血清尿酸动态变化与健康体检人群新发高血压的相关性及其预测效能  

Correlation between serum uric acid dynamic changes and incidence of new-onset hypertension in health examination populations and their predictive efficacy

作　　者：王东伟 刘芷含 苏彤 吴道兴 杨广[1] 孟令东 WANG Dongwei;LIU Zhihan;SU Tong;WU Daoxing;YANG Guang;MENG Lingdong(Department of Geriatrics,The First Affiliated Hospital of Shandong First Medical University(Shandong Qianfoshan Hospital),Jinan 250014,China;不详)

机构地区：[1]山东第一医科大学第一附属医院(山东省千佛山医院)老年医学科,山东济南250014 [2]济宁市第一人民医院心内科,山东济宁272002 [3]临沂市中心医院心内科,山东临沂276400 [4]青海省监狱管理局中心医院心内科,青海西宁810000

出　　处：《山东医药》2025年第4期54-58,共5页Shandong Medical Journal

基　　金：2021年度青海省“昆仑英才·高端创新创业人才”计划;青岛市科技惠民示范引导专项(22-3-7-smjk-8-nsh)。

摘　　要：目的分析血清尿酸动态变化(ΔsUA)与健康体检人群新发高血压的相关性,以及基线血清尿酸(sUA)和ΔsUA对新发高血压的预测效能。方法选择山东第一医科大学第一附属医院(山东省千佛山医院)健康管理中心2019—2021年同一健康体检人群为研究对象,对体检者进行ΔsUA(2021年基线sUA减去2019年基线sUA差值)四分位数及性别分层,利用Logistic回归模型分析ΔsUA与新发高血压的相关性,绘制限制性立方样条图及森林图进一步分析ΔsUA与新发高血压的相关性,另采用ROC曲线判断基线sUA和ΔsUA对新发高血压的预测效能。结果纳入2019年3122例健康体检者(男︰女为1205︰1917),2021年新发高血压621例。Logistic回归模型分析显示,总人群ΔsUA与新发高血压密切相关[OR(95%CI):1.008(1.006~1.009),P<0.05]。总人群以性别分层,随着ΔsUA升高,女性新发高血压风险较男性有增加趋势[Q4组(≥55.00µmol/L)OR(95%CI):女性比男性为3.207(2.192~4.692)比2.076(1.396~3.089)]。ΔsUA以四分位分层,以Q2组(-49.25~<1.00µmol/L)为参考组,Q1组(<-49.25µmol/L)新发高血压风险最低[OR(95%CI):0.537(0.401~0.721)],Q3组(1.00~<55.00µmol/L)和Q4组新发高血压风险逐渐增加[OR(95%CI):2.724(2.013~3.686)、4.882(3.577~6.664),P均<0.05]。当基线sUA的最佳临界值为0.398µmol/L时,其预测健康体检人群新发高血压的灵敏度为0.690、特异度为0.708;当ΔsUA的最佳临界值为0.541µmol/L时,其预测健康体检人群新发高血压的灵敏度为0.768、特异度为0.773。结论ΔsUA与健康体检人群新发高血压有关,其升高是健康体检人群新发高血压的独立危险因素,且女性新发高血压风险较男性高,ΔsUA对健康体检人群新发高血压有预测效能。Objective To investigate the association between dynamic changes in serum uric acid(ΔsUA)and the incidence of new-onset hypertension in a health examination population,and to evaluate the predictive efficacy ofΔsUA and baseline serum uric acid(sUA)for new-onset hypertension.Methods Subjects from Health Management Center of the First Affiliated Hospital of Shandong First Medical University(Shandong Qianfushan Hospital)in 2019-2021 were se-lected for the study.ΔsUA was defined as the difference between the 2021 sUA value minus the 2019 sUA value.Stratifi-cation was based on sex and quartiles ofΔsUA.The correlation betweenΔsUA and new-onset hypertension was analyzed using Logistic regression risk models with stepwise adjustment.We drew the restricted cubic spline plot and forest plot to further analyze the correlation betweenΔsUA and new-onset hypertension.In addition,the predictive efficacy of sUA andΔsUA for the new-onset hypertension was compared using receiver operating characteristic(ROC)curves.Results We included 1,222 healthy individuals(male-to-female ratio:1,205:1,917)from health examinations of March 2019 and identified 621 new-onset hypertension cases in 2021.Logistic regression analysis showed thatΔsUA was significantly asso-ciated with new-onset hypertension in the total population,with an adjusted odds ratio(OR)of 1.008(95%CI:1.006-1.009;P<0.05).When we stratified the population by gender,women exhibited a stronger trend of increasing hyperten-sion risk compared to men asΔsUA levels rose.Specifically,in the Q4 group(ΔsUA≥55µmol/L),the OR(95%CI)was 3.207(2.192-4.692)for women versus 2.076(1.396-3.089)for men.Using quartile stratification with the Q2 group(-49.25 to<1.00µmol/L)as the reference,we observed the lowest hypertension risk in the Q1 group(ΔsUA<-49.25µmol/L;OR=0.537,95%CI:0.401-0.721).The risk progressively increased in the Q3(1.00-<55.00µmol/L;OR=2.724,95%CI:2.013-3.686)and Q4 groups(≥55µmol/L;OR=4.882,95%CI:3.577-6.664),with both P<0.05.For predictive performance,the optim

关 键 词：血清尿酸动态变化 基线血清尿酸 新发高血压 性别差异 

分 类 号：R544.1[医药卫生—心血管疾病]