不同绝经状态下体质量指数对高尿酸与代谢综合征关系中介效应分析

Mediating effect of BMI on the relationship between hyperuricemia and metabolic syndrome in different menopausal status

目的 研究不同绝经状态下高尿酸与代谢综合征(metabolic syndrome,MS)患病风险的关联性,并探讨体质量指数(bodymassindex, BMI)在不同绝经状态下对高尿酸与MS关系的中介效应。方法 采用多阶段、分层整群抽样方法,抽取苗族女性作为研究对象。采用logistic回归模型分析高尿酸与MS的关联,计算MS患病风险。利用中介效应模型分析BMI在高尿酸与MS关系中的中介效应值。结果符合条件的研究对象共3 194人,绝经人群高尿酸和MS的检出率分别为58.26%、62.24%,大于未绝经人群高尿酸和MS的检出率(41.74%和37.76%)。多因素logistic回归显示,在未绝经及绝经人群中,高尿酸均与较高的MS风险相关,且绝经后的高尿酸与MS关联风险[OR (95%CI):2.58 (2.01~3.32)]强于绝经前[OR (95%CI):2.33 (1.72~3.14)]。中介效应分析显示,BMI介导高尿酸与MS的关联,中介效应值及其95%CI在未绝经人群、绝经人群中分别为0.03 (0.02~0.04)、0.05 (0.03~0.07),中介效应占比分别为18.81%、20.65%。结论 不同绝经状态下,高尿酸会增加MS的患病风险。BMI在高尿酸与MS的关系中起部分中介效应,且绝经后中介效应大于绝经前。

Objective To study the association between hyperuricemia and risk of metabolic syndrome(MS)in different menopausal status,and to explore the mediating effect of body mass index(BMI)on the relationship between hyperuricemia and MS.Methods Miao women were sampled using multistage,stratified cluster sampling method.The association between hyperuricemia and MS was analyzed and MS risk estimated using logistic regression models.The mediating effect of BMI in the relationship between hyperuricemia and MS was analyzed using mediation effect model.Results A total of 3194 study subjects were induded,the detection rates of hyperuricemia and MS among the post-menopausal women were 58.26%and 62.24%,respectively,both higher than those in pre-menopausal women(41.74%and 37.76%).Multivariable logistic regression showed that hyperuricemia was associated with higher MS risk in both post-menopausal and pre-menopausal groups,and the association was stronger in post-menopausal women[OR(95%CI):2.58(2.01-3.32)]than in pre-menopausal women[OR(95%CI):2.33(1.72-3.14)].Mediation analysis showed that BMI mediated the association between hyperuricemia and MS,with the mediating effect and its 95%CI in pre-menopausal and postmenopausal women being 0.03(0.02-0.04)and 0.05(0.03-0.07),respectively,and the proportions of the mediating effect being 18.81%and 20.65%,respectively.Conclusions In different menopausal status,hyperuricemia may increase the risk of MS.BMI may partially mediate the association between hyperuricemia and MS,the mediating effect being stronger in post-menopausal stage than in pre-menopausal stage.