绝经前后血尿酸水平变化的队列研究

A cohort study on the changes of serum uric acid in the pre⁃and post⁃menopause

目的探讨绝经前后血尿酸(serum uric acid,SUA)水平变化。方法基于开滦体检队列,用线性和分段线性混合效应模型分析绝经前后SUA变化,并分析基线年龄和基线BMI分别与绝经前后时间分段的相乘交互作用。结果2006―2020年的7次体检共3747例女性,共21223人次体检记录被纳入分析。首次体检平均年龄为(46.19±4.11)岁,中位绝经年龄为51.00(50.00,53.00)岁。与绝经前相比,绝经后SUA水平升高10.15μmol/L。SUA从绝经前11年开始缓慢增加,平均年增长量为1.99μmol/L;绝经前5~前2年每年平均增加3.30μmol/L;SUA在绝经前后2年的平均年增长量为4.60μmol/L;随后平均年增长量下降,在绝经5年后,平均年增长量降至1.77μmol/L。基线年龄<40岁与绝经后2~<5年(Pinteraction=0.009)和绝经≥5年(Pinteraction<0.001)的时间分段存在交互作用,基线年龄40~<45岁与绝经前后2年时间有交互作用(Pinteraction=0.033);除基线年龄<40岁对绝经2年后SUA变化有影响,其他基线年龄组SUA在绝经前后的变化一致。基线BMI与绝经前后各时间分段均无交互作用(均P_(interaction)>0.05)。结论绝经对SUA有不良影响,中年女性在绝经前后应关注SUA水平,采取积极防控策略。

Objective To investigate the changes of serum uric acid(SUA)around menopause.Methods The linear and piecewise linear mixed effect models were used to analyze SUA changes in the pre⁃and post⁃menopause on the Kailuan Health Examination cohort.Multiplicative interaction effects between baseline age as well as baseline BMI and segmented time periods pre⁃and post⁃menopause were also analyzed.Results A total of 3747 female with 21223 health examination records from 2006 to 2020(7 health examinations)were included in the analysis.The average age at the first health examination was(46.19±4.11)years,and the median age at menopause was 51(50,53)years.Compared to pre⁃menopause,SUA increased by 10.15μmol/L in post⁃menopause.SUA started to increase gradually from 11 years before menopause,with an average annual increase of 1.99μmol/L;From 5 to 2 years before menopause,SUA increased by an average of 3.30μmol/L per year;During the 2 years before and after menopause period,SUA increased by an average of 4.60μmol/L per year.After that,the average annual increase slowed,and after 5 years of menopause,the average annual increase in SUA dropped to 1.77μmol/L.There was an interaction between baseline age<40 years and the time segments of postmenopausal 2-<5 years after menopause(Pinteraction=0.009)and 5 years or more after menopause(Pinteraction<0.001),as well as between baseline age 40-<45 years and the 2 years before and after menopause(Pinteraction=0.033).Except for age under 40 years,which had an impact on SUA changes during 2 years after menopause,the SUA changes around menopause in other baseline age groups were consistent.There was no multiplication interaction effect between baseline BMI and various time segments around menopause(all P_(interaction)>0.05).Conclusions Menopause has an adverse effect on SUA.Middle⁃aged women should pay attention to their SUA levels around menopause and adopt proactive prevention and control strategies.