血尿酸与舒张压交互作用对痛风石发病风险的影响  

Association of the interaction between serum uric acid and diastolic blood pressure on the risk of tophi

作　　者：尉雅洁 潘月海 李克磊 马利丹[1] 程晓宇[1] 刘甜[1] 杨敏[1] 张洁[1] 周诗喆 王砚 陈颖[1] Yu Yajie;Pan Yuehai;Li Kelei;Ma Lidan;Cheng Xiaoyu;Liu Tian;Yang Min;Zhang Jie;Zhou Shizhe;Wang Yan;Chen Ying(Department of Endocrinology and Metabolism,the Affiliated Hospital of Qingdao University,Qingdao 266003,China;Department of Hand and Foot Surgery,the Affiliated Hospital of Qingdao University,Qingdao 266003,China;Institute of Nutrition and Health,Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院内分泌与代谢性疾病科,青岛266003 [2]青岛大学附属医院手足外科,青岛266003 [3]青岛大学营养与健康研究所,青岛266003

出　　处：《中华内分泌代谢杂志》2022年第12期1023-1028,共6页Chinese Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金青年科学基金(81600601);山东省自然科学基金(ZR2021MH363)。

摘　　要：目的分析痛风患者罹患痛风石的影响因素,探讨血尿酸与舒张压是否存在交互作用共同影响痛风石发病。方法回顾性选取2016年9月至2020年5月在青岛大学附属医院痛风临床医学中心门诊就诊的痛风患者4798例。分为痛风石组和无痛风石组,比较2组间相关指标差异,采用logistic回归模型分析痛风石的影响因素,构建交互作用模型分析痛风石发病风险间的相互作用。结果多元logistic回归分析显示,年龄、舒张压、饮酒史、痛风家族史、血尿酸、血尿素氮、肌酐清除率与痛风石形成有显著相关性。血尿酸相关交互作用分析结果显示,血尿酸与舒张压间存在明显的交互作用(P交互=0.014),与低血尿酸组相比,高血尿酸组低舒张压和高舒张压者发生痛风石的风险分别增加34.4%(OR=1.344,95%CI 1.105~1.635,P=0.003)和95.4%(OR=1.954,95%CI 1.558~2.450,P<0.001)。舒张压与血尿酸亚组分析结果显示,高舒张压组在低尿酸水平人群中发生痛风石风险的差异无统计学意义(P=0.238),但在高尿酸水平人群中,发生痛风石的风险比低尿酸组高67%(OR=1.670,95%CI 1.379~2.022,P<0.001)。结论年龄、舒张压、合并饮酒史及痛风家族史、血尿酸、肾功能与痛风石发生有相关性,高尿酸与高舒张压对痛风石发生有交互作用,对于此类人群必须加以重点关注,予以积极治疗。Objective To analyze the influencing factors of gout patients and explore whether there is an interaction between serum uric acid and diastolic blood pressure affecting the onset of tophi.Methods A total of 4798 gout patients were retrospective selected in the outpatient Department of the Gout Clinical Medical Center of the Affiliated Hospital of Qingdao University from September 2016 to May 2020.It was divided into tophi group and non-tophi group to compare the differences in indicators.A logistic regression model was used to analyze the influencing factors of tophi,and an interaction model was constructed to analyze the interactions.Results Multivariate logistic regression analysis showed significant associations between age,diastolic blood pressure,alcohol consumption history,gout family history,blood uric acid,urea nitrogen,and creatinine clearance and tophi formation.The results of blood uric acid-related interaction analysis showed a significant interaction between blood uric acid and diastolic blood pressure(Pinteraction=0.014),and the risk of developing tophi in low diastolic blood pressure and high diastolic blood pressure group increased by 34.4%(OR=1.344,95%CI 1.105-1.635,P=0.003)and 95.4%(OR=1.954,95%CI 1.558-2.450,P<0.001)in the high blood uric acid group compared with the low blood uric acid group.The results of diastolic blood pressure and blood uric acid subgroup analysis showed that there was no statistical difference in the risk of developing tophi in people with low uric acid levels(P=0.238),but in people with high uric acid levels,the risk of developing tophi was 67%(OR=1.670,95%CI 1.379-2.022,P<0.001)higher than that in the low uric acid group.Conclusion Age,diastolic blood pressure,combined alcohol consumption history and gout family history,blood uric acid,renal function are related to the occurrence of tophi.High uric acid and high diastolic blood pressure have interaction on the occurrence of tophi.Attention and proactive intervention shall be applied to this group of patients.

关 键 词：痛风 痛风石 尿酸 舒张压 交互作用 

分 类 号：R589.7[医药卫生—内分泌]