职业人群不健康行为生活方式与高尿酸血症的关系及高血压、血脂异常的效应修饰作用

Association between unhealthy lifestyles and hyperuricemia in occupational population and modification effect of hypertension and dyslipidemia

目的探索不健康行为生活方式与高尿酸血症的关系,以及高血压、血脂异常的效应修饰作用,为预防高尿酸血症提供理论依据。方法采用横断面调查研究设计,基于2021年10-12月来自四川省、贵州省28个地级市和重庆市33个区(县)中国铁路成都局集团有限公司的西南职业人群队列基线数据,通过问卷调查、体格测量及实验室生化检测收集研究对象的人口学特征、行为生活方式、慢性非传染性疾病患病情况。不健康行为生活方式得分根据吸烟、饮酒、膳食模式、体力活动和低体重/超重状况进行评分,分值越高不健康行为生活方式越多。采用多因素logistic回归模型分析不健康行为生活方式评分、吸烟状况、饮酒状况等与高尿酸血症的关系,采用分层分析探索高血压等疾病对不健康行为生活方式与高尿酸血症之间关系的修饰效应。结果共纳入11748名研究对象,高尿酸血症患病率为34.4%。多因素logistic回归分析显示,现在吸/既往吸烟、现在饮/既往饮酒及BMI异常是高尿酸血症患病的危险因素,不健康行为生活方式对高尿酸血症患病风险呈现累积效应,随着得分的升高,高尿酸血症患病风险升高,OR值由1.64(95%CI:1.34~2.00)上升至2.89(95%CI:2.39~3.50)。分层分析结果显示,在高血压及血脂异常人群中,不健康行为生活方式对高尿酸血症患病风险影响更大。结论多种不健康行为生活方式的共存会升高高尿酸血症患病风险,这一效应在高血压、血脂异常人群中更明显。及时纠正不健康行为生活方式,并控制高血压和血脂异常,降低患高尿酸血症的风险。

Objective To understand the relationship between unhealthy lifestyle and hyperuricemia,as well as the modification effects of hypertension and dyslipidemia in occupational population and provide a theoretical basis for the prevention of hyperuricemia.Methods A cross-sectional survey design was adopted,based on baseline data from the Southwest Occupational Population Cohort from China Railway Chengdu Group Co.,Ltd.,which included the population in 28 prefectures from Sichuan Province and Guizhou Province,and 33 districts(counties)from Chongqing Municipality between October and December 2021.This study collected the information about the demographics characteristics,lifestyles,and prevalence of chronic non-communicable diseases of the study subjects through questionnaire,physical measurement and laboratory biochemical test.The unhealthy lifestyle score was scored based on smoking,alcohol consumption,dietary patterns,physical activity,and low weight or overweight,with higher scores being associated with more unhealthy lifestyles.The multivariate logistic regression model was used to analyze the relationship between unhealthy lifestyle score,smoking,alcohol consumption,other factors and hyperuricemia,and the stratified analysis was used to explore the modification effect of hypertension and other diseases on the relationship between unhealthy lifestyle and hyperuricemia.Results A total of 11748 participants were included in this study,the prevalence of hyperuricemia was 34.4%.Multivariate logistic regression model showed that current/previous smoking,current/previous alcohol consumption and BMI abnormality were risk factors for hyperuricemia,and the unhealthy lifestyle score showed a"cumulative"effect on the risk for hyperuricemia,with higher score increasing the risk of hyperuricemia,and the OR increased from 1.64(95%CI:1.34-2.00)to 2.89(95%CI:2.39-3.50).Stratified analysis showed that unhealthy lifestyles had a greater impact on the risk for hyperuricemia in people with hypertension and dyslipidemia.Conclusions The coexistence of multiple unhealthy lifestyles might increase the risk of hyperuricemia,and this effect was stronger in participants with hypertension and dyslipidemia.Timely correction of unhealthy lifestyles,and control of hypertension and dyslipidemia might reduce the risk for hyperuricemia.