经历唐山地震应激的胎儿及婴儿成年后的尿酸水平

Serum uric acid of adults with Tangshan earthquake exposure in fetus and infancy period

目的探讨胎儿期及婴儿期经历地震应激对成年期血尿酸水平的影响。方法本研究的受试者来自开滦矿业集团和石家庄钢铁厂职工，共纳入996人。根据暴露于地震情况分为胎儿期地震暴露组（326人）、婴儿期地震暴露组（307人）以及对照组（333人），对照组为同时期出生于石家庄市，未经历地震的人群。根据暴露的妊娠时期不同，胎儿期地震暴露组又分为3个亚组，1～3个月胎儿暴露组，4。6个月胎儿暴露组，7—9个月胎儿暴露组。比较3组之间尿酸水平、高尿酸血症的发生率。比较高尿酸血症组与非高尿酸血症组的一般基线资料。同时以是否高尿酸血症为因变量，以性别、体质指数（BMI）、吸烟、饮酒、高血压病、糖尿病、受教育程度、婚姻状况、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C）、甘油三酯（TG）、总胆固醇（TC）为自变量进行Logistic回归分析。结果与对照组相比，胎儿期与婴儿期地震暴露组尿酸水平均升高，组间比较差异有统计学意义（F=15．810，P〈0．01）；3组间高尿酸血症发生率比较差异有统计学意义（χ2=20．628，P〈0．01），胎儿期与婴儿期地震暴露组高尿酸血症发生率均高于对照组，并且胎儿期高于婴儿期地震暴露组；胎儿期地震暴露组各亚组间尿酸水平、高尿酸血症发生率比较差异无统计学意义（P〉0．05）；回归分析结果表明胎儿期（OR=2．895，95％CI=1．652～5．075）、婴儿期（OR=1．882，95％CI=1．044—3．394）经历地震应激是导致高尿酸血症的危险因素。结论早年经历地震应激是成年期高尿酸水平及高尿酸血症发生率升高的危险因素之一，尤其在胎儿期经历地震应激人群校为突出。

Objective To investigate the effect of exposure in fetus and infancy on serum uric acid levels and the prevalence of hyperuricemia in adults. Methods Totals of 996 workers from Kailuan Group and Shijiazhuang steelworks were included. All subjects were divided into 3 groups： fetal exposure group （n=326）, infancy exposure group （n=307） and control group （n=333） according to their earthquake exposure. Subjects in fetal exposure group were further divided into 3 subgroups： 1-3 months fetal exposure group, 4-6 months fetal exposure group and 7-9 months fetal exposure group. The levels of uric acid and incidence of hyperuricemia were compared among three groups. General baseline data were compared between hyperuricemia group and non-hypemricemia group. While hyperuricemia was ependent variable, contemporary body mass index（BMI）, smoking, drinking, hypertension, diabetes mellitus, education, marital status, high density lipoprotein cholesterol（HDL-C）, low density hpoprotein cholesterol （LDL-C）, Triglyceride（TG）, total cholesterol（TC）were independent variables, logistic regression analysis was analyzed. Results Compared with the control group, fetal exposure group and infancy exposure group showed significandy elevated serum uric acid （F=15.810, P 〈 0.01）. Incidence of hyperuricemia was significantly different among three groups （ χ2=20.628, P 〈 0.01）. Fetal exposure group and infancy exposure group had significantly higher incidence of hyperuricemia than control group. And fetal exposure group had higher incidence of hyperuricemia than infancy exposure group. No significant differences were found in levels of uric acid and incidence of hypenn＇icemia among three subgroups in fetal exposure group （P 〉 0.05）. Logistic regression analysis showed that fetal and infancy earthquake exposure were risk factors of hyperuricemia （OR=2.895, 95%CI=1.652-5.075; OR=1.882, 95%CI=1.044.- 3.394）. Conclusions Early earthquake stress experience is an important risk factor of adulthood high uric acid levels and hyperuricemia, especially pregnancy earthquake stress experience.