老年冠心病患者中血清尿酸水平与代谢综合征的相关性分析

Relationship between serum uric acid level and metabolic syndrome in elderly patients with coronary heart disease

目的 探讨老年冠状动脉粥样硬化性心脏病(冠心病)患者中血清尿酸水平与代谢综合征(MetS)及其各组分的相关性,为老年冠心病患者MetS的防治提供依据。方法 本研究为横断面研究,选取2020年5月28日至2021年4月1日间就诊于河南省人民医院老年医学科的老年冠心病患者321例,根据是否合并MetS分为MetS组(141例)和非MetS组(180例),分析血清尿酸水平与MetS及其各组分的关系,应用ROC曲线分析血清尿酸的截断点。结果 在合并代谢综合症的老年冠心病患者中,血清尿酸水平显著升高[(383.30±90.42)mg/dl vs.(294.34±85.15)mg/dl,P<0.001];且尿酸是代谢综合症发生的危险因素(OR=2.141,95%CI:1.185~3.867,P=0.012)。随着四分位数尿酸水平的升高,体质指数(BMI)、空腹葡萄糖(FPG)、三酰甘油(TG)等水平逐渐升高,高密度脂蛋白胆固醇(LDL-C)逐渐下降,差异均具有统计学意义(P均<0.05)。相关性分析提示血清尿酸水平与MetS各组分存在显著相关性(BMI:r=0.326,P<0.001;FPG:r=0.198,P<0.001;收缩压:r=0.115,P=0.039;舒张压:r=0.112,P=0.045;TG:r=0.288,P<0.001;HDL-C:r=-0.230,P<0.001)。在ROC分析中,尿酸预测MetS的AUC为0.747(95%CI:0.695~0.800,P<0.001),截断值为332μmol/L。结论 老年冠心病患者血清尿酸水平与MetS及其各组分具有相关性,建议老年冠心病患者更应严格控制尿酸水平。

Objective To discuss the correlation among the level of serum uric acid(UA),metabolic syndrome(Met S) and different compositions of MetS in elderly patients with coronary heart disease(CHD),and provide a basis for preventing and treating MetS.Methods This study was a cross-sectional study.The elderly patients with CHD(n=321) were chosen from Department of Geriatrics in People’s Hospital of Henan Province from May 28,2020 to Apr.1,2021.All patients were divided,according to whether CHD complicated by MetS or not,into MetS group(n=141)and non-MetS group(n=180).The relationship among level of serum UA,MetS and different compositions of MetS was analyzed,and cut-off point of serum UA was analyzed by using ROC curve.Results The level of serum UA increased significantly in MetS group [(383.30±90.42) mg/dl vs.(294.34±85.15) mg/dl,P<0.001],and UA was a risk factor of MetS occurrence(OR=2.141,95%CI:1.185~3.867,P=0.012).With the increase of quartiles UA level,the levels of body mass index(BMI),fasting plasma glucose(FPG) and triglyceride(TG) increased gradually,and level of highdensity lipoprotein-cholesterol(HDL-C) decreased gradually(P<0.05).The results of correlation analysis showed that there was significant correlation between level of serum UA and different compositions of MetS(BMI:r=0.326,P<0.001,FPG:r=0.198,P<0.001,systolic blood pressure:r=0.115,P=0.039,diastolic blood pressure:r=0.112,P=0.045,TG:r=0.288,P<0.001,HDL-C:r=-0.230,P<0.001).The results of ROC curve analysis showed that AUC of UA was 0.747(95%CI:0.695~0.800,P<0.001) and cutoff value was 332 μmol/L in predicting MetS.Conclusion There is correlation among level of serum UA,MetS and different compositions of MetS in elderly CHD patients.It is suggested that level of serum UA should be strictly controlled in elderly CHD patients.