代谢综合征合并高尿酸血症对新发心血管疾病的影响  

The impact of metabolic syndrome combined with hyperuricemia on new-onset cardiovascular disease

作　　者：杨帆 朱保杰 宋海澄[2] 舒荣[2] 陈朔华[3] 吴寿岭[4] 崔刘福[2] 王洁蕊[2] Yang Fan;Zhu Baojie;Song Haicheng;Shu Rong;Chen Shuohua;Wu Shouling;Cui Liufu;Wang Jierui(School of Public Health,North China University of Science and Technology,Tangshan 063210,China;Department of Rheumatology and Immunology,Kailuan General Hospital,Tangshan 063210,China;Healthcare Center of Kailuan Group,Kailuan General Hospital,Tangshan 063210,China;Department of Cardiology,Kailuan General Hospital,Tangshan 063210,China)

机构地区：[1]华北理工大学公共卫生学院,唐山063210 [2]开滦总医院风湿免疫科,唐山063210 [3]开滦总医院开滦员工健康保障中心,唐山063210 [4]开滦总医院心内科,唐山063210

出　　处：《中华心血管病杂志》2025年第2期160-166,共7页Chinese Journal of Cardiology

摘　　要：目的探讨代谢综合征(MS)合并高尿酸血症(HUA)对新发心血管疾病发病风险的影响。方法本研究为前瞻性队列研究。选取2006年6月至2007年10月河北省唐山市开滦集团职工健康体检人群为研究对象。按照基线有无MS和HUA分为4组,包括正常组、单纯HUA组、单纯MS组和MS合并HUA组。对4组研究对象进行随访,以新发心血管疾病事件(卒中和心肌梗死)作为终点事件。绘制随访期间不同组别心血管疾病发生率的Kaplan-Meier生存曲线,并使用log-rank检验比较。采用多因素Cox回归分析HUA合并MS对心血管疾病发病风险的影响。采用似然比检验分析HUA与MS是否存在相乘和相加交互作用。结果共纳入82780人,年龄(51.5±12.6)岁,男性68622例(82.90%),中位随访时间14.97年。Kaplan-Meier生存曲线分析显示,MS合并HUA组心血管疾病的累计发病率最高(log-rank P<0.001)。多因素Cox回归分析显示,在校正混杂因素后,与正常组比较,MS合并HUA组发生心血管疾病的HR值及95%CI为1.24(1.12~1.38),高于单纯HUA组和单纯MS组。MS合并HUA对心血管疾病发生风险的影响呈相加效应[交互作用相对超额危险度为0.18(0.11~0.25),交互作用归因比为0.14(0.09~0.19)]。结论HUA合并MS是心血管疾病的独立危险因素,相较于单纯的MS或HUA,MS合并HUA对心血管疾病的影响更为显著。ObjectiveTo explore the impact of metabolic syndrome in conjunction with hyperuricemia on the risk of new-onset cardiovascular disease.MethodsThis study was a prospective cohort study.From June 2006 to October 2007,employees of Kailuan Group in Tangshan City,Hebei Province were selected as the research subjects.Participants were divided into four groups based on the presence or absence of metabolic syndrome and hyperuricemia.The groups include the normal group,pure hyperuricemia group,pure metabolic syndrome group,and the metabolic syndrome combined with hyperuricemia group.Four groups of participants were followed up,the primary endpoint was the occurrence of a first-ever cardiovascular disease event,including stroke and myocardial infarction.The cumulative incidence rates of cardiovascular disease in different groups during the continuous follow-up period were calculated using the Kaplan-Meier method,and the differences in cumulative incidence rates among groups were compared using the log-rank test.Multivariate Cox regression analysis was used to analyze the effect of hyperuricemia combined with metabolic syndrome on the risk of cardiovascular disease.The likelihood ratio test was used to analyze whether there was a multiplicative interaction and additive interaction between hyperuricemia and metabolic syndrome.ResultsA total of 82780 individuals were included,aged(51.5±12.6)years,and 68622(82.90%)were males,with a median follow-up of 14.97 years.Kaplan-Meier survival curve analysis showed that the cumulative incidence of cardiovascular disease was the highest in the metabolic syndrome combined with hyperuricemia group(log-rank P<0.001).Multivariate Cox regression analysis indicated that after adjusting for various confounding factors,the HR value and 95%CI of cardiovascular disease in the metabolic syndrome combined with hyperuricemia group were 1.24(1.12-1.38)compared with the normal group,which were higher than those in the pure hyperuricemia group and the pure metabolic syndrome group alone.The effect of

关 键 词：心血管疾病 代谢综合征 高尿酸血症 

分 类 号：R589[医药卫生—内分泌] R54[医药卫生—内科学]