打鼾与高尿酸交互作用对儿童青少年代谢综合征的影响  

Effects of interaction between snoring and hyperuricemia on the metabolic syndrome in school-aged children

作　　者：李凡 张隽 李艳艳 李妍 熊静帆[2] 张双霞 唐玉涵[3] 姚平 LI Fan;ZHANG Jun;LI Yan-yan;LI Yan;XIONG Jing-fan;ZHANG Shuang-xia;TANG Yu-han;YAO Ping(Department of Preventive Medicine,Medical College of Shihezi University,Shihezi,Xinjiang 832000,China;不详)

机构地区：[1]石河子大学医学院预防医学系,新疆石河子832000 [2]深圳市慢性病防治中心儿童青少年慢性病防控科 [3]华中科技大学同济医学院公共卫生学院营养与食品卫生学系

出　　处：《现代预防医学》2023年第20期3729-3733,3755,共6页Modern Preventive Medicine

基　　金：深圳市基础研究资助项目(KCXFZ20201221173400002);深圳医学重点学科建设经费资助项目(SZXK065)。

摘　　要：目的研究打鼾和高尿酸及其交互作用对儿童青少年代谢综合征(metabolic syndrome,MetS)的影响,为儿童青少年MetS针对性防控提供理论依据。方法从参加深圳市中小学生营养健康与生长发育评估与监测的7~17岁儿童青少年中获得人口学资料、打鼾、人体测量和生化指标等。Logistic回归模型评估打鼾、高尿酸与MetS的关联并利用相加模型来评估两者交互作用对MetS的影响。结果4466名参与者的年龄中位数为12.16岁,2454(54.9%)为男性。MetS、打鼾和高尿酸的检出率分别为3.2%、29.3%和33.4%。打鼾频次<1次/周、1~2次/周和≥3次/周与MetS患病存在正向关联,且呈逐渐上升的趋势(P<0.001)。打鼾(OR=2.085,95%CI:1.462~2.902)和高尿酸(OR=4.741,95%CI:3.144~7.148)均与MetS患病相关。此外,打鼾频次、打鼾与高尿酸对MetS患病均不存在相乘交互作用,但打鼾和高尿酸对MetS患病存在相加交互作用[超额相对危险度=3.801(0.060~7.542),交互作用归因比=0.418(0.154~0.683),交互作用指数=1.887(1.101~3.234)]。结论打鼾和高尿酸均是MetS的危险因素且二者可能存在协同作用,因此,需积极控制体重,持续气道正压通气、正畸治疗,限制油炸食物、肉类和海鲜摄入,增加蔬菜的摄入,来改善儿童青少年打鼾症状和降低尿酸水平,从而实现预防和管理MetS。Objective To study the interaction between snoring and hyperuricemia on metabolic syndrome(MetS)in children and adolescents,putting forward targeted countermeasures to prevent and control MetS in the specific subpopulation.Methods Demography data,snoring,anthropometric measurements,and biochemical indicators were obtained from children and adolescents aged 7-17 years old who participated in the evaluation and monitoring on school-based nutrition and growth in Shenzhen.Logistic regression model was conducted to evaluate the association between snoring and hyperuricemia on MetS,and an additive model to evaluate the impact of their interaction on MetS.Results The median age of 4466 participants was 12.16 years,and 2454(54.9%)were boys.The detection rates of MetS,snoring,and hyperuricemia accounted for 3.2%,29.3%,and 33.4%of the total population,respectively.The frequency of snoring<1 time/week,1-2 times/week,and≥3 times/week were positively correlated with MetS disease and showed a gradually increasing trend(P trend<0.001).Snoring(OR=2.085,95%CI:1.462-2.902)and hyperuricemia(OR=4.741,95%CI:3.144-7.148)were both associated with MetS.In addition,there was no multiplicative interaction between snoring frequency,snoring,and high uric acid on MetS,but snoring and high uric acid had an additive interaction on MetS[relative excess risk due to interaction=3.801(0.060-7.542),attributable proportion of interaction=0.418(0.154-0.683),synergy index=1.887(1.101-3.234)].Conclusion Snoring and hyperuricemia are both risk factors for MetS.There is a synergistic effect between snoring and hyperuricemia on the risk of MetS.Therefore,it is necessary to actively control weight,maintain positive airway pressure ventilation,orthodontic treatment,limit fried foods,meat,seafood,and increase vegetable intake to improve snoring and uric acid levels in children and adolescents,in order to achieve prevention and management of MetS.

关 键 词：儿童青少年 代谢综合征 打鼾 高尿酸 交互作用 

分 类 号：R179[医药卫生—妇幼卫生保健]