甲状腺功能正常的高血压患者血清甲状腺激素水平与高尿酸血症的相关性研究  

Correlation between Serum Thyroid Hormone and Hyperuricemia in Euthyroid Hypertensive Patients

作　　者：赵伟 杨珊珊 唐荣杰 杨芳 孙锋 廉秋芳 ZHAO Wei;YANG Shanshan;TANG Rongjie;YANG Fang;SUN Feng;LIAN Qiufang(Department of Cardiology,Xianyang Hospital of Yan'an University,Xianyang 712000,China;Medical School of Yan'an University,Yan'an 716000,China)

机构地区：[1]延安大学咸阳医院心血管内科,陕西省咸阳市712000 [2]延安大学医学院,陕西省延安市716000

出　　处：《中国全科医学》2022年第35期4394-4398,4405,共6页Chinese General Practice

基　　金：国家自然科学基金资助项目(82160090)——基于p38MAPK/NF-κB通路探讨Klotho对盐敏感性高血压肾损伤保护作用的研究。

摘　　要：背景血尿酸(SUA)与高血压的发生、发展密切相关,高血压患者常伴随甲状腺功能改变。但目前在甲状腺功能正常的高血压患者中,甲状腺激素水平与高尿酸血症(HUA)患病风险的相关研究鲜有报道。目的探讨甲状腺功能正常的原发性高血压(EH)患者血清甲状腺激素水平与HUA的相关性。方法回顾性选取2019年1月至2020年12月延安大学咸阳医院心血管内科收治的甲状腺功能正常的EH患者267例为研究对象,根据是否合并HUA分为非HUA组(166例)与合并HUA组(101例)。比较两组患者的一般资料及实验室检查指标,包括性别、年龄、体质指数(BMI)、收缩压(SBP)、舒张压(DBP)、吸烟史、饮酒史、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血肌酐(Scr)、SUA、促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))。采用多因素Logistic回归分析探讨EH患者发生HUA的影响因素;采用Pearson相关分析探讨甲状腺激素水平与SUA水平的相关性。结果两组患者性别、年龄、BMI、DBP、吸烟史、饮酒史比较,差异均有统计学意义(P<0.05);两组患者TC、TG、LDL-C、Scr、SUA水平比较,差异均有统计学意义(P<0.05);合并HUA组EH患者FT_(3)水平高于非HUA组(t=-5.066,P<0.05)。多因素Logistic回归分析结果显示,男性〔OR=2.843,95%CI(1.121,7.215),P=0.028〕,BMI值高〔OR=1.126,95%CI(1.020,1.234),P=0.018〕,TG〔OR=1.824,95%CI(1.300,2.560),P=0.001〕、LDL-C〔OR=2.804,95%CI(1.157,6.795),P=0.022〕、Scr〔OR=1.071,95%CI(1.041,1.102),P<0.001〕、FT_(3)〔OR=2.297,95%CI(1.326,3.977),P=0.003〕水平升高为EH患者发生HUA的危险因素;高龄〔OR=0.959,95%CI(0.931,0.989),P=0.007〕为EH患者发生HUA的保护因素。Pearson相关分析结果显示,EH患者FT_(3)水平与SUA水平呈正相关(r=0.327,P<0.001)。结论男性,BMI值高,TG、LDL-C、Scr、FT_(3)水平升高可能是EH患者发生HUA的危险Background Hypertension is closely related to serum uric acid(SUA)level,and often accompanied by thyroid function changes.However,there are few reports on the relationship between thyroid hormone level and hyperuricemia(HUA)in euthyroid hypertensive patients.Objective To explore the correlation between serum thyroid hormone level and HUA in euthyroid individuals with essential hypertension(EH).Methods Two hundred and sixty-seven euthyroid patients with EH were retrospectively selected from Department of Cardiology,Xianyang Hospital of Yan'an University from January 2019 to December 2020,including 101 with HUA(combined HUA group)and 166 without HUA(non-HUA group).The general demographic data and laboratory examination indices of the two groups were compared,including gender,age,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),smoking history,drinking history,total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),serum creatinine(Scr),SUA,thyroid-stimulating hormone(TSH),free triiodothyronine(FT_(3)),and free thyroxine(FT_(4)).Multivariate Logistic regression analysis was used to explore factors associated with HUA.Pearson correlation was used to examine the correlation between thyroid hormone level and SUA level.Results There were significant intergroup differences in gender ratio,mean age,BMI,and DBP,as well as prevalence of smoking history and drinking history(P<0.05).Moreover,the mean levels of TC,TG,LDL-C,Scr and SUA were also significantly different in the two groups(P<0.05).In particular,the mean level of FT_(3) in combined HUA group was significantly higher(t=-5.066,P<0.05).Multivariate Logistic regression analysis demonstrated that male〔OR=2.843,95%CI(1.121,7.215),P=0.028〕,higher BMI〔OR=1.126,95%CI(1.020,1.234),P=0.018〕,TG〔OR=1.824,95%CI(1.300,2.560),P=0.001〕,LDL-C〔OR=2.804,95%CI(1.157,6.795),P=0.022〕,Scr〔OR=1.071,95%CI(1.041,1.102),P<0.001〕and FT_(3)〔OR=2.297,95%CI(1.326,3.977),P=

关 键 词：原发性高血压 高尿酸血症 甲状腺激素类 三碘甲状腺原氨酸 甲状腺功能 相关性研究 

分 类 号：R544.1[医药卫生—心血管疾病]