肥胖症与高尿酸血症对急性心肌梗死的交互作用  

Interaction of obesity with hyperuricemia on acute myocardial infarction

作　　者：廖佩娟 吴金家 谭剑炼 李华华 LIAO Pei-juan;WU Jin-jia;TAN Jian-lian;LI Hua-hua(The Third Ward of the Department of Cardiology,Hezhou People′s Hospital,Hezhou 542899,Guangxi,China)

机构地区：[1]广西贺州市人民医院心血管内科三病区,广西贺州市542899

出　　处：《广西医学》2022年第16期1869-1873,共5页Guangxi Medical Journal

基　　金：广西贺州市科学研究与技术开发计划项目(贺科技20058)。

摘　　要：目的探讨肥胖症与高尿酸血症的交互作用对急性心肌梗死(AMI)的影响。方法选取862例行冠状动脉造影检查的患者作为研究对象,将患有AMI的患者纳入AMI组(n=336),将冠状动脉造影正常或冠状动脉狭窄程度<50%的患者纳入对照组(n=526)。比较两组患者的临床资料。采用Logistic回归模型分析危险因素对AMI的独立效应,再运用相乘模型和相加模型分别分析危险因素之间的相乘交互作用和相加交互作用。结果两组患者的性别、合并高血压情况、吸烟情况、合并肥胖症情况、合并高尿酸血症情况、合并血脂异常情况、LDL-C水平、同型半胱氨酸水平、C反应蛋白水平、白细胞计数、中性粒细胞百分比比较,差异均有统计学意义(均P<0.05)。多因素Logistic回归分析结果显示,以无肥胖症且无高尿酸血症者为参照,有肥胖症但无高尿酸血症者、无肥胖症但有高尿酸血症者、有肥胖症且有高尿酸血症者的AMI患病风险均升高(均P<0.05)。控制相关混杂因素后,交互作用分析结果显示,肥胖症与高尿酸血症对AMI的患病风险存在相乘交互作用[OR=8.303(95%CI:4.552,11.231),P=0.002]和正相加交互作用[相对超额危险度=0.123(95%CI:0.095,3.156);交互作用归因比=0.938(95%CI:0.512,0.956);交互作用指数=11.000(95%CI:4.375,15.263)]。结论AMI的患病风险与多种因素有关,肥胖症与高尿酸血症对AMI的患病风险存在交互作用,两者并存时可使AMI的患病风险增高。Objective To explore the effect of the interaction between obesity and hyperuricemia on acute myocardial infarction(AMI).Methods A total of 862 patients undergoing coronary angiography examination were selected as the research subjects.The patients with AMI were enrolled in the AMI group(n=336),and the patients with normal coronary angiography or the degree of coronary artery stenosis<50%were enrolled in the control group(n=526).The clinical data were compared between the two groups.The Logistic regression model was performed to analyze the independent effect of risk factors for AMI,and then the multiplicative model and additive model were employed to analyze the multiplicative and additive interactions between the risk factors,respectively.Results There were statistically significant differences in gender,and conditions of concomitant hypertension,smoking,concomitant obesity,concomitant hyperuricemia and concomitant dyslipidemia,as well as LDL-C level,homocysteine level,C-reactive protein level,white blood cell counts,neutrophil percentage between the two groups(all P<0.05).The results of multivariate Logistic regression analysis revealed that with reference to the patients without obesity and hyperuricemia,the patients with obesity but without hyperuricemia,without obesity but with hyperuricemia,and with obesity and hyperuricemia were all at increased risk of suffering from AMI(all P<0.05).After controlling related confounding factors,the results of interaction analysis interpreted that there were the multiplicative interaction(OR=8.303[95%CI:4.552,11.231],P=0.002)and the positive additive interaction(relative excess risk due to interaction=0.123[95%CI:0.095,3.156];attributable proportion of interaction=0.938[95%CI:0.512,0.956];synergy index=11.000[95%CI:4.375,15.263])between obesity and hyperuricemia on the risk of suffering from AMI.Conclusion The risk of suffering from AMI is related to many factors.Obesity and hyperuricemia have the interaction on the risk of suffering from AMI,and the co-existence of the t

关 键 词：急性心肌梗死 肥胖症 高尿酸血症 交互作用 患病风险 

分 类 号：R542.22[医药卫生—心血管疾病]