Department of Health Management Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.
Department of Health Management Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
BMJ Open. 2023 May 24;13(5):e072317. doi: 10.1136/bmjopen-2023-072317.
The purposes of the study were to investigate the detailed association of serum uric acid (SUA) with visceral fat area (VFA) and body fat percentage (BFP) as calculated by bioelectrical impedance analysis (BIA) and build non-invasive diagnosis models of hyperuricaemia by combining obesity-related indicators, age and sex.
A total of 19 343 adults were included. Multivariable regression analysis models were employed to analyse the association of SUA with VFA and BFP. Receiver operating characteristic curves were generated to diagnose hyperuricaemia in adults.
After fully adjusting for covariates, SUA was positively associated with VFA, BFP and body mass index (BMI) with βs of 0.447, 2.522 and 4.630 (95% CI= (0.412 to 0.482), (2.321 to 2.723) and (4.266 to 4.994)). After stratification by gender, this association persists (p<0.001). Fitted smoothing curves identified non-linear relationships between SUA and both VFA and BMI after full adjustment in males (inflection points: 93.9 cm and 30.9 kg/m). A non-linear relationship also exists between SUA and BFP in females (inflection point: 34.5%). A combined model incorporating BFP, BMI, age and sex exhibited the best ability to diagnose hyperuricaemia (AUC (area under the curve) =0.805, specificity=0.602, sensitivity=0.878). For normal-weight and lean populations, individuals with hyperuricaemia tended to have higher levels of VFA and BFP in females and males, respectively (p<0.001). The combination of VFA, BFP, BMI, age and sex exhibited the best ability to diagnose hyperuricaemia in normal-weight and lean populations (AUC=0.803, specificity=0.671, sensitivity=0.836).
VFA and BFP are independent factors associated with SUA. In males, SUA shows a non-linear relationship with VFA and BMI. In females, SUA and BFP exhibit a non-linear relationship. In normal-weight and lean individuals, the accumulation of VFA and BFP may be involved in hyperuricaemia. VFA and BFP were helpful in diagnosing hyperuricaemia in adults, especially for normal-weight and lean populations.
本研究旨在探讨血清尿酸（SUA）与内脏脂肪面积（VFA）和体脂百分比（BFP）的详细关联，BFP 由生物电阻抗分析（BIA）计算得出。并构建一种通过结合肥胖相关指标、年龄和性别来诊断高尿酸血症的非侵入性诊断模型。
共纳入 19343 名成年人。采用多变量回归分析模型分析 SUA 与 VFA 和 BFP 的关联。绘制受试者工作特征曲线以诊断成年人高尿酸血症。
在充分调整协变量后，SUA 与 VFA、BFP 和体重指数（BMI）呈正相关，β 值分别为 0.447、2.522 和 4.630（95%CI：（0.412 至 0.482）、（2.321 至 2.723）和（4.266 至 4.994））。按性别分层后，这种相关性仍然存在（p<0.001）。经充分调整后，在男性中，拟合平滑曲线确定了 SUA 与 VFA 和 BMI 之间的非线性关系（拐点：93.9cm 和 30.9kg/m）。在女性中，SUA 与 BFP 之间也存在非线性关系（拐点：34.5%）。在纳入 BFP、BMI、年龄和性别的综合模型中，诊断高尿酸血症的能力最佳（AUC（曲线下面积）=0.805，特异性=0.602，敏感性=0.878）。在正常体重和偏瘦人群中，女性和男性中血尿酸升高的个体的 VFA 和 BFP 水平均较高（p<0.001）。在正常体重和偏瘦人群中，VFA、BFP、BMI、年龄和性别的综合模型诊断高尿酸血症的能力最佳（AUC=0.803，特异性=0.671，敏感性=0.836）。
VFA 和 BFP 是与 SUA 相关的独立因素。在男性中，SUA 与 VFA 和 BMI 呈非线性关系。在女性中，SUA 和 BFP 呈非线性关系。在正常体重和偏瘦人群中，VFA 和 BFP 的积累可能与高尿酸血症有关。VFA 和 BFP 有助于诊断成年人高尿酸血症，尤其是对正常体重和偏瘦人群。
