Center of Health Management and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo 105-8470, Japan.
Metabolism. 2012 Feb;61(2):281-8. doi: 10.1016/j.metabol.2011.06.026. Epub 2011 Aug 23.
The objective of this study was to evaluate whether hyperuricemia, acidic urine, or their combination predicts metabolic syndrome (MetS). In study 1, 69,094 subjects who received a general health checkup between 1985 and 2005 were included in a cross-sectional study of serum uric acid (SUA) and urine pH in relation to MetS. In study 2, the association of SUA and urine pH with MetS development over a 5-year period was evaluated in 5617 subjects with body mass index less than 25 kg/m(2) at the first examination. In study 1, higher SUA and lower urine pH were both positively correlated to MetS status (P < .001). The combination of high SUA and low urine pH was significantly associated with higher MetS prevalence compared with the combination of low SUA and high urine pH (odds ratio, 3.383; 95% confidence interval [CI], 3.034-3.784 in men; odds ratio, 4.000; 95% CI, 2.992-5.452 in women). In study 2, the top quartile of SUA levels was associated with higher MetS development compared with the bottom quartile during the 5-year period in men (hazard ratio [HR], 1.793; 95% CI, 1.084-2.966; P = .023). In women, the HR was 3.732 (95% CI, 0.391-35.62; P = .252) for the upper vs the lower half of SUA levels. For urine pH, the HR was 1.955 (95% CI, 1.089-3.509; P = .025) for the bottom vs the top quartile in men. A likelihood ratio test confirmed that high SUA and low urine pH act synergistically in the development of MetS. High SUA, low urine pH, and their combination are predictive risk factors for MetS development.
本研究旨在评估高尿酸血症、酸性尿液或二者联合是否可预测代谢综合征（MetS）。在研究 1 中，纳入了 1985 年至 2005 年间接受全面健康检查的 69094 例受试者，分析了血清尿酸（SUA）和尿液 pH 值与 MetS 的关系。在研究 2 中，评估了在首次检查时 BMI ＜ 25 kg/m(2)的 5617 例受试者中，SUA 和尿液 pH 值与 5 年内 MetS 发生的相关性。在研究 1 中，较高的 SUA 和较低的尿液 pH 值与 MetS 状态均呈正相关（P＜0.001）。与低 SUA 和高尿液 pH 值的组合相比，高 SUA 和低尿液 pH 值的组合与更高的 MetS 患病率显著相关（男性比值比，3.383；95%置信区间 [CI]，3.034-3.784；女性比值比，4.000；95%CI，2.992-5.452）。在研究 2 中，与最低四分位相比，在 5 年内男性中 SUA 水平最高四分位与更高的 MetS 发生相关（风险比 [HR]，1.793；95%CI，1.084-2.966；P =.023）。在女性中，SUA 水平上半部分与下半部分相比，HR 为 3.732（95%CI，0.391-35.62；P =.252）。对于尿液 pH 值，男性中最低四分位与最高四分位相比，HR 为 1.955（95%CI，1.089-3.509；P =.025）。似然比检验证实，高 SUA 和低尿液 pH 值在 MetS 的发生中具有协同作用。高 SUA、低尿液 pH 值及其组合是 MetS 发展的预测性危险因素。
