深圳市社区65岁及以上老年人高尿酸血症与慢性肾病的相关性研究  

Correlation between hyperuricemia and chronic kidney disease among the elderly(≥65 years old)in Shenzhen community

作　　者：黄迁 徐健[1] 袁雪丽[1] 倪文庆[1] 张红敏 张艳 郑义锦 HUANG Qian;XU Jian;YUAN Xueli;NI Wenqing;ZHANG Hongmin;ZHANG Yan;ZHENG Yijin(Department of Geriatric Health Management,Shenzhen Chronic Diseases Prevention and Treatment Center,Shenzhen,Guangdong Province 518020,China;School of Public Health,Huazhong University of Science and Technology,Wuhan,Hubei Province 430300,China)

机构地区：[1]深圳市慢性病防治中心老年健康管理科,广东省深圳518020 [2]华中科技大学公共卫生学院,湖北省武汉430300

出　　处：《中国慢性病预防与控制》2023年第8期606-610,共5页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：国家自然科学基金(82273631);深圳市科技计划项目(JCYJ20220531094410024);广东省医学科研基金(A2022082);深圳医学重点学科建设经费资助项目(SZXK065)。

摘　　要：目的 探讨深圳市社区65岁及以上老年人高尿酸血症(hyperuricemia,HUA)与慢性肾病(chronic kidney disease,CKD)发病风险的关系,为制定CKD综合防治策略提供依据。方法 于2021年1—12月,采用方便抽样选取深圳市65岁及以上常住居民323 999名作为研究对象,进行问卷调查、体格检查和实验室检测。采用SAS 9.4软件进χ2检验,采用多因素logistic回归分析HUA与CKD发病风险的关联。结果 共纳入研究对象323 999名,检出CKD患者19 902例,检出率为6.14%;检出HUA患者65 632例,检出率为20.26%。多因素logistic回归分析结果显示,HUA(OR=4.78,95%CI:4.63~4.93)与CKD发病高风险相关(P<0.05)。分层分析结果显示,在对体质指数(BMI)、吸烟史、饮酒史、高血压、糖尿病、血脂异常等因素进行分层以后,所分的每一层,HUA均与CKD的发病高风险相关(P<0.01)。在相乘模型中,BMI、吸烟史,饮酒史、糖尿病、血脂异常与HUA对CKD的发病风险存在相乘交互作用(Pinteraction<0.05,Pinteraction<0.01),未发现年龄、高血压与HUA对CKD的发病风险存在相乘交互作用(Pinteraction>0.05)。在相加模型中,除吸烟史以外,年龄、BMI、高血压、糖尿病、血脂异常与HUA均存在正向相加交互作用,饮酒史与HUA存在负向相加交互作用。结论 HUA与CKD的发病高风险相关。控制血尿酸的水平可以更好地预防CKD的发生发展,尤其要重点关注多种相关因素同时存在的老年人群,从而降低CKD的患病风险。Objective To explore the relationship between hyperuricemia(HUA)and chronic kidney disease(CKD)among the elderly(≥65 years old),and provide the basis for developing the comprehensive strategy of the prevention and treatment of CKD.Methods From January to December 2021,323999 permanent residents(≥65 years old)in Shenzhen were selected as the subjects by convenience sampling.The investigation was performed with the questionnaires,physical examination and laboratory tests.Theχ^(2) test and multi-factor logistic regression were used to analyze the data and the correlation between HUA and the risk of developing CKD.The used software was SAS 9.4.Results A total of 323999 subjects were included,and 19902 patients with CKD were detected,the detection rate was 6.14%;65632 patients with HUA were detected,the detection rate was 20.26%.The results of multi-factor logistic regression analysis showed that HUA(OR=4.78,95%CI:4.63-4.93)was correlated with the high risk of developing CKD(P<0.05).Stratified analysis showed that after stratification of body mass index(BMI),history of smoking,history of alcohol consumption,hypertension,type 2 diabetes mellitus(T2DM),and dyslipidemia,HUA was correlated with the high risk of developing CKD in each stratum(P<0.01).In the multiplicative model,BMI,smoking history,drinking history,T2DM,and dyslipidemia were all found to have multiplicative interactions with HUA on the risk of development of CKD(Pinteraction<0.05,Pinteraction<0.01),and no multiplicative interactions were found between age,hypertension and HUA on the risk of development of CKD(Pinteraction>0.05).In the summation model,the age,BMI,hypertension,T2DM,and dyslipidemia were positively summed with HUA,except for history of smoking.There was negative summed interaction between drinking history and HUA.Conclusion HUA is correlated with a higher risk of developing CKD.Controlling the level of serum uric acid can better prevent the development of CKD,and it is especially important to focus on the elderly population with multiple

关 键 词：高尿酸血症 慢性肾病 横断面研究 

分 类 号：R692[医药卫生—泌尿科学]