体检人群中不同体重代谢表型及其变化与新发高尿酸血症的相关性  

Correlation between different body weight metabolic phenotypes and their changes and new-onset hyperuricemia in physical examination population

作　　者：牛相钧 苗鑫蕾 王倩倩 唐桂敏 谢霄玲 赵婉 冷松[1] Niu Xiangjun;Miao Xinlei;Wang Qianqian;Tang Guimin;Xie Xiaoling;Zhao Wan;Leng Song(Health Management Center,the Second Affiliated Hospital of Dalian Medical University,Dalian 116023,China)

机构地区：[1]大连医科大学附属第二医院健康管理中心,大连116023

出　　处：《中华健康管理学杂志》2024年第10期726-732,共7页Chinese Journal of Health Management

基　　金：大连医科大学附属第二医院"1+X"计划项目(2022DXDL01)。

摘　　要：目的探讨体检人群中不同体重代谢表型及其变化与新发高尿酸血症(HUA)的相关性。方法本研究为回顾性队列研究,选取2014年1月1日至2022年8月31日在大连医科大学附属第二医院健康管理中心进行常规体检且符合纳排标准的31956例受检者为研究对象,建立动态体检队列,随访终点为新发高尿酸血症或随访期结束。应用Cox回归逐步拟合模型分析不同体重代谢表型与HUA的发病风险,并对性别进行分层分析。按照研究对象体重代谢表型,将其分为代谢正常、非超重肥胖(NMNW)组、代谢正常、超重肥胖(NMO)组、代谢异常、非超重肥胖(AMNW)组以及代谢异常、超重肥胖(AMO)组,并根据随访期内研究对象体重代谢表型的变化情况计算变化后的高尿酸血症发病风险。在敏感性分析中通过更改HUA诊断标准、去除研究中随访第1年高尿酸血症发病者以及去除研究中年龄≥65岁的研究对象的方式验证结果的稳健性。结果与NMNW组相比,NMO组、AMNW组、AMO组HUA发病风险分别增加78.9%、61.3%、115.4%(χ^(2)=272.88、128.15、496.12,均P<0.001)。当基线为NMNW组时,随访终点转变为NMO组、AMO组状态时,HUA发病风险增加122.5%(χ^(2)=8.01,P<0.05)、137.4%(χ^(2)=15.99,P<0.001)。基线为AMNW组,随访终点转变为AMO组状态时,HUA的发病风险增加119.2%(χ^(2)=6.63,P<0.05)。基线为AMO组,随访终点转变为NMNW、AMNW组状态时,HUA的发病风险降低58.3%(χ^(2)=43.67,P<0.001)、27.2%(χ^(2)=16.07,P<0.001)。基线为NMO状态,随访终点转变为NMNW、AMNW组状态时,HUA的发病风险降低36.7%(χ^(2)=25.35,P<0.001)、30.9%(χ^(2)=9.70,P<0.05)。结论从代谢健康、非超重肥胖转变为代谢异常、超重肥胖与HUA发病风险升高相关,代谢健康或体重的改善与HUA发病风险的降低相关。Objective To study the correlation between different body weight metabolic phenotypes and their changes and new-onset hyperuricemia in physical examination population.Methods This study was a retrospective cohort study.A total of 31956 people who underwent routine physical examination and met the inclusion and exclusion criteria at the Health Management Center of the Second Affiliated Hospital of Dalian Medical University from January 1,2014 to August 31,2022 were selected as the study subjects to establish a dynamic physical examination cohort.The end point of follow-up was new-onset hyperuricemia or the end of follow-up period.Cox regression stepwise fitting model was used to analyze the risk of different body weight metabolic phenotypes and hyperuricemia,and stratified analysis was performed for gender.According to body weight metabolic phenotype,the subjects were divided into normal metabolism and normal weight(NMNW)group,normal metabolism and obesity(NMO)group,abnormal metabolism and normal weight(AMNW)group and abnormal metabolism and obesity(AMO)group.The risk of hyperuricemia was calculated according to the changes of body weight metabolic phenotype during the follow-up period.In the sensitivity analysis,the robustness of the results was verified by changing the diagnostic criteria for hyperuricemia,removing patients with hyperuricemia at the first year of follow-up,and removing subjects aged≥65 years.Results Compared with the NMNW group,the risk of hyperuricemia in the NMO group,AMNW group and AMO group increased by 78.9%,61.3%,115.4%,respectively(χ^(2)=272.88,128.15,496.12,all P<0.001).Patients who were initially classified as NMNW at baseline,if transitioned to NMO or AMO by the follow-up endpoint,their risk of hyperuricemia increased by 122.5%(χ^(2)=8.01,P<0.05)and 137.4%(χ^(2)=15.99,P<0.001),respectively.When the baseline AMNW group changed to AMO,the risk of hyperuricemia was increased by 119.2%(χ^(2)=6.63,P<0.05).For patients with AMO as baseline,if they turned into NMNW and AMNW at the end o

关 键 词：超重 肥胖症 代谢 高尿酸血症 队列研究 

分 类 号：R589.7[医药卫生—内分泌]