肥胖和代谢因子在高尿酸血症与高血压前期关联中的中介效应  

Mediating effects of obesity and metabolic factors in hyperuricemia and prehypertension

作　　者：黄鑫峰 何青 施欢欢 胡海平 陆璐 黄若酩 张晓阳 徐幽琼[1,2] Huang Xinfeng;He Qing;Shi Huanhuan;Hu Haiping;Lu Lu;Huang Ruoming;Zhang Xiaoyang;Xu Youqiong(Fuzhou Center for Disease Control and Prevention,Fujian Medical University,Fuzhou 350004,China;School of Public Health,Fujian Medical University,Fuzhou 350004,China)

机构地区：[1]福建医科大学附属福州市疾病预防控制中心,福州350004 [2]福建医科大学公共卫生学院,福州350004

出　　处：《中华流行病学杂志》2023年第10期1599-1603,共5页Chinese Journal of Epidemiology

基　　金：福州市科技计划(2022-S-032)。

摘　　要：目的评估肥胖和代谢因子在高尿酸血症(HUA)与高血压前期关联中的中介效应。方法采用多阶段分层整群随机抽样方法抽取福州市5个区(县)30个镇(街)90个村(居委会)共9 399人, 最终纳入研究4 754人。采用线性回归模型分析HUA与肥胖和代谢因子的关联, 单因素和多因素logistic回归模型分析HUA、肥胖和代谢因子与高血压前期的关联, 采用因果中介效应模型分析肥胖和代谢因子对HUA与高血压前期相关性的中介效应。结果在调整混杂因素后, HUA与TC、TG、HDL-C、LDL-C、BMI、腰围、肌酐、尿素氮均显著相关(P<0.001);HUA、腰围、BMI和TG与高血压前期均显著相关(P<0.001);腰围、BMI和TG对HUA与高血压前期的关联均有中介效应, OR值(95%CI)分别为1.018(1.007~1.027)、1.010(1.002~1.018)、1.010(1.003~1.017)(P<0.001), 中介比例分别为7.76%、4.31%和4.31%;TC、HDL-C、LDL-C、肌酐和尿素氮对两者关联无中介效应(P>0.05)。结论腰围、BMI和TG在HUA与高血压前期的关联中均存在中介效应, 对于一般人群而言, 应当控制体重、腰围和高脂饮食, 以降低高血压前期的发生。Objective To assess the mediating effects of obesity and metabolic factors in the relationship between hyperuricemia(HUA)and prehypertension.Methods A total of 9399 individuals were selected using a multistage stratified whole-group random sampling method from 90 villages(neighborhood committees)in 30 towns(streets)of 5 districts(counties)in Fuzhou.A total of 4754 study subjects were included.A linear regression model was used to analyze the association of HUA with obesity and metabolic factors.Single-factor and multi-factor logistic regression models were used to analyze the association of HUA,obesity,and metabolic factors with prehypertension.Mediating effects models were used to analyze the mediating effects of obesity and metabolic factors on the association between HUA and prehypertension.Results After adjusting for confounders,the association between HUA and cholesterol,triglycerides,HDL-C,LDL-C,BMI,waist circumference,creatinine,and urea nitrogen were significantly correlated(P<0.001).HUA,waist circumference,BMI,and triglycerides were significantly associated with prehypertension(P<0.001).Waist circumference,BMI,and triglycerides mediated the relationship between HUA and prehypertension,with OR(95%CI)of 1.018(1.007-1.027),1.010(1.002-1.018),and 1.010(1.003-1.017)(P<0.001),with mediating proportions of 7.76%,4.31%,and 4.31%respectively.No mediating effect of cholesterol,HDL-C,LDL-C,creatinine,and urea nitrogen was found on the relationship(P>0.05).Conclusions Waist circumference,BMI,and triglycerides all had mediating effects in the association between HUA and prehypertension.For the general population,weight control,waist circumference,and a high-fat diet should be used to reduce the occurrence of prehypertension.

关 键 词：高血压前期 高尿酸血症 肥胖 代谢因子 因果中介效应 

分 类 号：R181.3[医药卫生—流行病学] R589.7[医药卫生—公共卫生与预防医学] R544.1