Department of Social Medicine and Health Education, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, 100037, China.
Clin Rheumatol. 2019 May;38(5):1375-1384. doi: 10.1007/s10067-018-4391-9. Epub 2019 Jan 3.
Chronic exposure to high altitude may lead to hyperuricemia. We investigated the prevalence of hyperuricemia and its risk factors among employees in high-altitude areas. A cross-sectional survey with cluster sampling was performed at 23 worksites on the Qinghai-Tibet Plateau. Subjects were evaluated by using questionnaires, anthropometric and laboratory measurements, and abdominal ultrasound. A multilevel logistic regression model and restricted cubic spline were used to explore the associated factors of hyperuricemia. Of the 4198 employees included in the study, the age-standardized prevalence of hyperuricemia was 28.1% (95% confidence interval (CI) 26.7-29.5), with 31.9% (95%CI 30.2-33.6) in men and 17.9% (95%CI 15.7-20.1) in women. Hypertension, hyperlipidemia, and a meat-food pattern were positively associated with hyperuricemia in both sexes, while diabetes, shift work, body mass index, non-alcoholic fatty liver disease, and low intake of fruits and vegetables were significantly associated with hyperuricemia only in men. Furthermore, a nonlinear dose-response association between the number of cardiovascular risk factors (CRFs) and hyperuricemia was observed. Compared with those having 0 CRFs, the full-adjusted odds ratios (ORs) and 95%CIs for 1, 2, and ≥ 3 CRFs were 1.76 (95%CI 1.25-2.47), 2.54 (95%CI 1.81-3.55), and 3.05 (95%CI 2.16-4.31) in men, respectively, and 2.13 (95%CI 1.43-3.17), 2.78 (95%CI 1.71-4.53), and 3.13 (95%CI 1.50-6.55) in women, respectively. Hyperuricemia is common in employees at high-altitude areas. However, working at higher altitudes does not mean necessarily higher risk of hyperuricemia, as dietary factors and clustered CRFs are more significant. Thus, workplace-based lifestyle modifications should be promoted.
慢性暴露于高海拔地区可能导致高尿酸血症。我们调查了高海拔地区员工高尿酸血症的患病率及其危险因素。在青藏高原的 23 个工作场所进行了一项基于聚类抽样的横断面调查。通过问卷调查、人体测量和实验室测量以及腹部超声对受试者进行评估。使用多水平逻辑回归模型和限制立方样条来探讨高尿酸血症的相关因素。在纳入的 4198 名员工中,高尿酸血症的年龄标准化患病率为 28.1%(95%置信区间[CI] 26.7-29.5%),男性为 31.9%(95%CI 30.2-33.6%),女性为 17.9%(95%CI 15.7-20.1%)。高血压、高血脂和肉类饮食模式与两性的高尿酸血症呈正相关,而糖尿病、轮班工作、体重指数、非酒精性脂肪肝和水果及蔬菜摄入量低与男性高尿酸血症显著相关。此外,还观察到心血管危险因素(CRFs)数量与高尿酸血症之间呈非线性剂量反应关系。与无 CRFs 的人群相比,有 1、2 和≥3 个 CRFs 的男性校正后的优势比(OR)及其 95%CI 分别为 1.76(95%CI 1.25-2.47)、2.54(95%CI 1.81-3.55)和 3.05(95%CI 2.16-4.31),女性分别为 2.13(95%CI 1.43-3.17)、2.78(95%CI 1.71-4.53)和 3.13(95%CI 1.50-6.55)。高海拔地区员工高尿酸血症较为常见。然而,在高海拔地区工作并不一定意味着高尿酸血症的风险更高,因为饮食因素和聚集的 CRFs 更为重要。因此,应提倡以工作场所为基础的生活方式改变。