血红蛋白与血尿酸的相关性研究

The relationship between hemoglobin and serum uric acid

目的分析血红蛋白(Hb)与血尿酸(SUA)水平的关系,为预防和控制高尿酸血症(HUA)提供依据。方法选择2017年1月1日—2020年10月31日连续4年在浙江省人民医院健康体检,且2017年体检排除HUA者为研究对象,收集体质指数、血压、血常规和血生化指标等体检资料。以2017年Hb水平为暴露因素并按照其四分位数分组,以SUA升高(较基线上升60μmol/L)、SUA显著升高(较基线上升120μmol/L)、HUA(SUA>420μmol/L)和重度HUA(SUA≥480μmol/L)为终点事件,分析不同Hb分组终点事件的发生率、发生时间及发生风险。结果纳入排除HUA的健康体检者4073人,按Hb水平由低到高分为A组969人,B组907人,C组1109人,D组1088人。检出SUA升高745人,发生率为18.29%;SUA显著升高105人,发生率为2.58%;HUA 514例,发生率为12.62%;重度HUA 94例,发生率为2.31%。SUA升高、SUA显著升高的发生率随Hb水平升高呈下降趋势(P<0.05);A、B、C、D组SUA升高发生时间分别为2.788年、2.817年、2.860年、2.814年,差异有统计学意义(P<0.05);其他终点事件的发生时间差异均无统计学意义(P>0.05)。多因素Cox比例风险回归分析结果显示,调整性别、年龄、血清谷丙转氨酶、血清肌酐和体质指数等因素后,与A组比较,其他各组发生SUA升高、SUA显著升高和重度HUA的风险降低(HR:0.498~0.776,95%CI:0.253~0.981)。结论随Hb水平升高,SUA升高的发生率呈下降趋势,发生时间延长;与低Hb组相比,Hb水平较高组SUA升高、SUA显著升高及重度HUA发生风险较低。

Objective To analyze the relationship between hemoglobin(Hb)and serum uric acid(SUA),so as to provide basis for preventing hyperuricemia(HUA).Methods As the research subjects,people who underwent physical examination in Zhejiang Provincial People’s Hospital from January 1,2017 to October 31,2020 for 4 years in a row and who were non-HUA in 2017 were selected.The physical examination data were collected,including body mass index,blood pressure,blood routine,blood biochemical tests,etc.The subjects grouped by quartiles of Hb level in 2017.The occurrence of SUA elevation(SUA increased≥60μmol/L from baseline),significantly SUA elevation(SUA in-creased≥120μmol/L from baseline),HUA(SUA>420μmol/L)and severe HUA(SUA≥480μmol/L)in the next 3 years were taken as end events.The incidence,occurrence time and risk of end events in different Hb groups were analyzed.Results A total of 4073 subjects were selected and divided into 4 groups according to the Hb level from low to high,with 969 subjects in group A,907 subjects in group B,1109 subjects in group C and 1088 subjects in group D.SUA elevation was in 745 patients(18.29%);significantly SUA elevation was in 105 patients(2.58%);HUA was in 514 patients(12.62%);severe HUA was in 94 patients(2.31%).The incidence of SUA elevation and significantly SUA elevation showed a decreasing trend with the increase of Hb level(P<0.05).The occurrence time of SUA elevation in group A to D was 2.788,2.817,2.860 and 2.814 years,and the difference was statistically significant(P<0.05).There were no statistically significant differences in the occurrence time of other end events(P>0.05).The multivariate Cox proportional hazards regression analysis showed that compared with group A,other Hb groups had lower risk(HR=0.498-0.776,95%CI:0.253-0.981)of SUA elevation,significantly SUA elevation and severe HUA after adjusting for gender,age,ALT,Scr,body mass index,etc.Conclusions With the increase of Hb level,the incidence of SUA elevation may decrease and the occurrence time is prolonged.Compared with the lowest Hb group,the higher Hb groups had lower risk of SUA elevation,significantly SUA elevation and severe HUA.