尿酸的动态变化与代谢综合征的关联研究

The Correlation between Dynamic Changes of Uric Acid and Metabolic Syndrome

目的运用联合模型(Joint模型)分别探讨男性和女性尿酸(UA)值随时间的动态变化对代谢综合征(MetS)发生的影响,为MetS的预防提供依据。方法从辽宁省大连市某三甲医院健康体检中心收集2010年3月-2016年4月体检次数≥3的个体的体检数据,对男性和女性分别建立一般Cox模型和Joint模型,分析UA基线水平与纵向变化对MetS发生的影响。结果本研究最终有2317名健康体检者纳入分析。一般Cox模型结果显示,女性基线UA对数值(LNUA)与MetS发病呈正相关,基线LNUA每增加一个单位,发生MetS的危险性就增加3.6734倍(95%CI:1.6623,8.1180);Joint模型显示女性LNUA的纵向变化与MetS的发生呈正相关,个体LNUA每纵向增加一个单位,发生MetS的风险就增加9.2535倍(95%CI:1.3948,61.3962)。结论健康女性个体UA值的纵向增高会增加MetS发病风险,应关注女性个体UA值的动态变化,保持UA水平稳定,降低MetS发生的风险,而男性个体UA值与MetS的关联还有待于进一步研究。

Objective We aimed to explore the impact of dynamic changes of uric acid(UA)levels on the occurrence of metabolic syndrome(MetS)among male and female respectively by Joint model and to provide evidence for the prevention of MetS.Methods The subjects who underwent at least three annual health examinations during March 2010 to April 2016 in the health examination center of a hospital in Dalian City were enrolled in the cohort study.The general Cox model and the Joint model were established to analyze the effect of UA on the occurrence of MetS at the baseline and longitudinal levels in male and female populations.Results A total of 2,317 participants were included in the final analysis.The general Cox model results showed that the baseline logarithm UA(LNUA)in the female population was positively correlated with the incidence of MetS and the risk of developing MetS was increased 3.6734-fold(95% CI:1.6623,8.1180)for 1 unit increased in baseline LNUA level in the female population.The Joint model showed longitudinal LNUA changes in female population was positively correlated with the incidence of MetS and the risk of developing MetS was increased 9.2535-fold(95% CI:1.3948,61.3962)for 1 unit increased in LNUA level in the female population.Conclusion The longitudinal increments of UA levels for healthy female adults could increase the incidence risk of Mets,thus it is necessary to focus on the dynamic changes of UA levels and maintain the stability of UA levels for female so as to reduce the risk of MetS.However,the effect of UA on the MetS in male individuals still needs further study.