The Physical Examination Centre of the Second Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China.
Department of Health Statistics, School of Public Health, Dalian Medical University, Dalian, Liaoning, China.
BMJ Open. 2020 Jul 2;10(7):e035289. doi: 10.1136/bmjopen-2019-035289.
Many studies have demonstrated that elevated serum uric acid (SUA) level is linked with metabolic syndrome (MetS). However, whether there is a sex difference in the association between SUA and MetS has not been determined. This study aimed to accurately explore the impact of SUA longitudinal changes on MetS by sex.
A prospective cohort study.
The Health Check-up Centre of the Second Hospital affiliated with Dalian Medical University from 2010 to 2016.
A health check-up cohort of 577 men and 1698 women aged 20-60 years who did not exhibit MetS or hyperuricaemia at baseline and underwent at least two physical examinations from 2010 to 2016.
Weight, height, blood pressure and blood biochemistry parameters, including SUA, were measured. MetS was defined according to the Joint Interim Statement criteria.
Based on longitudinal data, a linear mixed-effects model was constructed to explore the characteristics of SUA dynamic changes in males and females, and joint modelling of longitudinal and survival data was done to analyse the association between SUA dynamic changes and MetS occurrence.
The natural logarithm of SUA (LNSUA) in females exhibited a gradually increasing trend, and its annual growth rate in females who developed MetS was greater than that of the non-MetS females. The longitudinal growth of SUA in females was a risk factor for the onset of MetS, and the estimated HR was 13.2580 (95% CI 1.9106 to 91.9957) for each 1-unit rise in LNSUA longitudinally. An association between the longitudinal growth of LNSUA and MetS was not found in males.
The longitudinal increase in SUA in females could increase the risk of MetS, even if the SUA changes within the normal range. The longitudinal increase in SUA in males was not a predictor for MetS.
许多研究表明，血清尿酸（SUA）水平升高与代谢综合征（MetS）有关。然而，SUA 与 MetS 之间的关联是否存在性别差异尚未确定。本研究旨在通过性别准确探讨 SUA 纵向变化对 MetS 的影响。
前瞻性队列研究。
大连医科大学附属第二医院健康体检中心，2010 年至 2016 年。
20-60 岁健康体检队列，基线时无 MetS 或高尿酸血症，2010 年至 2016 年至少进行两次体检，共 577 名男性和 1698 名女性。
测量体重、身高、血压和血液生化参数，包括 SUA。MetS 根据联合临时声明标准定义。
基于纵向数据，构建线性混合效应模型探讨男性和女性 SUA 动态变化的特征，并进行纵向和生存数据的联合建模，分析 SUA 动态变化与 MetS 发生的关系。
女性的 SUA 自然对数（LNSUA）呈逐渐上升趋势，发生 MetS 的女性的 SUA 年增长率大于非 MetS 女性。女性 SUA 的纵向增长是 MetS 发病的危险因素，LNSUA 每升高 1 个单位，估计 HR 为 13.2580（95%CI 1.9106 至 91.9957）。在男性中，未发现 LNSUA 纵向增长与 MetS 之间存在关联。
女性 SUA 的纵向升高可能会增加 MetS 的风险，即使 SUA 变化在正常范围内。男性 SUA 的纵向升高不是 MetS 的预测因素。
