不同诊断标准下农村老年人高尿酸血症患病率及影响因素分析

Prevalence and risk factors of hyperuricemia in rural elderly according to different diagnostic criteria

目的 探究在高尿酸血症(HUA)不同诊断标准下,辽宁省农村老年人HUA的患病率及影响因素。方法 本文纳入2017年9月至2018年5月辽宁省2个乡镇65岁及以上老年人2016例,分别根据流行病学标准(男性>420μmol/L,女性>360μmol/L)和指南标准(>420μmol/L)诊断HUA,并对其患病率、伴随疾病、实验室检查等结果进行比较,再通过多因素logistic回归,分析老年人HUA的影响因素。结果 (1)根据流行病学标准诊断HUA 102例,患病率5.1%;根据指南标准诊断HUA 60例,患病率3.0%。与血尿酸(SUA)正常组相比,HUA组:高体重指数(BMI)、大腰围、低估算肾小球滤过率(eGFR)、高三酰甘油(TG)、冠心病、糖尿病、房颤、血脂异常、肾功能不全、超重肥胖、中心性肥胖的比例更高。(2)根据性别进行亚组分析,指南标准下,65~69岁、70~74岁、缺乏运动、冠心病、高血压、糖尿病、血脂异常、卒中、超重肥胖、中心性肥胖者中,男性HUA患病率均高于女性。而流行病学标准下患病率均无性别差异。(3)多因素分析显示,冠心病、心房颤动、肾功能不全、超重肥胖、中心性肥胖、高三酰甘油或血脂异常为HUA的影响因素,指南标准下增加了男性。结论 不同诊断标准下,辽宁省农村老年人HUA患病率差异较大,按照指南标准各组患病率性别差异明显,因此流行病学研究中,流行病学标准优于指南标准。无论哪种诊断标准,老年HUA的影响因素差异不大。

Objective To explore the prevalence and risk factors of hyperuricemia(HUA)in rural elderly from Liaoning Province by different diagnostic criteria. Methods This article included 2016 elderly people aged 65 and over from two towns in Liaoning Province from September 2017 to May 2018. HUA was diagnosed by epidemiological criteria(male>420 μmol/L,female>360 μmol/L) and guideline criteria(SUA>420 μmol/L),and we compared the prevalence,comorbidities,laboratory examinations and other results. Multivariate logistic regression analysis was used to identify risk factors of HUA in the elderly. Results(1)According to epidemiological criteria,102 case of HUA were diagnosed with a prevalence of 5.1%;according to guideline criteria,60 case of HUA were diagnosed with a prevalence of 3.0%. Compared to the normal SUA group,the HUA group had: larger BMI and waist circumference,lower eGFR and higher TG,and the ratio of coronary heart disease,diabetes,atrial fibrillation,dyslipidemia,renal insufficiency,overweight/obesity,central obesity was higher.(2)According to the subgroup analysis based on gender,the HUA prevalence in males by guideline criteria was higher than that in females in patients aged 65-69,70-74,being in lack of exercise,with coronary heart disease,hypertension,diabetes,dyslipidemia,stroke,overweight/obesity,and central obesity. There was no gender difference by epidemiological criteria.(3)Multivariate analysis showed that coronary heart disease,atrial fibrillation,renal insufficiency,overweight/obesity,central obesity,hypertriglyceridemia were the risk factors of HUA. Guideline criteria also included male.Conclusion The prevalence of HUA in rural elderly in Liaoning Province is quite different by different diagnostic criteria.According to guidelia criterion,the prevalence of HUA in each group is significantly different in gender. Therefore,the epidemiological criteria are superior to the guideline criteria in epidemiological studies. No matter which diagnostic criteria,there is little difference in the risk factors of HUA in the elderly.