预防性服用阿司匹林与高尿酸血症之间的关系:基于NHANES数据库的分析

Analysis of the association between prophylactic use of aspirin and hyperuricemia based on the NHANES database

目的探究预防性服用阿司匹林对高尿酸血症(HUA)的影响,为HUA预防提供证据。方法采用横断面研究,纳入NHANES数据库2011-2018年收录的1898例成年人群,根据血清尿酸水平分为HUA组和对照组,收集预防性服用阿司匹林情况以及相关协变量。多因素logistic回归被用于分析预防性服用阿司匹林对HUA的影响,构建限制性立方样条(RCS)模型以明确阿司匹林服用剂量与HUA的剂量-反应关系。结果研究对象中共检出HUA患者406例(21.39%),HUA组预防性服用阿司匹林的比率(33.74%)高于对照组(24.06%),组间差异具有统计学意义(χ^(2)=15.499,P<0.01)。多因素logistic回归结果表明,在调整性别、年龄、种族、BMI、糖尿病史、肾脏虚弱/衰竭史、体力活动等协变量后,预防性服用阿司匹林仍然是HUA的独立危险因素(OR=1.553,95%CI:1.116~1.835)。RCS模型显示阿司匹林服用剂量与HUA呈正向线性相关(非线性P=0.895)。结论阿司匹林的预防性服用与HUA风险升高相关,应充分考虑患者的尿酸水平,在医生指导下合理使用阿司匹林。

Objective To explore the impact of prophylactic aspirin use on hyperuricemia(HUA)and provide evidence for the prevention of HUA.Methods A cross-sectional study was conducted to include 1898 adults from the national health and nutrition examination survey(NHANES)database from 2011 to 2018.They were divided into HUA and control groups based on serum uric acid levels.Information on prophylactic aspirin use and relevant covariates was collected.A multivariate logistic regression was used to analyze the impact of prophylactic aspirin use on HUA.Restricted cubic spline(RCS)models were constructed to clarify the dose-response relationship between aspirin dosage and HUA.Results A total of 406 patients with HUA(21.39%)were detected among the study subjects.The proportion of prophylactic aspirin use in the HUA group(33.74%)was higher than that in the control group(24.06%),and the difference between the groups was statistically significant(χ^(2)=15.499,P<0.01).Multivariate logistic regression analysis showed that prophylactic aspirin use was still an independent risk factor for HUA after adjusting for covariates such as gender,age,race,BMI,history of diabetes,history of renal weakness/failure,and physical activity(OR=1.553,95%CI:1.116-1.835).The RCS model showed a positive linear correlation between aspirin dosage and HUA(nonlinear P=0.895).Conclusion Prophylactic aspirin use is associated with an increased risk of HUA.It is necessary to fully consider the uric acid level of patients and use aspirin reasonably under the guidance of doctors.