中老年男性及绝经前后女性中血尿酸水平与代谢综合征的关系  

Relationship between serum uric acid levels and metabolic syndrome in Chinese premenopausal women, postmenopausal women, and men

作　　者：安平[1] 王安平[1] 闫文华[1] 窦京涛[1] 吕朝晖[1] 母义明[1] 

机构地区：[1]解放军总医院内分泌科,北京100853

出　　处：《中华内分泌代谢杂志》2017年第12期1031-1037,共7页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的 通过调查城市社区中老年人群高尿酸血症以及代谢综合征的患病状况,分析血清尿酸水平与代谢综合征的关系,并进一步探究性别差异与绝经前后对二者关系的影响,从而在尿酸水平的角度对代谢综合征的预防提供参考.方法 本研究采用横断面调查的方法,北京市古城社区、金顶街社区符合要求的40岁以上人群共计10191人（男性3627人,未绝经女性726人,绝经后女性5838人）纳入本次研究.所有研究对象均进行了标准调查问卷、体格检查、口服葡萄糖耐量试验、空腹生化测定（血尿酸、血脂、肝肾功能等）.高尿酸血症的诊断标准如下：男性〉420μmol/L,女性〉360μmol/L.代谢综合征的诊断参考国际糖尿病联合会的标准.分析血清尿酸水平的影响因素采用Pearson相关分析;分析血清尿酸水平与代谢综合征的关系采用logistic回归分析.结果 （1）在男性、未绝经女性和绝经后女性3组人群中,高尿酸血症的患病率分别为14.4％、6.2％和11.8％,代谢综合征的患病率分别为35.2％、28.9％和46.2％.（2）分别在3组人群中校正年龄和血肌酐水平后的偏相关分析结果显示,影响血清尿酸水平的各因素中,相关系数最大的三个因素均为三酰甘油、体重指数、腰围;并且以上影响因素在女性中的相关系数显著高于男性.（3）根据血清尿酸水平四分位数由低到高将各组人群分别分成Q1～Q4组,Logistic回归结果显示,以Q1组为对照,男性、未绝经女性和绝经后女性中Q4组患代谢综合征风险的OR值分别为1.404、3.538和2.088（均P〈0.05）;绝经后女性中,发生代谢综合征的风险随血清尿酸水平的升高而增加;且女性Q4组发生代谢综合征各组分的风险均大于男性Q4组.结论 中老年人群中血清尿酸水平与代谢综合征相互联系,并且此种联系在女性中更为密切.血清尿酸水平升高的人群发生代谢综合征的风险增大,且Objective The study was conducted to investigate the incidence of metabolic syndrome （ MS） and hyperuricemia in Chinese community residents, and to assess differences of menopausal status and genders in the relationship between MS and serum uric acid （ SUA ） levels. Methods A total of 10191 subjects （ 5838 postmenopausal women, 726 premenopausal women, and 3627 men） were recruited in this cross-sectional study. All participants received standard questionnaire survey, physical examination, oral glucose tolerance test, and laboratory examination （ serum uric acid, serum lipid, liver and kidney functions ） . MS was diagnosed according to the International Diabetes Federation （ IDF） criteria. Hyperuricemia was defined as SUA〉420μmol/L for men and〉360μmol/L for women. Results The prevalence of hyperuricemia was 14. 4% in men, 11. 8% in postmenopausal women, and 6. 2% in premenopausal women. The prevalence of MS was 35. 2% in men, 46. 2% in postmenopausal women, and 28. 9% in premenopausal women. The body mass index, waist circumference, and triglycerides levels were most strongly associated with SUA levels in all groups, while the correlation coefficients of these factors were higher in females than those in males. Individuals in the highest SUA quartile had 3. 538-fold, 2. 088-fold, and 1. 404-fold increased risk of MS as compared with those in the lowest quartile in premenopausal women, postmenopausal women, and men, respectively. The risks of developing each components of MS in females were higher than those in males. Conclusions There is an association between SUA level and MS, and the relationships between SUA levels and MS were much closer in females than those in males. Individuals with higher SUA levels were more likely to develop MS and its components than those with lower SUA levels. Premenopausal women with high level of SUA may have the highest risk of developing MS in Chinses community residents.

关 键 词：代谢综合征 血尿酸 高尿酸血症 性别 绝经 

分 类 号：R589[医药卫生—内分泌]