内蒙古自治区鄂尔多斯市某公司人群连续四年尿酸水平调查及相关因素分析

Survey for four consecutive years uric acid levels and related factors in a company in the Ordos region population

目的 分析鄂尔多斯地区某公司固定人群血尿酸水平变化趋势及影响因素,为临床诊疗提供依据.方法 选择鄂尔多斯地区某公司固定人群,用整群抽样的方法对该公司2013-2016年共计2 911例进行调查,分析连续4年尿酸水平,并与该地区早年结果进行比较,同时分析影响尿酸的因素.结果 采用单因素ANOVA统计分析,四年内被调查者男性不同年份之间：F（1.254,5.018） =6.612,P=0.046;不同年龄组之间：F（4.000,12.000）=25.920,P＜0.000;女性不同年份之间：F（1.768,7.073）=257.30,P＜0.000;不同年龄组之间：F（4.000,12.000） =202.200,P＜0.000.与早年结果比较,男性被调查者2009年、2011年、2016年间比较：F（1.069,4.277）=101.700,P=0.000;不同年龄组之间：F（4.000,8.000）=11.650,P=0.002;女性被调查者2009年、2011年、2016年间比较：F（1.851,7.403）=141.800,P＜0.000;不同年龄组之间：F（4.000,8.000）=13.480,P=0.001,差异均有统计学意义.采用Cox-Staut趋势性检验,对2013-2016年被调查者患病率进行统计,男性粗患病率分别为20.32％、25.29％、27.32％、28.46％,x2=12.768,P＜0.05;男性标化患病率分别为19.73％、23.66％、25.67％、26.52％,x2=13.441,P＜0.05;女性粗患病率分别为5.59％、6.88％、7.62％、7.98％,x2=18.435,P＜0.05;女性标化患病率分别为5.32％、5.97％、7.01％、7.11％,x2=19.325,P＜0.05.将被调查者以血尿酸水平进行划分,对17项内容进行独立样本t检验分析,BMI、教育水平、饮食、吸烟、饮酒、血糖、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）差异均有统计学意义（均P＜0.05）.对被调查者高尿酸血症（HUA）相关因素进行非条件Logistic回归分析,性别（OR=17.129,95％CI2.795 ～ 104.970,P＜0.01）、BMI（OR=17.129,95％CI2.795～104.970,P＜0.01）、饮酒（OR=9.467,95％ CI2.235 ～40.094,P＜0.01）、吸烟（OR =6.581,95％CI1.674～25.865,P＜0.01）、LDL（OR=14.978,95％ CI1.826 ～ 122.863,P＜0.05）、糖化血红蛋白（HbA1c）（OR=21.403,95％CI1.417～323.395,P＜0.05）是HUA的高风险因素.结论 该公司人群血尿酸水平近年来显著升高,影响血尿酸的因素繁多,应加强健康教育及重视HUA的诊疗.

Objective To analyze the trend and influencing factors of serum uric acid level in a fixed population in Erdos area,to provide a basis for clinical diagnosis and treatment.Methods Chose a fixed population of a company in Ordos region,the cluster sampling method was used to investigate a total of 2911 people of the company from 2013 to 2016.The levels of uric acid were analyzed for 4 consecutive years and compared with the results of the early years of the region,and the factors influencing uric acid were analyzed.Results One-way ANOVA statistical analysis showed that within four years the period between the male respondents in different years：F（1.254,5.018） =6.612,P =0.046;between different age groups：F （4.000,12.000） =25.920,P ＜ 0.000;female between different years：F（1.768,7.073） =257.300,P ＜ 0.000;between different age groups F（4.000,12.000） =202.200,P ＜ 0.000.Compared with the early results,male respondents between 2009,2011,2016 comparison：F（1.069,4.277） =101.700,P =0.000;between different age groups：F （4.000,8.000） =11.650,P =0.002;female respondents between 2009,2011,2016 comparison：F （1.851,7.403） =141.800,P ＜ 0.000;between different age groups F（4.000,8.000） =13.480,P =0.001,there were significant differences.The Cox-Staut trend test was used to analyze the prevalence of the respondents in 2013-2016,male crude prevalence rates were 20.32％,25.29％,27.32％,28.46％,respectively,x2 =12.768,P ＜0.05;male standardized prevalence rates were 19.73％,23.66％,25.67％,26.52％,respectively,x2 =13.441,P ＜ 0.05;female crude prevalence rates were 5.59％,6.88％,7.62％,7.98％,respectively,x2 =18.435,P ＜ 0.05;female standardized prevalence rates were 5.32％,5.97％,7.01％,7.11％,respectively,x2 =19.325,P ＜ 0.05.The subjects were divided into blood uric acid levels,an independent sample t test was performed on 17 items,BMI,education level,diet,smoking,drinking,GLU,TC,LDL-C had statistically significant differences （all P ＜ 0.05）.Non-conditional logistic regression analysis was performed on the relevant factors of hyperuricemia （H UA）,sex （OR =17.129,95 ％ CI：2.795 ～ 104.970,P ＜ 0.01）,BMI （OR =17.129,95％ CI：2.795 ～ 104.970,P ＜ 0.01）,drinking （OR =9.467,95 ％ CI：2.235 ～ 40.094,P ＜ 0.01）,smoking （OR =6.581,95％ CI：1.674 ～ 25.865,P ＜ 0.01）,LDL （OR =14.978,95％ CI：1.826 ～ 122.863,P ＜ 0.05）,HBA1C（OR=21.403,95％CI：1.417 ～323.395,P＜0.05） were high risk factors for HUA.Conclusion In recent years,the blood uric acid level has increased significantly,many factors affect blood uric acid should be strengthened emphasis on health education and treatment of HUA.