尿酸水平与中老年高血压患者新发慢性肾脏病的关联分析  

Association between uric acid and new‑onset chronic kidney disease in middle‑aged and elderly hypertensive patients

作　　者：周海新 吴晓林 李泽亚 赵宇[3] 陈伟华 杜冬杰 顾献忠 黄榕翀 Zhou Haixin;Wu Xiaolin;Li Zeya;Zhao Yu;Chen Weihua;Du Dongjie;Gu Xianzhong;Huang Rongchong(Department of Radiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Beijing Tongzhou Yongshun Community Health Service Center,Beijing 101125,China;Department of Cardiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院放射科,北京100050 [2]北京市通州区永顺社区卫生服务中心,北京101125 [3]首都医科大学附属北京友谊医院心血管中心,北京100050

出　　处：《中华全科医师杂志》2025年第3期257-262,共6页Chinese Journal of General Practitioners

基　　金：北京市高层次公共卫生技术人才建设项目‑领军人才(LJRC20240306)。

摘　　要：目的探讨尿酸水平与中老年高血压患者新发慢性肾脏病的关联。方法该研究为回顾性队列研究。纳入2016年6月至2020年12月于北京市通州区永顺社区卫生服务中心至少参加了2次年度健康体检的中老年高血压患者。两次健康体检间隔为3年,第1次体检时间为基线时间,第2次体检时间为随访截止时间。根据基线时入选者尿酸水平分为尿酸正常组和高尿酸血症组。收集入选者的相关临床资料。研究终点为新发慢性肾脏病。采用多因素logistic回归模型分析尿酸水平与中老年高血压患者新发慢性肾脏病的关联,并进一步对无症状高尿酸血症及不同性别的患者进行亚组分析。结果入选中老年高血压患者2472例,年龄(62.43±7.02)岁,男性733例(29.7%),其中高尿酸血症者710例(高尿酸血症组),尿酸水平正常者1762例(尿酸正常组)。校正了年龄、性别、体重指数、收缩压、糖尿病、估算的肾小球滤过率、降尿酸治疗情况后,多因素logistic回归分析结果显示合并高尿酸血症是中老年高血压患者新发慢性肾脏病的独立危险因素(OR=3.00,95%CI:1.87~4.80,P<0.001)。多因素logistic分析结果显示无论在男性还是女性中老年高血压患者中,尿酸水平升高均为新发慢性肾脏病的独立危险因素(均P<0.05),且无性别交互作用(P_(交互)>0.05)。多因素logistic分析结果显示合并无症状高尿酸血症是中老年高血压患者新发慢性肾脏病的独立危险因素(OR=3.00,95%CI:1.87~4.80,P<0.001),且无性别交互作用(P_(交互)>0.05)。结论高尿酸血症是中老年高血压患者新发慢性肾脏病的独立危险因素,无论在男性还是女性患者中尿酸水平升高均会增加新发慢性肾脏病风险,且无症状高尿酸血症即会增加新发慢性肾脏病风险。Objective To explore the association between uric acid and new‑onset chronic kidney disease(CKD)in middle‑aged and elderly hypertensive patients.Methods This was a retrospective cohort study.Middle‑aged and elderly hypertensive patients who had attended at least two annual health examinations at Yongshun Community Health Service Center in Tongzhou District,Beijing,from June 2016 to December 2020 were enrolled.The time interval between the two physical examinations was three years.The first physical examination time served as the baseline,and the second as the end of follow‑up.Based on the uric acid level at baseline,the participants were divided into the normal uric acid group and the hyperuricemia group.The relevant clinical data of the participants were collected.The endpoint of the study was new‑onset CKD.A multivariate logistic regression model was used to analyze the association between uric acid and new‑onset CKD in hypertensive patients.Results A total of 2472 middle‑aged and elderly hypertensive patients with an average age of(62.43±7.02)years were included.Of these,733(29.7%)were male.There were 710 patients with hyperuricemia(hyperuricemia group)and 1762 patients with normal uric acid levels(normal uric acid group).After adjusting for age,sex,body mass index(BMI),systolic blood pressure,diabetes mellitus,estimated glomerular filtration rate(eGFR),and uric acid‑lowering treatment,multivariate logistic regression analysis showed that combined with hyperuricemia was an independent risk factor for new-onset CKD in middle-aged and elderly hypertensive patients(OR=3.00,95%CI:1.87-4.80,P<0.001).The results of multivariate logistic analysis showed that elevated uric acid level was an independent risk factor for new-onset CKD in both male and female middle-aged and elderly hypertensive patients(both P<0.05),and there was no sex interaction(P for interaction>0.05).The results of multivariate logistic analysis showed that the combination of asymptomatic hyperuricemia was an independent risk factor

关 键 词：高血压 尿酸 慢性肾脏病 

分 类 号：R54[医药卫生—心血管疾病]