社区视角下老年人群高尿酸血症与慢性代谢性疾病的相关性分析

Correlation analysis between hyperuricemia and chronic metabolic diseases in the elderly population from the community perspective

目的分析社区老年人群高尿酸血症(HUA)患病现状,探讨HUA界值及血尿酸水平与慢性代谢性疾病的相关性。方法该研究为横断面研究,以2023年上海闵行区2个社区参与体检的1508例老年人为研究对象。主要观察指标为血清尿酸、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血脂检测、身高、体重、腰围、血压等。HUA定义为血清尿酸男性>420μmol/L,女性>360μmol/L。结果该人群HUA总体粗患病率为26.8%(404/1508,95%CI:24.6%~29.1%),男性为24.7%(182/736),女性为28.8%(222/772)。男女性患病率均随年龄增长呈上升趋势,并且HUA组慢性代谢性疾病患病率均显著高于非HUA组。女性HUA患者不同尿酸水平合并慢性代谢性疾病比例差异无统计学意义。多因素回归分析显示,高血压(OR_(男)=1.847,95%CI:1.209~2.820;OR_(女)=1.519,95%CI:1.009~2.288)、高TG(OR_(男)=1.296,95%CI:1.100~1.527;OR_(女)=1.619,95%CI:1.316~1.991)是HUA的危险因素,BMI与尿酸水平呈正相关关系。结论社区老年人群HUA患病率较高。高血压、高TG是HUA的危险因素。血尿酸>360μmol/L的女性均合并较高比例的慢性代谢性疾病,建议女性血尿酸控制目标水平<360μmol/L。

Objective To analyze the current status of hyperuricemia(HUA)in the elderly population in the community,explore the critical value of HUA,and the correlation between serum uric acid levels and chronic metabolic diseases.Methods A cross-sectional study was conducted on 1508 elderly individuals who participated in physical examinations in two communities in Minhang District,Shanghai in 2023.The main outcome measures were serum uric acid,fasting plasma glucose(FPG),glycated haemoglobin(HbA1c),and blood lipid detection.Height,weight,waist circumference,and blood pressure were also measured.HUA was defined as serum uric acid>420μmol/L in males and>360μmol/L in females.Results The estimated prevalence in this population was 26.8%(404/1508,95%CI:24.6%-29.1%)overall,24.7%(182/736)in males and 28.8%(222/772)in females.The prevalence of males and females increased with age,and the incidence of chronic metabolic diseases in HUA groups was significantly higher than those in non-HUA groups.There was no statistically significant difference in the proportion of chronic metabolic diseases among females with different serum uric acid levels in HUA.Multivariate regression analysis showed that hypertension(OR_(male)=1.847,95%CI:1.209-2.820;OR_(female)=1.519,95%CI:1.009-2.288),high values of TG(OR_(male)=1.296,95%CI:1.100-1.527;OR_(female)=1.619,95%CI:1.316-1.991)were the strong risk factors for HUA,and BMI was positively correlated with uric acid levels.Conclusion The prevalence of HUA among the elderly population in the Community is relatively high.Hypertension and high values of TG are strong risk factors for HUA.Females with serum uric acid>360μmol/L are associated with a higher proportion of chronic metabolic diseases.It is recommended to control the target level of serum uric acid in Females to be less than 360μmol/L.