Shimabukuro Tomoyuki, Ohmi Chietaka, Shiraishi Koji, Matsuyama Hideyasu
Department of Urology, Ube-kosan Central Hospital Corp.
Department of Urology, Graduate School of Medicine, Yamaguchi University.
Nihon Hinyokika Gakkai Zasshi. 2020;111(1):22-29. doi: 10.5980/jpnjurol.111.22.
(Background) Hyperuricemia is associated with hypertension, vascular disease, cardiovascular events, and renal dysfunction. Several studies have reported the relationship between serum uric acid (UA) level and clinical outcome in the general population. However, most such studies have not quantitatively evaluated the association between UA and age, body mass index (BMI), and estimated glomerular filtration rate (eGFR). (Method) From April 2015 to March 2016, a total 10,133 healthy individuals underwent multiphasic screening at our medical checkup center. Among all participants, eGFR was evaluated in 1,684 men and 1,195 women. The data of this cohort were reviewed and analyzed. (Results) The median age of men and women was 51.0 and 50.0 years, respectively. Median serum UA was 6.1 mg/dL in men and 4.5 mg/dL in women. The prevalence of hyperuricemia was 23.9% in men and 8.5% in women. In all 10-year age groups, men had significantly higher serum UAs than women. In men, no significant differences of serum UA were observed among 10-year age groups. Menopause-associated increases in serum UA among women were observed. Men in their 20s to 50s and women in their 30s to 60s showed significant differences in serum UA between each BMI category in the same age decade. Both men and women in their 40s to 60s showed significant differences in serum UA between each eGFR category in the same age decade. We used the results of multiple regression analysis to derive equations to predict the associations among these variables, as follows: men, UA (mg/dL) = 5.637+0.065 × (BMI) - 0.014 × (eGFR) (R = 0.059, P < 0.0001); women < 50 years old, UA (mg/dL) = 4.068+0.065 × (BMI) - 0.014 × (eGFR) (R = 0.091, P < 0.0001) and women > 50 years old, UA (mg/dL) = 4.311+0.075 × (BMI) - 0.017 × (eGFR) (R = 0.116, P < 0.0001). (Conclusions) We present epidemiological evidence indicating that the levels of serum UA vary with BMI and eGFR in both sexes. In women, it should be recognized that menopause is independently associated with higher levels of UA.
（背景）高尿酸血症与高血压、血管疾病、心血管事件及肾功能不全相关。多项研究报告了一般人群中血清尿酸（UA）水平与临床结局的关系。然而，大多数此类研究未对UA与年龄、体重指数（BMI）及估算肾小球滤过率（eGFR）之间的关联进行定量评估。（方法）2015年4月至2016年3月，共有10133名健康个体在我们的体检中心接受了多阶段筛查。在所有参与者中，对1684名男性和1195名女性进行了eGFR评估。对该队列的数据进行了回顾和分析。（结果）男性和女性的中位年龄分别为51.0岁和50.0岁。男性血清UA中位数为6.1mg/dL，女性为4.5mg/dL。高尿酸血症的患病率男性为23.9%，女性为8.5%。在所有10岁年龄组中，男性的血清UA显著高于女性。在男性中，各10岁年龄组之间血清UA无显著差异。观察到女性绝经后血清UA升高。20多岁至50多岁的男性和30多岁至60多岁的女性在同一年龄十年内各BMI类别之间血清UA存在显著差异。40多岁至60多岁的男性和女性在同一年龄十年内各eGFR类别之间血清UA存在显著差异。我们使用多元回归分析结果得出预测这些变量之间关联的方程如下：男性，UA（mg/dL）=5.637 + 0.065×（BMI） - 0.014×（eGFR）（R = 0.059，P < 0.0001）；50岁以下女性，UA（mg/dL）=4.068 + 0.065×（BMI） - 0.014×（eGFR）（R = 0.091，P < 0.0001）；50岁以上女性，UA（mg/dL）=4.311 + 0.075×（BMI） - 0.017×（eGFR）（R = 0.116，P < 0.0001）。（结论）我们提供的流行病学证据表明，男女血清UA水平均随BMI和eGFR而变化。在女性中，应认识到绝经与较高的UA水平独立相关。
