基于社区人群的血清尿酸水平与高血压发病率的6年随访研究

A six years observational cohort study of association between serum uric acid levels and the incidence of hypertension in community populations

目的利用观察性队列研究分析社区人群中血清尿酸水平与高血压发病率的相关性,探讨尿酸与高血压的关系。方法选择2010年江苏徐州地区某社区人群为研究对象,所有参与者均未患有高血压疾病。收集参与者的人体测量学资料、问卷调查资料和血清生化检查资料,根据尿酸四分位水平将人群分为四组,每年收集四组参与者的收缩压和舒张压的数值,参与者同一月内3次血压达到高血压状态则视为出现终点事件,统计分析尿酸与高血压发病的关系。随访最后共826例参与者被纳入研究。结果随访6年,四组参与者高血压的发病率分别为:34.5%、39.2%、41.0%和45.6%,除第1年、第2年四组发病不存在趋势外,其余4年的高血压的累计发病数均是随着尿酸水平的增加而增加的,趋势均存在统计学差异(均P<0.05)。Cox风险回归模型显示,在未校正其他指标的情况下,Q4组相比与Q1组高血压的发病率为3.982倍(P<0.01),校正各代谢因素后,高血压的发病风险仍为2.296倍(P<0.01),显示尿酸与高血压发病独立相关。结论尿酸与高血压发病密切相关,尿酸较高的人群患高血压疾病的风险增加,可能尿酸是高血压的危险因素之一。

Objective To investigate the association between serum uric acid(UA)levels and the incidence of hypertension in community populations by observational cohort study.Methods A community population in Xuzhou,Jiangsu province in 2010 was selected as the research object,and all participants did not suffer from hypertension.Anthropometric data,questionnaire data and serum biochemical data were collected.All participants were divided into four groups by UA quartile levels,and the systolic and diastolic blood pressure were collected annually for all four groups.It was defined as an outcome event while participants were meassured an elevated blood pressure three times in one month.The association between uric acid and hypertension was analyzed.A total of 826 participants were eventually included in the study.Results After 6 years follow-up,the prevalence of hypertension in the four groups was 34.5%,39.2%,41.0%,and 45.6%,respectively.Except the first year and the second year,the cumulative incidence of hypertension in the other four years increased with the increase of UA level,and the trend were statistically different(P<0.05).In the model of Cox risk regression,without adjusting for other indicators,the incidence of hypertension in the Q4 group was 3.982 times higher than that in the Q1 group(P<0.01).After adjusted those factors,the incidence of Q4 group was 2.296 times that of Q1group(P<0.01).These results showed the UA was an independent factor for hypertension.Conclusion There is a close association between UA and hypertension.People with higher UA levels are at increased risk for hypertension.UA may be the risk factor of hypertension.