糖耐量降低老年男性体检者尿酸与心脑血管事件及全因死亡的关系  

Relationship between serum UA with CCVE and all-cause mortality in elderly males with IGT detected in physical examination

作　　者：沈宗姮 刘小艳 邓玲 帅平 刘玉萍 Shen Zongheng;Liu Xiaoyan;Deng Ling;Shuai Ping;Liu Yuping(Health Management Center,Sichuan Provincial People's Hospital,Chengdu 610072,Sichuan Province,China)

机构地区：[1]四川省医学科学院四川省人民医院健康管理中心电子科技大学,成都610072

出　　处：《中华老年心脑血管病杂志》2021年第12期1236-1239,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家科技部重点研发计划项目(2017YFC0113901);四川省卫生健康科研项目(20PJ107)。

摘　　要：目的探讨糖耐量减低(IGT)的老年男性体检人群血清尿酸水平与心脑血管事件及全因死亡的关系。方法纳入2011年1月1日~2015年12月31日健康体检的年龄≥60岁的老年男性IGT患者523例,按尿酸三分位水平分为低分位组(尿酸<334μmol/L)174例、中分位组(尿酸334~396μmol/L)173例和高分位组(尿酸>396μmol/L)176例。随访至2020年12月31日,记录随访中发生的临床终点事件,包括全因死亡和各类心脑血管事件,用Cox比例风险分析。结果各组年龄、体质量指数、吸烟、饮酒、TC、肌酐、肾小球滤过率和高敏C反应蛋白水平比较,均有统计学差异(P<0.05,P<0.01)。随访期间,全因死亡96例(18.4%),其中心脑血管事件死亡29例(5.5%)。高分位组全因病死率及心脑血管事件病死率均明显高于低、中分位组(21.0%vs 16.7%和17.3%;7.4%vs 4.6%和4.6%,P<0.05)。Kaplan-Meier生存曲线分析显示,高分位组全因病死率及心脑血管事件病死率分别高于低分位组和中分位组(χ^(2)=14.348,χ^(2)=18.754,P;<0.01)。Cox比例风险模型分析显示,血尿酸水平与患者全因病死率不相关(P>0.05);以低分位组为参照,高分位组患者发生心脑血管事件死亡风险增加,其与患者心脑血管事件死亡独立相关(RR=1.351,95%CI:1.115~1.635,P<0.01)。结论不同血尿酸水平不是体检老年男性IGT患者的全因病死率的影响因素,但高血尿酸水平是其心脑血管事件死亡的独立危险因素。Objective To study the relationship between serum UA and cardiocerebrovascular events(CCVE) and all-cause mortality in elderly males with impaired glucose tolerance(IGT) detected in physical examination.Methods Five hundred and twenty-three ≥60 years old male patients with IGT detected in our hospital from 2011-01-01 to 2015-12-31 were divided into low serum UA(<334 μmol/L) group(n=174),median serum UA(334-396 μmol/L) group(n=173) and high UA(>396 μmol/L) group(n=176).The patients were followed up to 2020-12-31,during which the clinical end-point events were recorded.The risk of clinical end-point events was assessed according to the Cox proportional hazards model.Results Significant difference was detected in age, BMI,history of smoking and alcohol consumption, serum TC,UA,hs-CRP and GFR among the low, median and high serum UA groups(P<0.05,P<0.01).Of the 96 patients who died of all-cause during the follow-up period, 29(5.5%) died of CCVE.The all-cause mortality was significantly higher in high serum UA group than in low and median serum UA groups(21.0% vs 16.7% and 17.3%,7.4% vs 4.6% and 4.6%,P<0.05).Kaplan-Meier survival curve analysis showed that the all-cause and CCVE mortality were significantly higher in high serum UA group than in low and median serum UA groups(χ^(2)=14.348,χ^(2)=18.754,P;<0.01).Cox proportional harzards model analysis displayed that serum UA was not related with all-cause mortality in elderly male patients with IGT detected in physical examination(P>0.05).The risk of death due to CCVE was significantly higher in high serum UA group than in low serum UA group, which was independently related with the CCVE mortality in elderly male patients with IGT detected in physical examination(P<0.01).Conclusion Serum UA is not an independent risk factor for all-cause mortality while high serum UA is an independent risk factor for CCVE mortality in elderly male patients with IGT detected in physical examination.

关 键 词：葡糖耐受不良 尿酸 死亡率 心血管疾病 

分 类 号：R54[医药卫生—心血管疾病]