云南高原地区城区居民高尿酸血症发病情况及与慢性肾脏病的相关性研究

Study on the prevalence of hyperuricemia and its relationship with chronic kidney disease in the urban residents of Yunnan plateau area

目的了解云南高原地区居民高尿酸血症（hyperuricemia，HUA）发病情况及其与慢性肾脏病（chronickidneydisease，CKD）的关系。方法对玉溪市城区成年原住居民（n=4581）进行横断面调查，收集晨尿及抽取空腹血液检测尿液、血生化指标。结果玉溪市城区居民中HUA患病率为25．91％，其中男性患病率为34．15％，女性为15．55％，男性高于女性，差异有统计学意义（P〈0．01）。在30～49岁年龄段HUA患病率高于其他年龄段（P〈0．01）。多元Logistic回归分析显示，HUA、年龄、性别、高血糖、低高密度脂蛋白血症与CKD发病独立相关（P〈0．05），并且根据血尿酸四分位分组后高血尿酸（≥404μmol／L）组CKD的风险是低血尿酸（≤282μmol／L）组的3．447倍（OR=3．447，95％C／2．218—5．375，P〈0．01）。结论HUA与CKD发病独立相关。云南高原地区城区居民HUA患病率不同于东部沿海地区流行病学研究报道及最近10年国内一些发达地区的研究报道。

Objective To investigate the prevalence of hyperuricemia （HUA） and its relationship with chronic kidney disease （CKD） among the population of Yunnan Plateau area. Methods Residents aged over 18 years old （n=4581） in the city of Yuxi, a community where original inhabitants were relatively concentrated, were randomly chosen for screening cross-sectional. Fasting blood and urine samples were collected to detect blood and urine parameters. Results The prevalence of HUA in the community residents was 25.91%, of which the prevalence of HUA was 34.15% in male and 15.55% in female. The prevalence of HUA in men was higher than that in women, and the difference was statistically significant （P 〈 0.01）. In the age of 30-49 years old, the prevalence of HUA was higher than that in other age groups （P 〈 0.01）. Multivariate logistic regression analysis showed that HUA, age, gender, hyperglycemia, low HDL levels were independently associated with CKD （P 〈 0.05）. In addition, high blood uric acid （≥404 μmol/L） group has a higher risk of CKD than low blood uric acid （≤282 μmol/L） group, when divided into four groups according to the blood uric acid level （OR=3.447, 95% CI 2.218- 5.375, P〈0.01）. Conclusions HUA is independently associated with CKD. The prevalence of HUA in community residents of Yunnan Plateau （Yuxi） is different from their counterparts in eastern coastal area and the data of developed regions reported by studies in past 10 years.