Department of Cardiology, Tianjin Fifth Central Hospital, 300450, Tianjin, China.
Department of Laboratory, Tianjin Fifth Central Hospital, 300450, Tianjin, China.
BMC Geriatr. 2021 Oct 2;21(1):527. doi: 10.1186/s12877-021-02483-5.
The elevated serum uric acid (SUA) is associated with an increased risk of hypertension and nutritional status. Malnutrition might modify the association of SUA with hypertension. Therefore, the aims of this study were to examine the mediation effect of malnutrition on the association of SUA with the risk of hypertension in Chinese population.
The study was based on the China Health and Nutrition Survey in 2009. Participants aged ≥ 60 years with complete analyzed data were eligible. The Geriatric Nutritional Risk Index (GNRI) was calculated by serum albumin (ALB) and BMI. Participants were identified as hypertension if systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg or receiving antihypertensive drug.
There were 2371 participants included in the final analysis. In total, there was a significant mediation effect of the GNRI on the relationship between SUA level with hypertension (P < 0.001; OR: 1.096; and 95 % CI: 1.048-1.146). And the proportion mediated was 17.77 %. The results stratified by sex were consistent with those of total population. The significant mediation effects of the GNRI were found in the 60-69 years and 70-79 years groups (P = 0.002 and 0.032; OR: 1.099 and 1.075; and 95 % CI: 1.036-1.165 and 1.006-1.148, respectively) but not in the 80-99 years group (P = 0.303). The proportions mediated were16.22 % and 18.36 %, respectively.
The GNRI can mediate and account for approximately 17.77 % of the relationship between SUA level and the risk of hypertension. And this mediation effect was fully observed in both males and females, especially in the 60-79 years population.
血清尿酸（SUA）升高与高血压风险增加有关，同时也与营养状况有关。营养不良可能会改变 SUA 与高血压之间的关联。因此，本研究旨在探讨营养不良对 SUA 与中国人群高血压风险之间关联的中介作用。
本研究基于 2009 年中国健康与营养调查，纳入了具有完整分析数据且年龄≥60 岁的参与者。通过血清白蛋白（ALB）和 BMI 计算老年营养风险指数（GNRI）。若收缩压≥140mmHg 和/或舒张压≥90mmHg 或正在服用降压药物，则将参与者诊断为高血压。
最终纳入 2371 名参与者进行分析。SUA 水平与高血压之间存在显著的 GNRI 中介效应（P<0.001；OR：1.096；95%CI：1.048-1.146）。中介比例为 17.77%。按性别分层的结果与总体人群一致。在 60-69 岁和 70-79 岁组中，GNRI 的显著中介作用（P=0.002 和 0.032；OR：1.099 和 1.075；95%CI：1.036-1.165 和 1.006-1.148），但在 80-99 岁组中无显著中介作用（P=0.303）。中介比例分别为 16.22%和 18.36%。
GNRI 可以中介和解释 SUA 水平与高血压风险之间约 17.77%的关系。这种中介作用在男性和女性中均得到充分观察，尤其是在 60-79 岁人群中。
