血尿酸水平与颈动脉内中膜厚度的研究

Relationship between Serum Uric Acid and Carotid Intima Media Thickness

目的探讨不同血尿酸水平与动脉硬化早期指标颈动脉内中膜厚度(cIMT)之间的关系。方法采用随机按年龄分层抽样方法,抽取≥40岁的某矿场工人5 440例,按照血尿酸水平进行分组,多因素分析血尿酸与cIMT的关系。结果 (1)5 294例研究对象纳入统计分析,非高尿酸组4 739例(89.5%),高尿酸组555例(10.5%)。(2)高尿酸组的年龄、cIMT、体质量指数(BMI)、收缩压(SBP)、对数转换后的甘油三酯(Log-TG)、总胆固醇(TC)、肌酐(Cr)的均值和饮酒、喜盐、锻炼比例均高于非高尿酸组,差别有统计学意义(P<0.05)。(3)多因素线性回归模型分析显示,校正相关因素后,血尿酸每增加1mg/dL,cIMT增加分别为:总人群0.01mm(95%CI:0.01~0.01,P<0.05),女性0.03 mm(95%CI:0.02~0.04,P<0.05),男性0 mm(95%CI:0.00~0.01,P=0.072)。(4)多因素Logistic回归分析结果显示,校正相关因素后,高尿酸组cIMT≥1mm的风险是非高尿酸组的倍数分别为:总人群是1.27倍(95%CI:1.01~1.60,P<0.05)、女性是1.99倍(95%CI:1.29~3.06,P<0.05)、男性是1.06倍(95%CI:0.81~1.39,P=0.67)。结论女性的血尿酸水平与cIMT增厚有关,高尿酸血症可能更易发生动脉硬化。

Objective To investigate the relationship between serum uric acid level and carotid intima media thickness as an early indicator of arterial stiffness.Methods A total of 5 440 cases of a mine workers aged ≥40 years were randomly divided into two groups according to the level of serum uric acid.The relationship between serum uric acid and cIMT was analyzed by multivariate analysis.Results （1）5 294 participants were included in the study：non-hyperuricemia group 4 739 cases （89.5%）,hyperuricemia group 555 cases （10.5%）.（2） Mean age,cIMT,BMI,SBP,Log-TG,TC,Cr levels,and percentage of drinking,high salt diet,and extent of exercise in the hyperuricemia group were higher than those in the non-hyperuricemia group and he difference was statistically significant（P〈0.05）.（3） Multiple linear regression showed that as serum uric acid increased by 1mg/dL after adjustment for relevant factors,carotid intima-media thickness increased in the following fashion：general population 0.01 mm （95%CI 0.01-0.01,P〈0.05）,women 0.03 mm （95%CI 0.02-0.04,P〈0.05）.and men 0.00 mm （95%CI 0.00-0.01,P=0.072）,respectively.（4） Logistic multivariate regression analysis showed that after adjustment for relevant factors,the risk of cIMT≥1 mm in the hyperuricemia group was higher than that in the non-hyperuricemia group.The ORs were 1.27 （95%CI 1.01-1.60,P〈0.05） in all participants,1.9 （95%CI 1.29-3.06,P〈0.05） in female participants,1.06 （95%CI 0.81-1.39,P=0.67） in male participants.Conclusions In women the level of serum uric acid is related to carotid intima media thickening,and hyperuricemia may more likely lead to develop atherosclerosis.