尿酸与腹型肥胖及代谢综合征相关性研究  

The correlation between serum uric acid level and abdominal obesity or metabolic syndrome

作　　者：尹雪瑶[1] 周嘉强[1] 余丹[1] 潘倩倩[1] 董雪红[1] 郑芬萍[1] 李红[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院内分泌科,杭州310016

出　　处：《中华内科杂志》2014年第1期13-18,共6页Chinese Journal of Internal Medicine

基　　金：国家科技支撑计划（2009BAI80B01）;浙江省重大科技专项重点社会发展项目（2009C0310-4）

摘　　要：目的 探讨血清尿酸（UA）水平的变化与腹型肥胖及代谢综合征（MS）的相关性.方法 875例40 ～ 65岁杭州社区居民进入研究,其中男350例,女525例.对所有研究对象均进行问卷调查、体检和血清学检查,并进行腹部MRI扫描,测量腹内脂肪面积和皮下脂肪面积,分析UA水平与腹型肥胖和MS的相关性,并确定UA作为MS诊断的参考指标的最佳界值.结果 该人群中随着UA水平增加,腹型肥胖（男性OR =4.35,95％ CI 1.91 ～9.90;女性OR=5.44,95％CI2.41 ～ 12.31）和MS（男性OR=4.47,95％ CI2.08 ～9.62;女性OR=11.62,95％ CI 3.43 ～ 39.37）风险增加.多项logistic回归分析显示,UA是TG升高（男性OR =2.23,95％ CI 1.02 ～4.87;女性OR=3.04,95％ CI1.49 ～6.23）、女性腹型肥胖（OR=3.23,95％ CI 1.32～7.91）和血压升高（OR=2.35,95％ CI1.37～4.05）的独立危险因素.在女性中,根据腹内脂肪面积建立多元线性回归模型,UA的最佳切点为244.0 μmol/L,而通过受试者ROC曲线获得MS诊断的最佳界值为258.8 μmol/L.结论 在我国中年人群中,UA与腹型肥胖和MS密切相关.UA水平升高是女性腹型肥胖和MS的独立危险因素.Objective To investigate the relationship between serum uric acid （UA） level and abdominal obesity or metabolic syndrome （MS）.Methods A total of 875 subjects,with 350 males and 525 females,aged 40-65 years old,were enrolled in this study.The clinical and biochemical data were collected and MRI was used to assess the visceral and subcutaneous adipose tissues.The relationships between UA level and abdominal obesity or MS were analyzed,and the cut-off values of UA for abdominal obesity and MS were determined.Results Raised risks of abdominal obesity （OR =4.35,95% CI 1.91-9.90 in males; OR =5.44,95% CI 2.41-12.31 in females） and MS （OR =4.47,95 % CI 2.08-9.62 in males; OR =11.62,95% CI 3.43-39.37 in females） were observed with the increase of UA level.The multiple logistic regression analysis showed that UA was an independent risk factor for hypertriglyceridemia （OR =2.23,95% CI 1.02-4.87 in males ; OR =3.04,95% CI 1.49-6.23 in females） in all subjects and for abdominal obesity（OR =3.23,95% CI 1.32-7.91） and hypertension （OR =2.35,95% CI 1.37-4.05）in the females.Among the females,the regression line analyzed by simple correlation indicated that the UA level of 244.0 μmol/L was corresponded to the visceral adipose tissue area of 80 cm2.The optimal cut-off point of UA for the diagnosis of MS was 258.8 μmol/L determined by the receiver operating characteristic curve.Conclusions The level of UA is closely correlated with abdominal obesity and MS in the middleaged Chinese.The elevated UA level is an independent risk factor for abdominal obesity and MS in the female.

关 键 词：尿酸 代谢综合征X 向心性肥胖 

分 类 号：R589[医药卫生—内分泌] R589.2[医药卫生—内科学]