成人血清尿酸水平与肾功能异常的关系

Relationship between serum uric acid level and abnormal renal function in adults

目的 探索成人血尿酸(SUA)水平与肾功能异常的关系。方法 选取正常体检者12 138例为研究对象。通过问卷调查收集受试者一般资料,并检测血肌酐(Scr)、SUA和空腹血糖。依据估算肾小球滤过率(e GFR)将受试者分为肾功能异常组(1 607例)和肾功能正常组(10 531例)。在男性和女性分别以420μmol/L和360μmol/L为界分为高尿酸血症组和正常尿酸组;将正常尿酸组按SUA四分位数分为4组。在不同性别中分析肾功能异常的患者比例随SUA水平变化的趋势。在不同性别、年龄、文化程度、锻炼、高血压和糖尿病患病情况的亚组中采用Logistic回归分析SUA水平对肾功能的影响。结果 在男性和女性中,随着SUA水平升高,SUA四分位数各组和高尿酸血症患者占比在肾功能异常组中呈递增趋势(Z男性=6.411,Z女性=23.800,P<0.01)。Logistic回归结果显示与第一分位组相比,第二、三、四分位组和高尿酸血症组均为肾功能异常的危险因素(P<0.05)。在男性和女性中SUA与肾功能异常之间存在明显的剂量-反应关系(Pfortrend<0.01)。这种关系在不同年龄、文化程度、锻炼情况、高血压和糖尿病患病情况亚组中都有统计学意义。结论 SUA水平升高与肾功能异常的风险增加有关,且存在剂量-反应关系。

Objective To explore the relationship between serum uric acid(SUA) levels and renal function decline in adults.Methods A total of 12 138 normal physical examination subjects were selected as research subjects.General data of subjects were collected by questionnaire,and serum creatinine(Scr),SUA and fasting blood glucose were measured.Subjects were divided into two groups based on estimated glomerular filtration rate(eGFR):the abnormal renal function group(1 607 cases) and the normal renal function group(10 531 cases).Men and women of subjects were divided into the hyperuricemia group and the normal uric acid group according to 420 μmol/L and 360 μmol/L uric acid levels,respectively.The normal uric acid group was then divided into four sub-groups according to SUA quartile.Trends in the proportion of patients with abnormal renal dysfunction with SUA levels were analyzed in different genders.Logistic regression was used to analyze the influence of SUA level and renal function in subgroups with different gender,age,education level,exercise,hypertension and diabetes.Results In men and women,with the increase of SUA level,the proportion of SUA quartile groups and hyperuricemia patients in the renal dysfunction group showed an increasing trend(Zmale=6.411;Zfemale=23.800,P <0.01).Logistic regression results showed that compared with the first quartile group,the second,third,and fourth quartile groups and hyperuricemia group were all risk factors of renal dysfunction(P <0.05).There was a significant dose-response relationship between SUA and renal dysfunction in both men and women(Pfor trend<0.01).The relationship was statistically significant across subgroups of age,education,physical activity,hypertension and diabetes.Conclusion Elevated SUA are related with an increased risk of renal dysfunction in a dose-response relationship.