上海浦东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 A Community Population of Pudong District in Shanghai

目的:探讨上海浦东地区常住人群中高尿酸血症的患病率及与慢性肾脏病危险因素的关系。方法:对上海浦东地区一个社区中1 024例常住居民进行问卷调查、尿酸、肌酐及慢性肾脏病相关危险因素的检测。采用多因素Logistic回归分析高尿酸血症发生的影响因素。本研究中以尿酸>420μmol/L(男性)、>360μmol/L(女性)定义为高尿酸血症。结果:在1 024例资料完整的居民中,年龄(56±14)岁,男女比例为404∶620,CKD患者为116例,高尿酸血症患者为182例(17.77%),其中非CKD患者为34例(18.58%),CKD患者为148例(81.42%),且CKD患者中女性高于男性;对高尿酸血症患者和非高尿酸血症患者CKD相关危险因素比较发现高尿酸血症患者年龄[(60±15)岁vs(55±13)岁,P<0.01]、SBP[(135±13)mm Hg vs(128±15)mm Hg,P<0.01]、DBP[(85.55±8.31)mm Hg vs(82.99±8.55)mm Hg,P<0.01]、BMI(26.26±3.47)kg/m2vs(23.91±3.64)kg/m2,P<0.01]、腰/臀围比[(0.88±0.05)vs(0.86±0.06),P<0.01]、血BUN[(5.41±1.50)mmol/L vs(4.87±1.27)mmol/L,P<0.01]、血清肌酐[(127.83±36.56)μmol/L vs(143.17±38.46)μmol/L,P<0.01]高于非高尿酸血症组,e GFR[(127.83±36.56)ml·min-1·1.73 m-2vs(143.17±38.46)ml·min-1·1.73 m-2,P<0.01]低于非高尿酸血症组,且高血压病(P<0.01)、心血管病(P=0.04)和高脂血症(P<0.01)比例高于非高尿酸血症患者。单因素回归分析显示年龄、SBP、DBP、BMI、腰/臀围比、BUN、血肌酐、Hb和e GFR与尿酸水平具有相关性;多因素Logistic回归显示性别、SBP、BMI和血肌酐以及高脂血症与高尿酸血症发生独立相关。结论:在上海社区人群中,高尿酸血症的患病率为17.77%,随着CKD的进展,高尿酸血症的发病率增加;相关危险因素包括性别、SBP、BMI、腰/臀围比、血肌酐。

Objective：To investigate the Prevalence of hyperuricemia and the relationships between hyperuricemia and the chronic kidney disease in adult residents of Pudong New Area, Shanghai. Methods： 1 024 residents were randomly selected from a community of Pudong district. Questionnaires and laboratory test were taken. Risk factors for hyperuricemia was analyzed by multivariate logistic. Hyperuricemia was defined by gender - specific criteria of serum UA 〉 420 μmol/L in males and 〉 360 μmol/L in females. Results：We included 1 024 residents. The average age was 56 ± 14 years old. The male to female ratio was 1： 1.53. The overall prevalence of hyperuricemia was 17.77% and CKD was 81.42%. Participants with HUA typically had higher age[ （60 ± 15 ） vs （55 ± 13） years old, P 〈 0.01 ], higher SBP[ （ 135 ± 13 ） vs （ 128 ± 15） mmHg, P 〈 0.01 ], DBP[ （85.55 ± 8.31 ） vs （82.99 ±8.55） mmHg, P〈0.01], BMI[（26.26 ±3.47） vs （23.91 ±3.64） kg/m^2, P〈0.01], WHR[（0.88 ±0.05） vs （0.86 ± 0.06）, P〈0.01], BUN[（5.41 ±1.50） vs （4.87±1.27） μmol/L, P〈0.01], Ser[（127.83±36.56） vs （143.17±38.46） μmol/L, P〈0. 01], lowereGFR[（127.83±36.56） vs （143.17±38.46） ml·min^-1 ·1.73m^-2, P〈0. 01]. Also, they had higher percentage of hypertension （ P 〈 0.01 ）, hyperlipidemia （ P = 0.04 ） and cardiovascular diseases （ P 〈 0.01 ）. Univariate analysis showed that HUA was associated with age, SBP, DBP, BMI, WHR, BUN, Ser, Hb and eGFR. Multivariate logistic regression analysis showed that gender, SBP, BMI and Set were independent factors for HUA. Conclusion：The prevalence of HUA in community of Shanghai was 17.77%. With the CKD progression, the prevalenee of HUA increased. The risk factor for HUA included gender,SBP, BMI, WHR and Scr.