血尿酸与代谢综合征关系的横断面研究

The relationship between serum uric acid and metabolic syndrome:a cross-sectional study

目的分析血尿酸(UA)与代谢综合征(MS)之间的关系。方法1680例北京社区居民纳入了此次调查分析。MS发病危险比值比(OR)采用多因素logistic回归计算,UA与各指标间的相关关系采用多元线性回归分析。结果校正性别、年龄后MS组UA水平高于非MS组(299.23μmol/L与269.15μmol/L,P<0.001),随着MS成分由0个增加至4或5个,UA水平逐渐升高为257.04μmol/L,263.03μmol/L,281.19μmol/L,295.80μmol/L和303.39μmol/L(线性趋势P=0.002)。校正年龄、性别、肌酐、估计肾小球滤过率(eGFR)、低密度脂蛋白胆固醇(LDL-C)、超敏C反应蛋白(hs-CRP)、吸烟、饮酒、运动等因素后,多元logistic回归分析显示与UA最低四分位水平(UAⅠ)相比,UA二、三、四分位水平(UAⅡ,Ⅲ,Ⅳ)MS发生风险比值比(OR)分别为1.721(95%CI:1.208~2.451,P<0.05),2.237(95%CI:1.562~3.204,P<0.01),4.559(95%CI:3.090~6.727,P<0.01)。多元线性回归分析显示,UA与腰围、体质指数、三酰甘油、LDL-C水平呈独立正相关。应用受试者工作曲线(ROC)诊断MS的UA最佳截断点为276.35μmol/L,敏感性和特异性分别为64.6%和52.8%。结论高UA水平是MS发生的相关因素,UA升高对MS有一定的筛查诊断价值。

Objective To explore the relationship between uric acid(UA)and metabolic syndrome(MS).Methods A cohort of 1680 community-based population in Beijing was investigated.Multivariate logistic regression analysis was used to estimate the odds ratios(OR)of MS,and multiple linear regression analysis was performed to discuss the association between UA and characteristic variables.Results Serum UA level was higher in metabolic syndrome(MS)population compared to those without the MS(299.23μmol/L vs 269.15μmol/L,P<0.001)after adjusted for age and sex.UA increased with the rise of MS components from 0 through 4 or 5(257.04,263.03,281.19,295.80 and 303.39μmol/L,respectively,P=0.002 for linear trend).Compared with the first UA quartile(UA I),the multiple logistic regression analysis demonstrated that the risk of MS in those with the second,third and fourth UA quartiles were 1.721(95%CI:1.208-2.451,P<0.05),2.237(95%CI:1.562-3.204,P<0.01),4.559(95%CI:3.090-6.727,P<0.01),repectively,after adjusting for age,sex,creatinine,eGFR,LDL-C,hs-CRP,smoke,drink and exercise.UA was positively related to waist circumference,BMI,triglycerides,LDL-C with multiple linear regression analysis.The optimal cutoff point of UA by using receiver operating characteristic(ROC)curve to diagnose MS was 276.35μmol/L.The sensitivityand specificity were 64.6%and 52.8%,respectively.Conclusion In this cohort,higher UA level is associated with higher incidence of MS and has certain clinical significance for screeing MS.