非酒精性脂肪性肝病患者血清尿酸水平与代谢综合征的相关性分析  

Associations between serum uric acid levels and metabolic syndrome in patients with non-alcoholic fatty liver disease

作　　者：高丽君 朱大龙[2] 周卫红[3] 毕艳[2] 王静[3] 冯文焕[1] Gao Lijun;Zhu Dalong;Zhou Weihong;Bi Yan;Wang Jing;Feng Wenhuan(Department of Endocrinology,Drum Tower Clinical Hospital,Medical School of Southeast University,210008 Nanjing,China;不详)

机构地区：[1]东南大学医学院鼓楼临床医院内分泌科,江苏南京210008 [2]南京大学医学院附属鼓楼医院内分泌科 [3]南京大学医学院附属鼓楼医院体检中心

出　　处：《临床内科杂志》2020年第8期579-582,共4页Journal of Clinical Internal Medicine

基　　金：江苏省医学重点学科资助项目(ZDXKB2016012);南京市医药卫生科研课题(YKK18067)。

摘　　要：目的探讨非酒精性脂肪性肝病(NAFLD)患者血清尿酸水平与代谢综合征(MS)的关系。方法选取参加体检的NAFLD患者1716例,根据是否合并MS分为MS组(860例)和非MS组(856例),测定其身高、体重、BMI、腰围和血压;检测其空腹血糖(FPG)、血清尿酸、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)、ALT和肌酐(SCr)并进行比较。再将其分为正常尿酸组(1143例)和高尿酸血症组(573例),比较两组的MS组分。结果与非MS组比较,MS组患者的腰围、BMI、收缩压、舒张压、FPG、TG、TC、尿酸水平明显升高,HDL-C明显降低(P<0.01)。MS组伴发高尿酸血症、高血压病、糖尿病及肾结石的患者比例高于非MS组(P<0.01)。高尿酸血症组的腰围、收缩压、血清TG明显高于正常尿酸组(P<0.05),血清FPG和HDL-C水平低于正常尿酸组(P<0.01),剔除糖尿病患者后两组FPG水平比较差异无统计学意义(P>0.05)。NAFLD患者的血清尿酸水平与血压、腰围、TG呈正相关,与FPG及HDL-C呈负相关(P<0.05);高尿酸血症为NAFLD患者发生MS的独立危险因素(OR=1.785,P<0.001)。结论NAFLD合并MS患者血清尿酸水平显著升高,高尿酸血症是NAFLD患者伴发MS独立危险因素。Objective To explore the relationship between serum uric acid levels and metabolic syndrome(MS)in patients with non-alcoholic fatty liver(NAFLD).Methods A total of 1716 patients with NAFLD who underwent health examination were divided into MS group(860 cases)and non-MS group(856 cases)according to whether existed MS.Height,weight,BMI,waist circumference(WC)and blood pressure were measured.Serum fasting plasma glucose(FPG),uric acid,total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),ALT and creatinine(SCr)were detected and compared.They were also divided into normal uric acid group(1143 cases)and high uric acid group(573 cases)and MS components were compared between the two groups.Results Compared with those in the non-MS group,patients in the MS group had higher WC,BMI,systolic blood pressure(SBP),diastolic blood pressure(DBP),and serum FPG,TG,TC and uric acid levels,but decreased serum HDL-C levels(P<0.01).The ratios of patients with hyperuricemia,hypertension,diabetes and kidney stones were higher in MS group than those in non-MS group(P<0.01).Patients with hyperuricemia had higher WC,SBP,DBP and serum TG levels,but lower serum FPG and HDL-C levels(P<0.01),while no different serum FPG levels existed between the two groups when excluding diabetic patients.Correlation analysis showed that serum uric acid levels were positively correlated with blood pressure,WC and serum TG levels,while negatively correlated with serum FPG and HDL-C levels in all NAFLD patients(P<0.05).Hyperuricemia was an independent risk factor for MS in patients with NAFLD(OR=1.785,P<0.001).Conclusion Patients with NAFLD have higher serum uric acid levels when accompanied by MS.Hyperuricemia is an independent risk factor for MS in patients with NAFLD.

关 键 词：非酒精性脂肪性肝病 高尿酸血症 代谢综合征 

分 类 号：R575.5[医药卫生—消化系统] R589[医药卫生—内科学]