健康体检成人体重变化与高尿酸血症发病关系的队列研究  

A cohort study of the relationship between weight change and risk of hyperuricemia in adults receiving health checkups

作　　者：唐桂敏 苗鑫蕾 王倩倩 赵婉 牛相钧 谢霄玲 刘爽 冷松[1] Tang Guimin;Miao Xinlei;Wang Qianqian;Zhao Wan;Niu Xiangjun;Xie Xiaoling;Liu Shuang;Leng Song(Health Management Center of 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740-746,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);大连医科大学附属第二医院临床教学能力提升"1+X"计划(2023YXYJSXWLW004)。

摘　　要：目的探讨健康体检成人体重变化与高尿酸血症(HUA)发病的关系。方法本研究属于回顾性队列研究,选取于2014年1月至2022年12月在大连医科大学附属第二医院健康管理中心进行了≥2次健康体检的37722例受检者,收集其初次体检和随访时的一般资料及实验室检查结果。体重变化定义为随访终点时的体重与基线体重的差值/基线体重,按体重变化百分比分为显著减重组(体重变化≤-5.0%)、轻度减重组(-5.0%<体重变化≤-1.0%)、体重稳定组(-1.0%<体重变化<1.0%)、轻度增重组(1.0%≤体重变化<5.0%)和显著增重组(体重变化≥5.0%)。建立单因素和多因素logistic回归模型计算不同体重变化发生HUA风险的OR值(95%CI),并按照性别和基线体重指数(BMI)分组进行亚组分析。敏感性检验通过变更HUA诊断标准后重复主要分析。结果对受检者平均随访(2.98±1.77)年,显著减重组、轻度减重组、体重稳定组、轻度增重组和显著增重组的受检者分别有4155例(11.0%)、8660例(23.0%)、5144例(13.6%)、11512例(30.5%)和8251例(21.9%)。logistic回归分析结果显示,以体重稳定组为参照,显著减重组、轻度减重组、轻度增重组和显著增重组发生HUA的多变量调整OR值依次为0.692(95%CI:0.606~0.791)、0.921(95%CI:0.829~1.022)、1.148(95%CI:1.040~1.267)、1.505(95%CI:1.354~1.673),未发现性别和基线BMI分组与体重变化的交互作用。敏感性分析结果与主要分析结果相似,与体重稳定组相比,显著减重组发生HUA的风险降低了25.2%,显著增重组发生HUA的风险增加了64.7%。结论在成年健康体检人群中,无论正常体重还是超重肥胖者,增重≥5.0%使HUA发病风险升高,而减重≥5.0%与HUA发病风险降低有关。Objective To explore the relationship between weight change and the development of hyperuricemia(HUA)in adults receiving health checkups.Methods A retrospective cohort study.A total of 37722 subjects who underwent two or more health checkups at the Health Management Center of the Second Affiliated Hospital of Dalian Medical University from January 2014 to December 2022 were included,and the general information and laboratory findings at the time of the initial health checkups and follow-up were collected.Weight change was defined as the ratio of difference between the weight at the last follow-up and the baseline weight to baseline weight.The subjects were grouped with weight change:significant weight loss group(weight change≤-5.0%),mild weight loss group(-5.0%<weight change≤-1.0%),weight stabilization group(-1.0%<weight change<1.0%),mild weight gain group(1.0%≤weight change<5.0%)and significant weight gain group(weight change≥5.0%).Univariate and multivariate logistic regression models were built to calculate the odds ratios(OR)and 95%CIs for the risk of HUA with different weight changes,and subgroup analyses were performed according to gender and baseline body mass index(BMI)groups.Sensitivity tests were performed by repeating the main analysis after changing the diagnostic criteria for HUA.Results The subjects were followed up for(2.98±1.77)years.There were 4155(11.0%),8660(23.0%),4144(13.6%),11512(30.5%)and 8251(21.9%)subjects in the significant weight loss group,mild weight loss group,weight stabilization group,mild weight gain group,and significant weight gain group,respectively.Logistic regression analysis showed that,using weight stabilizers as a reference,the multivariable adjusted OR value for the risk of HUA in subjects with significant weight loss,mild weight loss,mild weight gain,and significant weight gain,was 0.692(95%CI:0.606-0.791),0.921(95%CI:0.829-1.022),and 1.148(95%CI:1.040-1.267),1.505(95%CI:1.354-1.673),respectively.No interaction effects between gender and baseline BMI grouping on

关 键 词：高尿酸血症 体重变化 风险因素 LOGISTIC模型 

分 类 号：R589.7[医药卫生—内分泌]