基于倾向性评分探讨高尿酸血症对非酒精性脂肪肝发病风险的影响  

Study on the Effect of Hyperuricemia on the Risk of Nonalcoholic Fatty Liver Disease Based on Propensity Score

作　　者：马志敏 徐超楠 武志远 张姗 陶丽新[1,2] 郑德强 郭秀花 杨兴华 Ma Zhimin;Xu Chaonan;Wu Zhiyuan(School of Public Health,Capital Medical University,Beijing 100069;Beijing Municipal Key Laboratory of Clinical Epidemiology,Beijing 100069;Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]首都医科大学公共卫生学院,北京100069 [2]北京市临床流行病学北京市重点实验室,北京100069 [3]北京大学第三医院,北京100191

出　　处：《四川医学》2020年第3期294-298,共5页Sichuan Medical Journal

摘　　要：目的分析高尿酸血症与非酒精性脂肪肝(NAFLD)发病风险的关系,为NAFLD的防治提供依据。方法以2012年至2016年的北京健康管理队列随访人群为研究对象,以483例高尿酸血症患者为暴露组,4825例血尿酸正常人群为对照组。利用倾向性评分均衡两组的混杂因素后,采用logistics回归模型分析匹配前后高尿酸血症与NAFLD发病风险的关系。结果匹配前,除了吸烟、饮食习惯、锻炼程度外,其他因素在两组分布不平衡。按1∶3匹配后,453例高尿酸血症患者成功匹配1235例血尿酸正常人,所有协变量在两组间达到均衡。匹配前,多因素logistics回归分析表明,高尿酸血症会增加NAFLD的发病风险[OR=1.84,95%CI(1.45,2.33),P<0.0001]。匹配后,这种关系依然有统计学意义[OR=1.46,95%CI(1.14,1.88),P=0.0028]。结论高尿酸血症对NAFLD的发病有影响,是NAFLD的独立危险因素,控制血尿酸水平可以防治NAFLD发生发展。Objective To analyze the relationship between hyperuricemia and the risk of non-alcoholic fatty liver disease(NAFLD),we aimed to provide evidence for the prevention and treatment of NAFLD.Methods Study participants were from Beijing Health Management Cohort during 2012 to 2016.483 participants with hyperuricemia were considered as the exposure group,and 4825 individuals with normal uric acid were considered as control group.We performed the propensity score to balance the confounding factors between those two groups,and then logistic regression model was respectively conducted to analyze the relationship between hyperuricemia and NAFLD risk before and after matching.Results Before matching,except for smoking,eating habits,exercise level,other factors were unevenly distributed in those two groups.After a 1:3 match,453 patients with hyperuricemia successfully were matched 1235 normal uric acid,and all covariates were balanced between groups.Before matching,multivariate logistic regression analysis showed that hyperuricemia increased the risk of NAFLD[OR=1.84,95%CI(1.45,2.33),P<0.0001].After matching,this relationship was still statistically significant[OR=1.46,95%CI(1.14,1.88),P=0.0028].Conclusion Hyperuricemia exerts an effect on the development of NAFLD and is an independent risk factor for NAFLD.Controlling serum uric acid levels can prevent the development of NAFLD.

关 键 词：高尿酸血症 非酒精性脂肪肝 倾向性评分分析 

分 类 号：R589.7[医药卫生—内分泌]