[北京市在职人员高尿酸血症的横断面研究：患病率及危险因素]

Fang Wei-Gang, Huang Xiao-ming, Wang Yu, Zhu Wei-guo, Bie Zhi-xin, Chen Jia-lin, Zeng Xue-jun

Division of General Internal Medicine, Peking Union Medical College Hospital, Beijing 100730, China.

Zhonghua Yi Xue Za Zhi. 2006 Jul 4;86(25):1764-8.

OBJECTIVE

To investigate prevalence of hyperuricemia and its risk factors in Beijing.

METHODS

A cross-sectional study was carried out in four groups of state-employees in Beijing, China. Demographic, dietary and clinical data were collected by questionnaires, physical examination, and biochemical assay. Data were analyzed by multivariate logistic regression models.

RESULTS

1217 men and 780 women participated in the study. HDL and LDL were excluded as they were not missing completely at random in missing variable analysis. The serum uric acid level was (331 +/- 74) micromol/L (mean +/- SD) for men and (254 +/- 61) micromol/L (mean +/- SD) for women. It was stable for both sexes before the age of 50, increased in women but tended to decrease in man thereafter. 13.8% of men and 6.0% of women had hyperuricemia, which was defined as serum uric acid >or= 416.4 micromol/L in men and >or= 356.9 micromol/L in women, or taking medication for it. The prevalence of hyperuricemia increased steadily as women aged and surpassed that of men after the age of 70, while it appeared to decrease after 60 in men. Multivariate logistic regression models found that male gender (OR 2.46, 95% CI 1.63 - 3.69), non-Han Chinese ethnicity (OR 2.47, 95% CI 1.02 - 5.98 for Chinese Muslim), renal dysfunction (OR 12.88, 95% CI 4.07 - 40.79 for GFR < 30 ml/min), and diuretics (OR 2.25, 95% CI 1.42 - 3.57) were associated with increased risk of hyperuricemia, whereas retirement (OR 0.21, 95% CI 0.12 - 0.38) was associated with substantially reduced risk of hyperuricemia, after adjusted for overweight/obesity, hypertension and hypertriglyceridemia. Age, menopause, low-dose aspirin were not found to be associated with hyperuricemia independently. Although retirement was associated with less consumption of meat, fat, alcohol (beer, hard liquor, and wine), and more physical exercises, neither of these factors were found to be associated with hyperuricemia independently.

CONCLUSIONS

Male gender, non-Han Chinese ethnicity (Muslim), renal dysfunction, diuretics, overweight/obesity, hypertension and hypertriglyceridemia are associated with increased risk of hyperuricemia. Retirement is associated with reduced risk of hyperuricemia.

目的

调查北京地区高尿酸血症的患病率及其危险因素。

方法

在中国北京对四组国企员工进行了一项横断面研究。通过问卷调查、体格检查和生化检测收集人口统计学、饮食和临床数据。采用多因素逻辑回归模型进行数据分析。

结果

1217名男性和780名女性参与了本研究。在缺失变量分析中，高密度脂蛋白（HDL）和低密度脂蛋白（LDL）因并非完全随机缺失而被排除。男性血清尿酸水平为（331±74）μmol/L（均值±标准差），女性为（254±61）μmol/L（均值±标准差）。两性在50岁之前血清尿酸水平稳定，50岁之后女性升高而男性趋于下降。13.8%的男性和6.0%的女性患有高尿酸血症，高尿酸血症定义为男性血清尿酸≥416.4μmol/L、女性≥356.9μmol/L，或正在接受相关治疗。高尿酸血症患病率随女性年龄增长稳步上升，70岁后超过男性，而男性在60岁后患病率似乎下降。多因素逻辑回归模型发现，在调整了超重/肥胖、高血压和高甘油三酯血症后，男性（比值比[OR]2.46，95%置信区间[CI]1.63 - 3.69）、非汉族（中国穆斯林的OR为2.47，95%CI 1.02 - 5.98）、肾功能不全（估算肾小球滤过率[GFR]<30ml/min时的OR为12.88，95%CI 4.07 - 40.79）和利尿剂（OR 2.25，95%CI 1.42 - 3.57）与高尿酸血症风险增加相关，而退休（OR 0.21，95%CI 0.12 - 0.38）与高尿酸血症风险大幅降低相关。未发现年龄、绝经、低剂量阿司匹林独立与高尿酸血症相关。虽然退休与肉类、脂肪、酒精（啤酒、烈性酒和葡萄酒）摄入量减少及体育锻炼增多有关，但这些因素均未独立与高尿酸血症相关。