以代谢综合征为标准探讨高尿酸血症诊断标准的性别差异合理性研究  

The rationality of gender-specific diagnostic criteria of hyperuricemia in preventing metabolic syndrome

作　　者：王淼[1] 刘静[1] 王薇[1] 孙佳艺[1] 刘军[1] 齐玥[1] 秦兰萍[1] 解武祥[1] 王瑛[1] 赵冬[1] 

机构地区：[1]首都医科大学附属北京安贞医院--北京市心肺血管疾病研究所流行病研究室,100029

出　　处：《心肺血管病杂志》2016年第3期161-165,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金："十二五"国家科技支撑计划(2011BAI11B03);北京市优秀人才培养资助项目(2014000021469G232)

摘　　要：目的：探讨男女不同的高尿酸（UA）血症诊断标准在代谢综合征（MS）的早期检出和预防中的必要性和合理性。方法：本研究利用通过整群抽样结合分层随机抽样建立的中国多省市心血管病队列研究人群中参加了2007年危险因素调查的5 740名研究对象的数据开展研究。结果：将人群UA水平按238μmol/L、297μmol/L、357μmol/L和416μmol/L四个切点进行分层。UA水平在238-297μmol/L时,男性MS现患率高于女性（28.5%vs.22.9%,!2=5.739,P=0.017）,在其他UA分层水平中男女两性MS现患率的差异均无统计学意义（P〉0.05）。以UA水平〈238μmol/L的人群作参照,多因素分析结果显示男性中UA水平在357-416μmol/L时的MS患病风险升高已经有统计学意义（OR=1.84,95%CI：1.20-2.83,P〈0.001）。女性中UA水平在297-357μmol/L时的MS患病风险增加开始有统计学显著性（OR=1.84,95%CI：1.44-2.37,P〈0.001）。在任意UA分层水平,男性MS患病风险均不低于女性。结论：男女不同的高UA血症诊断标准可能不利于男性人群MS的预防和控制。Objective： To explore whether the gender-specific diagnostic criteria of hyperuricemia was rational on the early prevention and control of metabolic syndrome（ MS）. Methods： The participants in this study were from the China Multi-provincial Cohort Study. The cohort study was carried out in 1992 by combined using the methods of clustering sampling and stratified random sampling to explore the determinant factors for the incidence of CVD in China. The reexamination data of CVD risk factors in 2007 from 5 740 participants were used in this study. The MS was defined according to the criteria published by Chinese guidelines on prevention and treatment of dyslipidemia in adults. The logistic regression was used to explore the independent correlation between uric acid（ UA） and MS. Results： The prevalence of MS increased with the elevated serum UA level on a linear rising trend in both sexes（ male： β = 5. 337,R2= 0. 921,P = 0. 010; female： β = 7. 085,R2= 0. 979,P = 0. 001）. When participants were stratified by different cutting points of UA level（ 238μmol / L,297 μmol / L,357 μmol / L,and 416 μmol / L）,the prevalence rate of MS was higher in the male than that in the female（ 28. 5% vs. 22. 9%,χ2= 5. 739,P = 0. 017） among participants whose UA levels were in the range of 238 μmol / L to 297 μmol / L. The difference of prevalence rates of MS were not statistically significant between the sexes at other UA levels（ P〉0. 05）. After adjusted age,serum creatinine,and HOMA index,the UA level was independently correlated with the prevalence of MS in the male after UA level increased to 357μmol /L and in the female after UA level increased to 297 μmol /L. Compared to the participants whose UA level were lower than 238 μmol / L,the odds ratio of UA for MS was 1. 84（ 95% CI： 1. 20- 2. 83） in the male whose UA levels were in the range of 357 μmol / L to 416 μmol / L,the odds ratio was 1. 84（ 95% CI： 1. 44-2. 37） in the female whose UA levels were in the range of 297 μmol

关 键 词：尿酸 高尿酸血症 代谢综合征 性别 

分 类 号：R54[医药卫生—心血管疾病]