中老年腹型肥胖患者血尿酸水平与代谢综合征相关性分析

Analysis of correlation between serum uric acid levels and metabolic syndrome in middle-aged and elderly patients with abdominal obesity

目的探讨中老年腹型肥胖患者血尿酸水平与代谢综合征(MS)的相关性。方法以参加REACTION研究(广西部分)回访的腹型肥胖患者为研究对象。所有患者都有完整的问卷调查、体检和血清学检查资料。比较不同尿酸水平代谢综合征患病率的差异,并用Logistic回归模型分析尿酸水平与MS患病风险之间的关系。结果对入选的379例腹型肥胖患者进行分析,男141例,女238例,年龄43.1~86.1岁,平均(62.3±9.7)岁。超重/肥胖(BMI≥25 kg/m2)患者272名,占总人数的71.77%(272/379)。高尿酸血症总体患病率为28.23%(107/379),其中男性患病率为47.52%(67/141),女性患病率为16.81%(40/238),男性患病率高于女性(χ2=41.216,P<0.001)。MS总体患病率为59.10%(224/379),其中男性患病率为66.67%(94/141),女性患病率为54.62%(130/238),男性患病率高于女性(χ2=5.314,P=0.021)。男性患者按尿酸水平四分位分组,MS患病率分别为60%、71.42%、62.85%、72.22%,各组患病率差异无统计学意义(P>0.05);女性患者按尿酸水平四分位分组,MS患病率分别为36%、58.33%、56.66%、66.67%,第1四分位与第2、3、4四分位患病率差异有统计学意义(P值分别为0.013、0.021、0.001)。Logistic回归分析提示,经校正年龄后,男性患者尿酸水平与MS患病率无统计学关联(P=0.609);女性患者尿酸水平和MS呈正相关(OR值1.045,P=0.005)。女性患者尿酸处于第2四分位(291.2~332.0μmol/L)、第3四分位(332.0~395.3μmol/L)和第4四分位(>395.3μmol/L)MS患病率是第1四分位(<291.2μmol/L)的2.3、2.2、3.2倍(P值分别为0.034、0.046、0.003)。结论尿酸水平与MS在腹型肥胖患者中存在性别差异,女性患者尿酸水平与MS患病率密切相关。

Objective To investigate relationship between serum uric acid levels and metabolic syndi, ome（MS）in abdom-inal obesity patients.Methods Obesity patients who were paid return visit in the REACTION study （ part of Guangxi） were selected as study objects.All patients had complete questionnaires,physical examinations and serological tests data.Then,the prevalence of metabolic syndrome was compared among different uric acid levels,and the relationship between uric acid levels and the risk of MS was analyzed by Logistic regression model.Results 379 abdominal obesity patients were analyzed, 141 of them were males and 238 were females,ages ranged from 43.1 to 86.1 years, mean（62.3±9.7）years.There were 272 over- weight/obese（ BMI ≥25 kg/m^2）patients, accounting for 71.77% of the total number（272/379） .The overall prevalence of hy-peruricemia was 28 .23%（107 /379 ） ,among which the prevalence of males was 47.52%（67/141） ,and that of females was 16 .81%（40 /238 ） , that of males was higher than that of females（χ^2 = 41 .216 ,P〈0 .001） .The overall prevalence of MS was 59 .10%（224 /379 ） , among which the prevalence of males was 66.67%（94 /141 ） , and the prevalence of females was 54.62% （130/238） ,that of males was higher than that of females（χ^2 = 5.314 ,P = 0.021）.Male patients were divided into quartile groups according to uric acid levels,the prevalence of MS was 60%, 71.42%, 62.85% and 72.22%, respectively, difference was not statistically significant among each group（P〉0.05） .Female patients were also divided into quartile groups based on uric acid 1eve1s,the prevalence of MS was 36% ,58.33% ,56.66% and 66.67% respective1y,there was statistically significant difference between the prevalence at the first quartile, the second quartile, the third quartile and the fourth quartile （ P was 0.013,0.021 and 0.001） .Logistic regression analysis showed that the levels of uric acid in male patients were not statistically related to the prevalence of MS after correcting for a ge （P= 0.609 ） .The uric acid levels in female patients were positively cor-related with MS （ OR was 1.045 , P=0.005 ） . The prevalence of uric acid in female patients at the second quartile （291 .2- 332.0μmol/L） ,the third quartile（332.0- 39.5.3 μmol/L） and the fourth quartile（ 〉395.3 μmol/L） was 2 .3,2.2 and 3.2 times of that（ 〈291.2μmol/L） at the first quartile（ P = 0.034,0.046 and 0.003,respectively） .Conclusion There are gender-related differences in the correlation between uric acid level and MS in patients with abdominal obesity,and the u-ric acid levels in female patients are closely related to the prevalence of MS.