非高血压人群中基线血清尿酸浓度与血压长期变化趋势的关联  

The relationship between serum uric acid and the change trend of blood pressure in adults without hypertension

作　　者：宋崑[1] 许海燕[2] 顾叶青[2] 侍洪斌[1] 张卿[1] 刘莉[1] 孟革[2] 牛凯军[1,2] SONG Kun;XU Hai-yan;GU Ye-qing;SHI Hong-bin;ZHANG Qing;LIU Li;MENG Ge;NIU Kai-jun(Health Management Centre, Tianjin Medical University General Hospital, Tianjin 300052, China;Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University)

机构地区：[1]天津医科大学总医院健康管理中心,300052 [2]天津医科大学营养流行病学研究所、公共卫生学院

出　　处：《天津医药》2017年第3期263-267,共5页Tianjin Medical Journal

基　　金：天津市科技支撑计划重点项目(11ZCGYSY05700,12ZCZDSY20400,13ZCZDSY20200)

摘　　要：目的在非高血压成年人群中,评估基线血清尿酸是否能够预测血压的长期变化趋势。方法该研究资料来自2007—2013年在天津医科大学总医院体检中心健康体检人员的体检数据,随访时间的中位数是3.0年,该纵向研究对象均无高血压既往史。总研究人数为26 904例,其中男13 596例、女13 308例。血清尿酸浓度使用酶学分析法测量。采用重复测量方差分析来评估基线尿酸浓度五分位水平与随访期间血压变化的关系。结果控制混杂因素后,在男性人群中,血清尿酸5个水平组的收缩压(mmHg,1mm Hg=0.133 kPa)前后变化值分别为1.2(1.0,1.4)、1.3(1.0,1.5)、1.4(1.2,1.7)、1.5(1.3,1.8)和1.7(1.5,2.0);舒张压(mmHg)前后变化值分别为0.8(0.6,1.0)、1.0(0.8,1.1)、1.0(0.8,1.2)、1.2(1.0,1.4)和1.4(1.2,1.6),基线尿酸浓度与随访期间收缩期和舒张期血压变化均呈正相关(均P_(时间×组)<0.01)。然而,没有发现女性人群中有类似的关联(均P_(时间×组)>0.05)。结论在非高血压男性人群中,基线血清尿酸水平预测了长期的血压变化,类似的关联在女性中没有发现。Objective To evaluate the relationship between serum uric acid (SUA) and the long-term change trend of blood pressure (BP) in adults without hypertension. Methods The longitudinal data were collected from Tianjin Medical University, General Hospital-Health Management Centre during 2007 to 2013. The median duration of follow-up was 3.0 years. A total of 26 904 participants (males, 13 596; females, 13 308) were hypertension-free at baseline. SUA concentrations were determined by the enzymatic methods. A repeated measures ANCOVA analysis was used in this study. Results After multiple adjustments, in males, the variations of systolic BP (mmHg) for increasing quintiles of SUA were 1.2 (1.0, 1.4), 1.3 (1.0, 1.5), 1.4 (1.2, 1.7), 1.5 (1.3, 1.8) and 1.7 (1.5, 2.0); and the variations of diastolic BP (mmHg) for increasing quintiles of SUA were 0.8 (0.6, 1.0), 1.0 (0.8, 1.1), 1.0 (0.8, 1.2), 1.2 (1.0, 1.4) and 1.4 (1.2, 1.6). Repeated ANOVA analysis showed a significant and positive correlation between SUA levels and the change of systolic BP and diastolic BP in males (Ptime × group<0.01 both in systolic BP and diastolic BP), but not in females (systolic BP: Ptime × group= 0.57; diastolic BP: Ptime × group= 0.60).Conclusion This study has demonstrated that SUA level is an independent predictor for the change of blood pressure in males, but not in females.

关 键 词：尿酸 血压 纵向研究 性别因素 成年人 前期高血压 

分 类 号：R181.37[医药卫生—流行病学]