI:0.669~0.881)为HUA的保护因素。结论上海市浦东新区HUA患病率较高,年龄及性别差异影响HUA患病率,维持理想体质指数、血压及血脂水平等在防治HUA中起重要作用。

Objective To investigate the morbidity and risk factors of hyperuricemia （HUA） in Pudong new district of Shanghai for exploring the blood uric acid level of the residents.Methods During January-July of 2013,the multi-stage stratified random sampling method was used to select 9 294 residents （20-80 years old） for a cross-sectional study.The investigation was performed with questionnaire,physical examination and blood tests （uric acid,blood lipid,blood glucose and kidney function）.The t test,x2 test and logistic regression analysis were used to analyze the data with SPSS 22.0 software.Results The morbidity of HUA was 15.54%,male morbidity （18.83%） was significantly higher than female morbidity （13.64%） （P〈0.05）.The HUA morbidity （25.81%）of males （20-29 years old） was the highest for males,then male morbidity decreased with age until 50 years old.The female HUA morbidity increased after 40 years old,and the HUA morbidity （24.37%） of females （70-80 years old） was the highest for females.According to education levels,the HUA morbidity （18.62%） of residents with high school level （≤ primary school level） was the highest,secondly the HUA morbidity of residents with high school level was 16.22%.As compared with residents with good life style,the HUA morbidity of residents with smoking,drinking and night shift increased significantly （P〈0.01）.The HUA morbidities of residents with T2DM,hypertension,dyslipidemia,chronic kidney disease and c-obesity were 20.10%,22.46%,20.87%,21.43% and 21.24%,respectively,which were significantly higher than those （14.47%,10.81%,10.57%,14.12% and 8.85%） of residents without any disease （P〈0.01）.The HUA morbidity （29.17%） of residents with obesity was the highest,secondly the HUA morbidity of residents with overweight was 16.71% （P〈0.05）.Multivariable logistic regression analysis showed that drinking （OR=1.370,95%CI：1.151-1.631）,hypertension （OR=1.780,95%CI：1.512-1.930）,dyslipidemia （OR=1.712,95%CI：1.514-1.935）,chronic kidney disease （OR=1.546,95%CI：1.346-1.776）,overweight （OR=1.461,95%CI：1.233-1.732）,obesity （OR=2.498,95%CI：2.045-3.051） and c-obesity （OR=1.495,95%CI：1.273-1.755） were the independent risk factors of HUA,and female （OR=0.768,95%CI：0.669-0.881） was a protective factor of HUA.Conclusion The HUA morbidity in Pudong new district of Shanghai is higher,the differences of age and gender can influence the HUA morbidity.BMI,blood pressure and blood lipid play the important roles for preventing and treating HUA.