体检人群中高尿酸血症与脂肪肝的相关性研究

Research on the correlation between hyperuricemia and fatty liver in population undergoing physical examination

目的:研究体检人群中高尿酸血症与脂肪肝之间的关系。方法:选取2018年1至12月于体检中心行血尿酸和肝脏超声检查的99963个体检者资料进行横断面研究,将体检者分为高尿酸血症组和非高尿酸血症组。采用多因素Logistic回归分析高尿酸血症与脂肪肝之间是否具有相关性。结果:研究对象中,女44241人,年龄(42.04±13.07)岁;男55722人,年龄(41.73±12.76)岁;高尿酸血症患者24152例(24.2%),脂肪肝患者27858例(27.9%)。高尿酸血症组患者年龄、高血压、2型糖尿病、甘油三酯、总胆固醇、高密度脂蛋白、低密度脂蛋白、收缩压、舒张压、BMI、γ-谷氨酰胺转移酶、碱性磷酸酶、谷丙转氨酶、谷草转氨酶、肌酐均高于非高尿酸血症组,差异有统计学意义(P<0.001);高尿酸血症组患者高密度脂蛋白低于非高尿酸血症组,差异有统计学意义(P<0.001)。高尿酸血症组患者的脂肪肝患病率明显高于非高尿酸血症组(50.5%vs 20.7%),差异有统计学意义(P<0.001)。在调整了年龄、性别、高血压、2型糖尿病、肝功能、血脂等混杂因素后,数据显示高尿酸血症与脂肪肝患病风险成独立正相关,OR值为1.479(95%CI 1.417~1.544,P<0.001)。结论:体检人群中脂肪肝患病率和高尿酸血症密切相关,对尿酸水平的监测和管理以降低脂肪肝的疾病负担是一个值得探索的研究方向。

Objective:To study the relationship between hyperuricemia and fatty liver in population undergoing physical examination.Methods:A cross-sectional study was conducted among 99963 person who underwent blood uric acid and liver ultrasound examinations in the physical examination center of Wuhan Tongji Hospital from January 2018 to December 2018.They were divided into hyperuricemia group and non-hyperuricemia group.Hyperuricemia was diagnosed according to the level of blood uric acid(biochemical indicators):male≥416 ummol/L(7.0mg/dl),female≥358 ummol/L(6.0mg/dl);The diagnosis of fatty liver was made by two ultrasound doctors.Multivariate logistic regression was used to analyze the correlation between hyperuricemia and fatty liver.Results:A total of 99963 subjects were included in this study,including 44241 females aged(42.04±13.07)years old,55722 males aged(41.73±12.76)years old,24152 patients with hyperuricemia(24.2%)and 27858 patients with fatty liver(27.9%).Age,hypertension,type 2 diabetes mellitus,triglyceride,total cholesterol,high density lipoprotein,low density lipoprotein,systolic pressure,diastolic pressure,BMI,γ-glutamyltransferase,alkaline phosphatase,alanine aminatransferase(ALT),aspartate aminotransferase(AST)and creatinine in hyperuricemia group were higher than those in non-hyperuricemia group,and the difference was statistically significant(P<0.001);high density lipoprotein in hyperuricemia group was lower than that in non-hyperuricemia group,and the difference was statistically significant(P<0.001).The prevalence of fatty liver in hyperuricemia group was significantly higher than that in non-hyperuricemia group(50.5%vs 20.7%),and the difference was statistically significant(P<0.001).After adjusting for age,gender,hypertension,type 2 diabetes mellitus,liver function,blood fat and other confounding factors,the data showed that hyperuricemia was independently and positively correlated with risk of fatty liver disease,with an OR value of 1.479(95%CI 1.417-1.544,P<0.001).Conclusion:In this paper,it was found there was a close relationship between the prevalence of fatty liver and hyperuricemia in population undergoing physical examination.It is a worthwhile research direction to reduce the disease burden of fatty liver by monitoring and managing the level of uric acid.