健康体检者血尿酸和γ-谷氨酰转肽酶水平与代谢综合征的关联性分析

Correlation analysis on relationships between levels of serum uric acid and γ-glutamyl transpeptidase and metabolic syndrome in healthy physical examination population

目的:分析血尿酸(SUA)和γ-谷氨酰转肽酶(γ-GGT)水平与代谢综合征(MS)患病的关联性,探讨SUA与γ-GGT在MS中的交互作用,为MS的风险预测和早期干预提供依据。方法:采用整群抽样方法共抽取延边朝鲜族自治州安图县医院体检中心20~79岁健康体检者7 560名,按照MS诊断标准分为MS及其相关代谢指标异常组和MS及其相关代谢指标正常组,收集各组研究对象的性别、年龄、身高、体质量、收缩压(SBP)和舒张压(DBP)以及血清空腹血糖(FBG)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-c)、SUA和γ-GGT等指标,Logistic回归分析法分析不同代谢异常患者患病风险,并分析各组患者各种代谢指标异常患病的交互作用。结果:MS及其相关代谢指标异常组研究对象的高尿酸血症(HUA)和γ-GGT水平升高患病风险均高于MS及其相关代谢指标正常组,随着SUA和γ-GGT水平升高,MS及其相关代谢异常患病风险逐渐升高。MS及其相关代谢指标异常组研究对象的HUA和γ-GGT水平升高患病风险是MS及其相关代谢指标正常组的4.660倍(95%CI:3.571~6.085)和5.260倍(95%CI:4.009~6.897),随着代谢异常程度增加,HUA和γ-GGT水平升高患病风险逐渐升高。SUA和γ-GGT水平均升高组研究对象的肥胖、高血压、血脂异常、高血糖和MS患病风险分别是SUA和γ-GGT水平均正常组的1.930倍(95%CI:1.617~2.304)、 1.618倍(95%CI:1.352~1.935)、 4.011倍(95%CI:3.245~4.958)、 1.890倍(95%CI:1.654~2.393)和2.695倍(95%CI:2.248~3.230)。SUA和γ-GGT水平升高对血脂异常患病存在相加交互作用,其交互效应指数(S)和归因交互效应百分比分别为1.17和10.9%。结论:SUA和γ-GGT水平与MS及其相关各种代谢指标异常患病风险有密切关联,SUA和γ-GGT水平升高与代谢异常程度有关联。HUA并发γ-GGT水平升高明显增加高血压、血脂异常和MS的患病风险,且SUA和γ-GGT水平升高对血脂异常患病具有相加交互作用。

Objective:To analyze the relationship between the serum uric acid(SUA)and γ-glutamyl transpeptidase(γ-GGT)levels and metabolic syndrome(MS) and discuss the interaction of SUA andγ-GGT in MS,and to provide the basis for the risk prediction and early intervention of MS. Methods:A total of 7 560 healthy physical examination population aged 20-79 years old in the Physical Examination Center of Antu County Hospital in Yanbian Korean Autonomous Prefecture were selected by cluster sampling method. They were divided into MS and its related metabolic abnormality group and MS and its related metabolic index normal group according to the diagnostic criteria of MS. Gender,age,height,body mass,systolic blood pressure,diastolic blood pressure,and fasting serum glucose(FBG),triglycerides(TG),high-density lipoprotein cholesterol(HDL-c),SUA and γ-GGT and other indicators the subjects in various groups were collected. Logistic regression analysis was used to detect the risks of different metabolic index disorders of the patients,and to analyze the interactions of different metabolic disorders of the patients. Results:The risks of hyperuricemia(HUA)and elevated γ-GGT level of the subjects in MS and its related metabolic abnormality group were higher than those in MS and its related metabolic index normal group,and the risk of MS and its related metabolic abnormalities were increased gradually with the increasing of SUA and γ-GGT levels. The risks of increased HUA and γ-GGT levels of the subjects in MS and its related metabolic index abnormality group were 4. 660 times(95%CI:3. 571-6. 085)and 5. 260 times(95%CI:4. 009-6. 897)higher than those in MS and its related metabolic index normal group;with the increasing of degrees of the metabolic abnormalities,the risks of elevated HUA andγ-GGT levels of the subjects were increased. The risks of obesity, hypertension,dyslipidemia,hyperglycemia and MS of the subjects in increased SUA level and increased γ-GGT group were 1. 930(95%CI:1. 617-2. 304),1. 618(95%CI:1. 352-1. 935),4. 011(95%CI:3. 245-4. 958),1. 989(95%CI:1. 654-2. 393),and 2. 695(95%CI:2. 248-3. 230)times higher than those in normal SUA level and normal γ-GGT level groups,respectively. There was additive interaction between increased SUA andγ-GGT levels on dyslipidemia,and the synergy index(S)and attributable proportion due to interaction were1. 17 and 10. 9%,respectively. Conclusion:The SUA and γ-GGT levels are closely related to the risks of MS and its related metabolic abnormalities,and the increased SUA and γ-GGT levels are associated with the degree of metabolic abnormalities. HUA combined with increased γ-GGT level can significantly increase the risks of hypertension,dyslipidemia and MS,and increased SUA and γ-GGT levels have an additive interaction on the dyslipidemia.