高龄女性血尿酸水平与肾功能的关联性

Association between serum uric level and renal function in elderly women

目的:探讨高龄女性血尿酸水平与肾功能的关联性。方法:对符合要求的230例,年龄71~93岁的女性进行临床资料的收集、体格检查及实验室检查,采用多元线性回归及logistic回归分析血尿酸水平变化对肾功能的影响。结果:血尿酸四分位分组,UA1(157~μmol/L)、UA2(262~μmol/L)、UA3(312~μmol/L)、UA4(362~556μmol/L)各组慢性肾脏病(CKD)检出率分别为31.58%、39.66%、53.45%、84.21%,差异有统计学意义(P<0.05)。校正了年龄、BMI和血清总胆固醇(TC)后,多元线性回归分析显示,高龄女性的eGFR与其血尿酸水平间存在显著的负相关关系,与UA1组比较,UA2、UA3、UA4组的eGFR值下降幅度逐渐增大(UA2:β=-4.50,95%CI=-9.04^-0.04;UA3:β=-6.57,95%CI=-10.67^-2.47;UA4:β=-13.48,95%CI=-17.73^-9.23)。校正上述混杂因素后,多元logistic回归分析显示,CKD的发病风险与血尿酸水平间呈现出明显的正相关关系,与UA1组比较,UA4组人群出现CKD的风险最高(OR=10.64,95%CI=4.15~27.34,P<0.01)。结论:高血尿酸水平是高龄女性eGFR下降和CKD患病率增加的独立危险因素。

Objective:To investigate the relationship between the renal function and the serum uric acid(SUA)level in elderly women.Methods:A total of 230 qualified female patients(71-93 years)were asked to complete a questionnaire and do medical checkups.Multiple linear regression and logistic regression were used respectively to analyze the association between SUA and renal function.Results:The prevalences of chronic kidney disease(CKD)in four SUA quartiles(UA1:157-mmol/L,UA2:262-μmol/L,UA3:312-μmol/L,UA4:362-556μmol/L)were 31.58%,39.66%,53.45%and 84.21%,respectively,with significant difference(P<0.05).A significant inverse correlation was observed between the estimated glomerular filtration rate(eGFR)and SUA based on a multivariable linear regression model after adjusting age,body mass index(BMI)and total cholesterol(TC).Compared with those in UA1,higher SUA levels were significantly associated with a greater decline in eGFR(UA2:β=-4.50,95%CI:-9.04,-0.04;UA3:β=-6.57,95%CI:-10.67,-2.47;UA4:β=-13.48,95%CI:-17.73,-9.23)after adjusting the above confounding factors.Meanwhile,a multiple logistic regression analysis clearly revealed that participants in the UA4 category had the highest odds to develop CKD as compared to their counterparts,in which the adjusted odds was 10.64 times of that in participants from UA1(OR:10.64,95%CI:4.15-27.34,P<0.01).Conclusion:Elevated SUA was an independent risk factor of the declined renal function and significantly associated with increased odds of CKD in old women.