彝族城乡居民血尿酸水平与慢性肾脏病发病率研究  

Study on Serum Uric Scid Level and Chronic Kidney Disease Incidence of the Urban and Rural Residents of Yi Nationality

作　　者：蔡丹 谢小华[3] 张玉梅 楚远珍 张海英 朱红梅 田浩明[1] 陈涛[1] Cai Dan;Xie Xiaohua;Zhang Yumei;et al(West China Hospital , Sichuan University , Chengdu Sichuan 610041;Pidu District People＇s Hospital, Chengdu, Sichuan 61500;The First People＇s Hospital of Liangshan, Xichang, Sichuan 61500, China)

机构地区：[1]四川大学华西医院内分泌代谢科,四川成都610041 [2]成都市郫都区人民医院内分泌代谢科,四川成都611730 [3]凉山州第一人民医院内分泌科,四川西昌61500

出　　处：《四川医学》2018年第3期299-302,共4页Sichuan Medical Journal

摘　　要：目的探讨遗传背景相同但生活方式不同的彝族城乡两组人群血尿酸水平及与慢性肾脏病(CKD)的关系。方法本研究纳入了1024例彝族城乡人群(身份证核对),其中农村598例,城市426例,男436例,女588例。收集每例患者的一般临床特征及CKD相关危险因素资料,如吸烟、饮酒、是否合并糖尿病、高血压、高血脂等。测量血尿酸水平、尿白蛋白肌酐比值(ACR)并计算肾小球滤过率(e GFR)。采用卡方趋势检验评估不同尿酸水平的人群CKD患病率变化的趋势,采用多因素Logistic回归分析研究尿酸与CKD之间的关系。结果城市人群平均血尿酸水平(341.0±96.4)μmol/L高于农村人群(315.7±85.6)μmol/L(P<0.001)。城市人群中总CKD患病率28.0%,农村人群总CKD患病率13.8%,城市人群CKD患病率高于农村(P<0.0001);卡方趋势检验显示随着尿酸水平的升高,城市人群CKD患病率呈上升趋势(P<0.05),农村人群此趋势不如城市人群明显;多因素Logistic回归分析显示高尿酸水平是CKD独立危险因素。结论在相同的遗传背景下,不同的生活方式导致彝族城市人群血尿酸水平及CKD高于农村人群;升高的尿酸水平可能是导致彝族城市人群CKD风险升高的原因之一。Objective To discuss the relationship between serum uric acid levels of the urban and rural two groups of Yi nationality residents with the same genetic background but different lifestyles and chronic kidney disease（ CKD）.Methods There were 1024 urban and rural Yi nationality residents（ checked by Identity Cards） included in the study,including 598 rural,426 urban residents,436 men and 588 women. Collect general clinical features and CKD-related risk factors of every patient,such as smoking,drinking,with or without diabetes,hypertension and hyperlipemia.Measure the serum uric acid level,albumin-to-creatinine ratio（ ACR） and calculate the glomerular filtration rate（ e GFR）. Evaluate the trend of CKD incidence in people with different uric acid levels by chi-square trend test,and research the relationship between uric acid and CKD by multivariable Logistic regression analysis.Results The average serum uric acid level of urban residents（ 341. 0±96. 4μmol/L） are higher than that of rural residents（ 315. 7±85. 6μmol/L）（ P0. 001）.The total CKD incidences are 28. 0% in urban residents,13. 8% in rural residents,and unban residents have a higher CKD incidence than rural residents（ P0. 0001）; chi-square trend test shows that the CKD incidence of urban residents rise with the increase of uric acid level,and this trend in rural residents are less obvious; multivariable Logistic regression analysis shows that high uric acid level is an independent risk factor for CKD.Conclusion Under the same genetic background,different lifestyles make the urban residents have higher serum uric acid levels than rural residents; the raised uric acid level could be one of the reasons that lead to the rising CDK risk of urban Yi nationality residents.

关 键 词：尿酸 尿白蛋白肌酐比值 肾小球滤过率 慢性肾脏病 生活方式 

分 类 号：R589.7[医药卫生—内分泌] R692.5[医药卫生—内科学]