含糖饮料的摄入与高尿酸血症风险：来自墨西哥卫生工作者队列研究参与者的纵向分析。
Sugar-sweetened beverage consumption and risk of hyperuricemia: a longitudinal analysis of the Health Workers Cohort Study participants in Mexico.
机构信息
Research Center in Policy, Population, and Health, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico.
CONACYT, Center for Population Health Research, National Institute for Public Health, Cuernavaca, Morelos, Mexico.
出版信息
Am J Clin Nutr. 2020 Sep 1;112(3):652-660. doi: 10.1093/ajcn/nqaa160.
BACKGROUND
The elevated consumption of sugar-sweetened beverages (SSBs) in Mexico is an important public health concern. However, the association between SSB consumption and hyperuricemia has been scarcely studied and not well documented.
OBJECTIVES
To prospectively evaluate the association between SSB consumption and risk of hyperuricemia in Mexican adults.
METHODS
A longitudinal analysis was conducted using data from the Health Workers Cohort Study. Participants were followed from 2004 to 2018, with measurements every 6 y. The analysis sample consisted of 1300 adults, aged 18 to 85 y. SSB consumption during the previous year was evaluated through a semiquantitative FFQ. Hyperuricemia was defined as a concentration of uric acid ≥7.0 mg/dL in men and ≥5.7 mg/dL in women. We evaluated the association of interest using 2 methodologies: fixed-effects logistic regression and generalized estimating equations (GEEs). Potential confounders were included in both approaches.
RESULTS
At baseline, median intake of SSBs was 472.1 mL/wk (IQR: 198.8-1416.4 mL/wk), and 233 participants had hyperuricemia. Uric acid was higher in participants with an SSB intake ≥7 servings/wk, compared with those with an intake <1 serving/wk (P < 0.001). Participants who changed from the lowest to the highest category of servings consumption experienced 2.6 increased odds of hyperuricemia (95% CI: 1.27, 5.26). Results from the GEE model indicated the odds of hyperuricemia increased by 44% (OR=1.44; 95% CI: 1.13, 1.84) in the 2-6 servings/wk group, and by 89% (OR=1.89; 95% CI: 1.39, 2.57) in the ≥7 servings/wk categories, compared with the <1 serving/wk category. Diet soft drinks were not associated with hyperuricemia.
CONCLUSIONS
Our results suggest that the consumption of SSBs is associated with an increased risk of hyperuricemia in Mexican adults, but diet soft drink consumption is not, which supports the need to strengthen existing recommendations to reduce the intake of SSBs.The Health Workers Cohort Study (HWCS) has been approved by the Institutional Review Board of the Mexican Social Security Institute (12CEI 09 006 14), and the National Institute of Public Health of Mexico (13CEI 17 007 36).
背景
墨西哥人含糖饮料（SSB）的摄入量增加是一个重要的公共卫生问题。然而，SSB 消费与高尿酸血症之间的关系研究甚少，也没有很好地记录。
目的
前瞻性评估墨西哥成年人 SSB 消费与高尿酸血症风险之间的关系。
方法
使用健康工作者队列研究的数据进行纵向分析。参与者从 2004 年到 2018 年进行随访，每 6 年测量一次。分析样本包括 1300 名年龄在 18 至 85 岁的成年人。通过半定量 FFQ 评估 SSB 在前一年的摄入量。高尿酸血症定义为男性尿酸浓度≥7.0mg/dL 和女性≥5.7mg/dL。我们使用 2 种方法评估了感兴趣的关联：固定效应逻辑回归和广义估计方程（GEE）。在这两种方法中都纳入了潜在的混杂因素。
结果
在基线时，SSB 的中位摄入量为每周 472.1 毫升（IQR：198.8-1416.4 毫升/周），有 233 名参与者患有高尿酸血症。与每周摄入量<1 份相比，每周摄入量≥7 份的参与者尿酸水平更高（P<0.001）。与最低摄入量组相比，摄入量从最低到最高组的参与者高尿酸血症的几率增加了 2.6 倍（95%CI：1.27，5.26）。GEE 模型的结果表明，每周摄入 2-6 份的参与者高尿酸血症的几率增加了 44%（OR=1.44；95%CI：1.13，1.84），每周摄入≥7 份的参与者高尿酸血症的几率增加了 89%（OR=1.89；95%CI：1.39，2.57），与每周摄入<1 份相比。无糖软饮料的消费与高尿酸血症无关。
结论
我们的结果表明，SSB 的摄入与墨西哥成年人高尿酸血症的风险增加有关，但无糖软饮料的摄入与高尿酸血症无关，这支持了加强现有建议以减少 SSB 摄入量的必要性。健康工作者队列研究（HWCS）已获得墨西哥社会保障研究所机构审查委员会（12CEI 09 006 14）和墨西哥国家公共卫生研究所（13CEI 17 007 36）的批准。
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