某三甲医院医师人群高尿酸血症与代谢综合征患病的相关性分析  

Correlation between hyperuricemia and metabolic syndrome in class 3A comprehensive hospital physicians

作　　者：王亚莎[1] 王伟占 李永辉[1] 田凤石[1] WANG Yasha;WANG Weizhan;LI Yonghui;TIAN Fengshi(The Forth Central Hospital of Tianjin,Tianjin 300140,China)

机构地区：[1]天津市第四中心医院,天津300140

出　　处：《山东医药》2018年第30期9-13,共5页Shandong Medical Journal

基　　金：天津市卫生行业重点攻关项目(13KG117);天津市卫计委科技基金面上项目(2015KY06);天津市第四中心医院硕博基金项目(2016S10)

摘　　要：目的探讨医师人群中高尿酸血症(HUA)与代谢综合征(Met S)患病的相关性。方法采用病例对照研究方法,以天津市某三甲医院的684例进行健康体检的医师为研究对象,将228例诊断为Met S的医师作为Met S组,456例非Met S的医师作为对照组。所有研究对象填写调查问卷,测量体格检查指标包括身高、体质量、腰围(WC)、收缩压(SBP)、舒张压(DBP)等项目;采集血液标本,测量空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血清胰岛素(Ins)、血清肌酐(SCr)、血清尿酸(SUA)等指标。根据SUA诊断HUA,计算两组HUA的检出率。分别采用简单相关模型、调整年龄模型评价各指标间的相关性。比较合并不同数量的Met S成分者SUA水平的差异。采用非条件Logistic回归模型分析调整性别、年龄等因素影响后HUA与Met S的关系。结果 Met S组SUA水平高于对照组(P<0.01)。Met S组与对照组HUA的检出率分别为28.51%(65/228)和8.99%(41/456),Met S组HUA的检出率高于对照组(P<0.01)。调整年龄因素的影响后,男性与女性医师的SUA水平与WC、BMI、SBP、TG、LDL-C、SCr均呈正相关,而与HDL-C呈负相关(P均<0.05)。随Met S组成成分个数增加,SUA水平增加(rs=0.368,P<0.01)。HUA患者中女性医师的Met S患病风险高于男性(OR男性为2.493,OR女性为7.923)。调整年龄、BMI、SCr、TC、LDL-c、Ins、HOMA-IR、吸烟史、饮酒史、体育锻炼等因素后,HUA依然会增加男女医师Met S的患病风险(OR男性=2.463,95%CI:1.226~4.950;OR女性=5.499,95%CI:2.246~13.461)。结论医师人群中SUA水平与Met S患病及其成分的相关性较高,HUA可能是医师人群Met S患病的独立危险因素。女性医师HUA者的Met S患病风险高于男性医师。Objective To explore the correlation between hyperuricemia（ HUA） and metabolic syndrome（ Met S） in physicians. Methods The case-control study method was applied,physicians working in a Class 3 A comprehensive hospital were selected as the research objects. A total of 228 Met S physicians were randomly selected as the case group,and456 non-Met S physicians were randomly selected as the control group. All subjects completed the questionnaire; physical examination indicators,including height,body mass,waist circumference（ WC）,systolic blood pressure（ SBP）,and diastolic blood pressure（ DBP）,were measured. Blood samples were collected to detect the fasting blood glucose（ FBG）,total cholesterol（ TC）,triglycerides（ TG）,high-density lipoprotein cholesterol（ HDL-C）,low-density lipoprotein cholesterol（ LDL-C）,serum insulin（ Ins）,serum creatinine（ SCr）,and serum uric acid（ SUA）. The HUA was diagnosed according to the SUA level,and the detection rates of HUA in both groups were calculated separately. The correlation between the indicators was evaluated by using a simple correlation model and an age-adjusted model. SUA levels were compared for patients with different numbers of Met S components. The unconditional logistic regression model was used to analyze the relationship between HUA and Met S after adjusting the gender,age and other influencing factors. Results The SUA level in the Met S group was higher than that in the control group（ P〈0. 01）. The detection rates in the Met S group and the control group were 28. 51%（ 65/228） and 8. 99%（ 41/456）,respectively; the detection rate of HUA in the Met S group was higher than that in the control group（ P〈0. 01）. The SUA levels for both gender were positively correlated with WC,BMI,SBP,TG,LDL-C and SCr,while were negatively correlated with HDL-C after adjusting the influence of age（ all P〈0. 05）. The SUA level increased with the number of Met S components（ rs= 0. 368,P〈0. 01）. Female HUA patients

关 键 词：血清尿酸 高尿酸血症 代谢综合征 性别 医师 病例对照研究 

分 类 号：R181.38[医药卫生—流行病学] R589[医药卫生—公共卫生与预防医学]