某部干部血尿酸水平及尿酸排泄能力相关影响因素分析  

The influencing factors of serum uric acid levels and uric acid excretion in the officers at a military unit

作　　者：黄火高[1] 张宝和[2] 连士杰[2] 康怡[3] 胡瑞兰[2] 马英霞[2] 李勇[2] 孙洪良[2] 于海[2] 华伟[2] 杜凯音[2] 田光[4] 申明达[4] 翟鑫[4] 徐洪涛 

机构地区：[1]海军总医院内分泌风湿免疫科,北京100048 [2]海军总医院干部保健科,北京100048 [3]海军总医院特需医疗部,北京100048 [4]海军总医院医务部,北京100048 [5]海军总医院院办,北京100048

出　　处：《转化医学杂志》2014年第5期282-285,301,共5页Translational Medicine Journal

基　　金：海军后勤项目(CHJ12L024)

摘　　要：目的研究某部干部血尿酸及肾脏排泄尿酸变化的影响因素,查找尿酸升高的可能危险因素,为控制尿酸提供指导依据。方法利用年度干部体检对某部参加体检的非痛风和尿酸未受明确因素影响的1 096人进行问卷调查,及血生化等检查,并计算体质指数、尿白蛋白肌酐比、尿酸-肌酐廓清率比值。以男性血尿酸>420μmol/L(7.0 mg/dL)、女性血尿酸>357μmol/L(6.0 mg/dL)为高尿酸血症组,余为非高尿酸血症组;以尿酸-肌酐廓清率比值由低到高分为尿酸低排组、混合组和尿酸高排组。汇总数据后进行统计学分析。结果男性血尿酸明显高于女性[(330.9±69.4)mmol/L与(249.4±55.2)mmol/L)];高尿酸血症患病率男性与女性无明显差别。高尿酸血症组体质指数、收缩压、舒张压、三酰甘油、血肌酐、尿素氮、高敏C反应蛋白、同型半胱氨酸、尿白蛋白肌酐比、腰围、臀围均明显高于非高尿酸血症组,而高密度脂蛋白、尿酸-肌酐廓清率比值明显低于非高尿酸血症组。高尿酸血症与体质指数、三酰甘油、血肌酐、高敏C反应蛋白、尿白蛋白肌酐比、尿酸-肌酐廓清率比值密切相关,其中尿酸-肌酐廓清率比值、三酰甘油、体质指数为重要影响因素。血尿酸与三酰甘油、体质指数、腰围、臀围、舒张压呈正相关,与尿酸-肌酐廓清率比值呈负相关。尿酸-肌酐廓清率比值与三酰甘油呈显著负相关。性别、三酰甘油、血肌酐、尿酸和尿白蛋白肌酐比对尿酸-肌酐廓清率比值有影响,其中三酰甘油和尿酸对尿酸-肌酐廓清率比值存在负性影响。结论血尿酸变化受多种因素影响,可改变的影响因素集中于肾脏排泄能力、三酰甘油和体质量,应作为防治高尿酸血症的重点。Objective To study the influencing factors of serum uric acid levels and uric acid excretion in the officers at a military unit, in order to search the potential risk factors corre-sponding to the elevation of serum uric acid, and provide guidance to the control of uric acid levels. Methods In 1 096 cases, a questionnaire survey was provided for the retired officers in the military unit.Based on predefined inclusion and exclusion criteria, healthy officers or officers who took no drugs affecting uric acid metabolism were selected.Body mass index (BMI), urinary albumin creati-nine ratio (ACR) and uric acid to creatinine clearance rate (Cua/Ccr) were measured, and the data was analyzed.Results Men had higher serum uric acid levels compared with women [(330.9± 69.4)mmol/L vs.(249.4±55.2) mmol/L].There was no significant difference in the prevalence of hyperuricemia (HUA) between men and women (8.7% vs.5.6%).HUA group had higher BMI, systolic blood pressure, diastolic blood pressure, triglyceride (TG), creatinine (Cre), blood urea nitrogen (BUN), high-sensitivity C-reactive protein (hs-CRP), homocysteine (HCY), ACR, waist circumference and hip circumference, compared with non-hyperuricemia (NHUA) group;whereas high-density lipoprotein and Cua/Ccr were significantly lower.HUA was closely correlated to BMI, TG, Cre, hs-CRP, ACR and Cua /Ccr.The major influencing factors were Cua/Ccr, TG and BMI.Serum uric acid level was positively correlated with TG, BMI, waist circumference, hip circ-umference, or diastolic blood pressure, respectively; and was negatively correlated with Cua/Ccr. There was a significant negative correlation between Cua/Ccr and TG.Gender, TG, creatinine, uric acid,and ACR had a effect on Cua /Ccr,where TG and uric acid had a negative effect on Cua/Ccr. Conclusion Serum uric acid levels can be influenced by a number of factors.The key variable factors, including renal excretion, TG and body weight, are potential targets for prevention of hyperuricemia.

关 键 词：尿酸 尿酸排泄 三酰甘油 体质指数 危险因素 

分 类 号：R589[医药卫生—内分泌]