类风湿关节炎患者血清镁浓度与代谢综合征 糖尿病 高血压 高尿酸血症之间的关系

Association between serum magnesium concentration and metabolic syndrome,diabetes,hypertension,hyperuricemia in patients with rheumatoid arthritis

目的探究RA患者血清镁浓度与代谢综合征(MetS)、糖尿病、高血压、高尿酸血症(HU)之间的关系。方法收集2013年6月至2019年2月在天津市第一中心医院1009例RA患者,测量患者血清镁浓度,收集患者人口统计学、临床及实验室指标,以及生活和工作习惯及服药情况。根据血清镁水平的五分位数分布由低到高分为5组,分别为Q1~Q5组。应用多变量调整的Logistic回归模型评估血清镁与MetS、糖尿病、高血压、HU之间的关系。结果在MetS多变量调整的回归分析中,与Q1组血清镁相比,Q2、Q3、Q4、Q5组血清镁OR值95%CI分别为0.26[95%CI(0.09,0.76),P=0.01],0.17[95%CI(0.06,0.47),P<0.01],0.27[95%CI(0.09,0.76),P=0.01],0.22[95%CI(0.09,0.58),P<0.01],趋势P值<0.01。在糖尿病多变量调整的回归分析中,模型二调整多项潜在混杂因素后,血清镁Q3和Q5组与Q1组相比,OR值95%CI分别为0.58[95%CI(0.35,0.96),P=0.03],0.51[95%CI(0.29,0.89),P=0.02],趋势P值=0.01。但是在模型三加入肾小球滤过率作为协变量,这种相关性没有统计学意义(P>0.05),趋势P值=0.06。在高血压,HU多变量调整的回归模型中,未显示与血清镁具有关联性(P>0.05),趋势P值也均>0.05。结论RA患者血清镁浓度与MetS患病率呈负相关,与高血压、HU未显示相关性,在调整肾小球滤过率后与糖尿病的负相关性也无统计学意义。

Objective To examine the associations between serum magnesium(Mg)concentration and metabolic syndrome(MetS),diabetes(DM),hypertension(HTN),hyperuricemia(HU)in rheumatoid arthritis(RA)patients.Methods From June 29,2013 to February 29,2019,1009 RA patients were collected at Tianjin First Central Hospital.The Mg concentration,clinical and laboratory indicators,living habits and medication were collected.The multivariate adjusted Logistic regression model was used to evaluate the relationship between Mg and MetS,DM,HTN,and HU.Results Compared with the lowest quintile serum magnesium,In the MetS regression analysis,OR and 95%CI were 0.26[95%CI(0.09,0.76),P=0.01)],0.17[95%CI(0.06,0.47),P<0.01],0.27[95%CI(0.09,0.76),CI=0.01],and 0.22[95%CI(0.09,0.58),P<0.01],in second,third,fourth,and fifth(highest)quantiles of serum Mg,respectively,P for trend<0.01.In DM regression analysis,after adjusting for multiple potential confounders in Model 2,OR and 95%CI were 0.58[95%CI(0.35,0.96),P=0.03],and 0.51[95%CI(0.29,0.89),P=0.02],in third and fifth quantiles of the serum Mg,respectively,P for trend=0.01.But in model 3 this correlation disappears.HTN and HU were not associated with serum Mg(P>0.05),P for trend>0.05.Conclusion There was a negative correlation between serum Mg concentration and MetS in RA patients,But no correlation with HTN,HU.After adjusting the glomerular filtration rate,the negative correlation between serum Mg and DM also disappeared.