江西婺源高血压患者体重指数和腰高比与高尿酸血症的关联性研究

陈浩; 吴谦; 章如山; 邹剑飞; 王瑞; 唐根富

doi:10.16766/j.cnki.issn.1674-4152.003103

江西婺源高血压患者体重指数和腰高比与高尿酸血症的关联性研究

doi: 10.16766/j.cnki.issn.1674-4152.003103

安徽医科大学卫生管理学院，安徽合肥 230032

基金项目:

国家自然科学基金面上项目 81773534

详细信息

通讯作者:
唐根富，E-mail：tanggenfu@163.com

中图分类号: R544.1 R589.7
计量
- 文章访问数: 172
- HTML全文浏览量: 38
- PDF下载量: 11
- 被引次数: 0
出版历程
- 收稿日期: 2022-09-26
- 网络出版日期: 2023-09-13

The relationship between body mass index and waist-height ratio and hyperuricemia in patients with hypertension in Wuyuan, Jiangxi Province

School of Health Management, Anhui Medical University, Hefei, Anhui 230032, China

摘要

摘要: 目的探究体重指数(BMI)和腰高比(waist-height ratio, WHtR)对高血压患者罹患高尿酸血症(hyperuricemia, HUA)的影响，为早期预防高血压合并HUA提供依据。方法 2022年7—8月采用多阶段抽样的方法抽取婺源县5个乡镇，共纳入1 522例高血压患者进行现场问卷调查，体格检查以及生化指标检测。将研究对象按照是否患有HUA分为病例组和对照组，采用logistic回归分析BMI与WHtR和HUA的关系，并采用受试者工作特征曲线进行评价。结果 1 522例高血压患者年龄为(63.99±8.80)岁，本研究共检出HUA患者600例(39.4%)。多因素logistic回归结果显示，超重(24≤BMI＜28)、肥胖(BMI≥28)、中心性肥胖(WHtR≥0.5)均为高血压患者HUA患病的重要危险因素，OR值分别为1.828(95% CI：1.444~2.314)、2.955(95% CI：2.052~4.257)、2.105(95% CI：1.629~2.720)。BMI和WHtR曲线下面积分别为0.599(95% CI：0.570~0.628)和0.583(95% CI：0.554~0.612)。结论超重、肥胖、中心性肥胖促进HUA在高血压人群中的发生，当地高血压管理机构应重视高血压患者BMI和WHtR的评估和干预。
- 高血压 /
- 肥胖指标 /
- 高尿酸血症
Abstract: Objective To investigate the effects of body mass index (BMI) and waist-height ratio (WHtR) on hyperuricemia (HUA) in hypertensive patients, and to provide a basis for the early prevention of hypertension complicated with HUA. Methods A total of 1 522 hypertensive patients were enrolled in 5 townships from July to August 2022 in Wuyuan County by multi-stage sampling, they were included for on-site questionnaire survey, physical examination and biochemical index detection. The subjects were divided into case group and control group according to whether they had HUA, the relationship between BMI and WHtR and HUA was analyzed by logistic regression, and the receiver operating characteristic curve was used for evaluation. Results The mean age of 1 522 hypertensive patients was (63.99±8.80) years, and a total of 600 HUA patients (39.4%) were detected in this study. Multivariate logistic regression results showed that overweight (24≤BMI < 28), obesity (BMI≥28), and central obesity (WHtR≥0.5) were important risk factors for HUA in hypertensive patients, with OR values of 1.828 (95% CI: 1.444-2.314), 2.955 (95% CI: 2.052-4.257), and 2.105 (95% CI: 1.629-2.720), respectively. The area under the BMI and WHtR curves were 0.599 (95% CI: 0.570-0.628) and 0.583 (95% CI: 0.554-0.612), respectively. Conclusion Overweight, obesity and central obesity promote the occurrence of HUA in hypertensive population, and local hypertension management agencies should pay attention to the evaluation and intervention of BMI and WHtR in hypertensive patients.
- Hypertension /
- Obesity index /
- Hyperuricemia

HTML全文

图 1 BMI与WHtR的ROC曲线

Figure 1. ROC curve between BMI and WHtR

下载: 全尺寸图片幻灯片

表 1 1 522例高血压患者一般资料比较

Table 1. Comparison of general data of 1 522 patients with hypertension

组别	例数	性别(男性/女性，例)	年龄(x±s, 岁)	职业为农民[例(%)]	婚姻状况为已婚[例(%)]	BMI (x±s)	WHtR (x±s)
非HUA组	922	404/518	63.89±8.58	760(82.4)	809(87.7)	23.32±3.14	0.53±0.06
HUA组	600	340/260	64.17±9.16	465(77.5)	515(85.8)	24.64±5.63	0.55±0.06
统计量		24.015^a	-0.620^b	5.624^a	1.173^a	-5.236^b	-5.387^b
P值		＜0.001	0.535	0.018	0.279	＜0.001	＜0.001

组别	例数	当前吸烟[例(%)]	当前饮酒[例(%)]	TC (x±s, mmol/L)	TG (x±s, mmol/L)	HDL-C (x±s, mmol/L)	LDL-C (x±s, mmol/L)
非HUA组	922	213(23.1)	270(29.3)	4.79±0.97	1.81±1.06	1.35±0.30	3.02±0.77
HUA组	600	154(25.7)	202(33.7)	4.71±0.92	2.00±1.21	1.30±0.29	3.00±0.75
统计量		1.307^a	3.263^a	1.350^b	-3.081^b	2.569^b	0.639^b
P值		0.253	0.071	0.177	0.002	0.010	0.523
注：^a为χ²值，^b为t值。

下载: 导出CSV

表 2 Logistic回归分析变量赋值情况

Table 2. Logistic regression analysis variable assignment

变量	赋值方法
HUA	否=0，是=1
性别	男性=0，女性=1
年龄	＜55岁=0，55~＜65岁=1，≥65岁=2
职业	农民=0，非农民=1
婚姻状况	已婚=0，未婚、离异、丧偶=1
BMI	正常=0，低体重=1，超重=2，肥胖=3
WHtR	非中心性肥胖=0，中心性肥胖=1
吸烟	当前吸烟=0，当前不吸烟=1
饮酒	当前饮酒=0，当前不饮酒=1

下载: 导出CSV

表 3 BMI与WHtR和HUA的logistic回归分析

Table 3. Logistic regression analysis of BMI, WHtR and HUA

变量	未调整模型
变量	HUA[例(%)]	B	SE	Wald χ²	P值	OR(95% CI)
BMI
低体重	23(34.8)	0.120	0.270	0.200	0.655	1.128(0.665~1.913)
超重	242(45.7)	0.572	0.116	24.160	＜0.001	1.772(1.411~2.226)
肥胖	87(56.5)	1.007	0.180	31.356	＜0.001	2.738(1.925~3.896)
WHtR
≥0.5	432(43.6)	0.665	0.125	28.482	＜0.001	1.944(1.523~2.482)

变量	调整模型
变量	HUA[例(%)]	B	SE	Wald χ²	P值	OR(95% CI)
BMI
低体重	23(34.8)	0.071	0.276	0.066	0.798	1.073(0.624~1.845)
超重	242(45.7)	0.603	0.120	25.143	＜0.001	1.828(1.444~2.314)
肥胖	87(56.5)	1.084	0.186	33.878	＜0.001	2.955(2.052~4.257)
WHtR
≥0.5	432(43.6)	0.744	0.131	32.403	＜0.001	2.105(1.629~2.720)
注：调整模型中，调整变量为性别、年龄、职业、婚姻、吸烟、饮酒、TC、TG、HDL-C、LDL-C。均以正常组为对照。

下载: 导出CSV

表 4 不同性别间BMI与WHtR和HUA的关联分析

Table 4. Association of BMI, WHtR and HUA in different genders[cases (%)]

变量	男性人群
变量	HUA[例(%)]	B	SE	Wald χ²	P值	OR(95% CI)
BMI
低体重	13(37.1)	0.274	0.390	0.492	0.483	1.315(0.612~2.825)
超重	130(49.8)	-0.122	0.209	0.343	0.558	0.885(0.588~1.332)
肥胖	42(66.7)	0.487	0.325	2.240	0.134	1.627(0.860~3.079)
WHtR
≥0.5	259(52.0)	0.596	0.219	7.431	0.006	1.815(1.182~2.787)

变量	女性人群
变量	HUA[例(%)]	B	SE	Wald χ²	P值	OR(95% CI)
BMI
低体重	10(32.2)	0.386	0.459	0.709	0.400	1.472(0.599~3.618)
超重	112(41.6)	0.862	0.200	17.015	＜0.001	2.285(1.543~3.383)
肥胖	45(49.5)	1.239	0.267	21.453	＜0.001	3.450(2.043~5.828)
WHtR
≥0.5	223(36.7)	0.115	0.272	0.178	0.673	1.122(0.658~1.913)
注：均以正常组为对照。

下载: 导出CSV

参考文献(20)

[1]	中国高血压防治指南修订委员会. 中国高血压防治指南(2018年修订版)[J]. 中国心血管杂志, 2019, 24(1): 24-56. doi: 10.3969/j.issn.1007-5410.2019.01.002 Chinese Hypertension Prevention and Treatment Guidelines Revision Committee. 2018 Chinese guidelines for the management of hypertension[J]. Chinese Journal of Cardiovascular Medicine, 2019, 24(1): 24-56. doi: 10.3969/j.issn.1007-5410.2019.01.002
[2]	SU H Y, YANG C, LIANG D, et al. Research advances in the mechanisms of hyperuricemia-induced renal Injury[J]. Biomed Res Int, 2020, 26: 5817348. DOI: 10.1155/2020/5817348.
[3]	刘甜, 王禹川, 刘梅林. 高尿酸血症与高血压关系的研究进展[J]. 中国医药, 2021, 16(6): 935-938. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYG202106033.htm LIU T, WANG Y C, LIU M L. Research progress on the relationship between hyperuricemia and hypertension[J]. China Medicine, 2021, 16(6): 935-938. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYG202106033.htm
[4]	GROSSMAN C, GROSSMAN E, GOLDBOURT U. Uric acid variability at midlife as an independent predictor of coronary heart disease and all-cause mortality[J]. PLoS One, 2019, 14(8): e0220532. DOI: 10.1371/journal.pone.0220532.
[5]	孟雪莲, 鲍立平, 徐晓艳, 等. 孕前体质指数及妊娠期体重增长与妊娠糖尿病发病率的相关性[J]. 河北医学, 2021, 27(12): 2043-2046. doi: 10.3969/j.issn.1006-6233.2021.12.024 MENG X L, BAO L P, XU X Y, et al. The Relationship Between Body Mass Index and Weight Gain During Pregnancy and the Incidence of Gestational Diabetes[J]. Hebei Medicine, 2021, 27(12): 2043-2046. doi: 10.3969/j.issn.1006-6233.2021.12.024
[6]	吴林飞, 郑黎芳, 张奇, 等. 不同年龄组肥胖指标与心血管疾病危险因素的相关性分析[J]. 心脑血管病防治, 2022, 22(1): 90-92, 96. https://www.cnki.com.cn/Article/CJFDTOTAL-XXFZ202201025.htm WU L F, ZHENG L F, ZHANG Q, et al. Correlation analysis between obesity indexes and cardiovascular disease risk factors in different age groups[J]. Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, 2022, 22(1): 90-92, 96. https://www.cnki.com.cn/Article/CJFDTOTAL-XXFZ202201025.htm
[7]	吴建华, 郭鹏辉, 赖秋娴, 等. 体检人群高尿酸血症合并泌尿系结石相关临床特点及危险因素[J]. 现代医药卫生, 2022, 38(22): 3908-3910, 3914. doi: 10.3969/j.issn.1009-5519.2022.22.027 WU J H, GUO P H, LAI Q X, et al. Clinical features and risk factors associated with urinary stones in the physical examination population[J]. Journal of Modern Medicine & Health, 2022, 38(22): 3908-3910, 3914. doi: 10.3969/j.issn.1009-5519.2022.22.027
[8]	王友发, 孙明晓, 薛宏, 等. 《中国肥胖预防和控制蓝皮书》解读及中国肥胖预防控制措施建议[J]. 中华预防医学杂志, 2019, 52(9): 875-884. WANG Y F, SUN M X, XUE H, et al. Understanding the China Blue Paper on Obesity Prevention and Control and policy implications and recommendations for obesity prevention and control in China[J]. Chinese Journal of Preventive Medicine, 2019, 52(9): 875-884.
[9]	袁空军, 杨媛, 赵创艺, 等. 腰围、腰围身高比联合体质指数预测血脂异常病人患病风险效果评价[J]. 护理研究, 2022, 36(11): 1894-1900. doi: 10.12102/j.issn.1009-6493.2022.11.003 YUAN K J, YANG Y, ZHAO C Y, et al. Evaluation of the effect of waist circumference, waist-to-height ratio combined with body mass index in predicting the risk of disease in patients with dyslipidemia[J]. Chinese Nursing Research, 2022, 36(11): 1894-1900. doi: 10.12102/j.issn.1009-6493.2022.11.003
[10]	林淑芃. 《中国高尿酸血症与痛风诊疗指南(2019)》解读[J]. 临床内科杂志, 2020, 37(6): 460-462. doi: 10.3969/j.issn.1001-9057.2020.06.022 LIN S P. Interpretation of Chinese Guidelines for the Diagnosis and Treatment of Hyperuricemia and Gout (2019)[J]. Journal of Clinical Internal Medicine, 2020, 37(6): 460-462. doi: 10.3969/j.issn.1001-9057.2020.06.022
[11]	姜一农. 高血压伴无症状高尿酸血症管理中国专家共识[J]. 中华高血压杂志, 2022, 30(11): 1014-1019, 1000. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGZ202211004.htm JIANG Y N. Chinese expert consensus on the management of hypertension with asymptomatic hyperuricemia[J]. Chinese Journal of Hypertension, 2022, 30(11): 1014-1019, 1000. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGZ202211004.htm
[12]	任娜, 王伟英, 侯芳素, 等. 老年高血压合并高尿酸血症影响因素分析[J]. 解放军医药杂志, 2019, 31(2): 54-56. doi: 10.3969/j.issn.2095-140X.2019.02.013 REN N, WANG W Y, HOU F S, et al. Analysis of Influencing Factors of Elderly Patients with Hypertension Associated by Hyperuricemia[J]. Medical & Pharmaceutical Journal of Chinese People's Liberation Army, 2019, 31(2): 54-56. doi: 10.3969/j.issn.2095-140X.2019.02.013
[13]	谭树凤, 沈红卫, 李桃, 等. 上海市浦东新区某社区老年人群体检结果及5年随访分析[J]. 中华全科医学, 2022, 20(10): 1715-1717, 1785. doi: 10.16766/j.cnki.issn.1674-4152.002687 TAN S F, SHEN H W, LI T, et al. Healthy examination results and 5-year follow-up analysis of the elderly in a community of Pudong New Area, Shanghai[J]. Chinese Journal of General Practice, 2022, 20(10): 1715-1717, 1785. doi: 10.16766/j.cnki.issn.1674-4152.002687
[14]	莫文秋, 李双蕾, 陈文辉, 等. 无症状高尿酸血症危险因素的调查与研究[J]. 医学综述, 2020, 26(23): 4745-4748, 4753. doi: 10.3969/j.issn.1006-2084.2020.23.031 MO W Q, LI S L, CHEN W H, et al. Investigation and Study of Risk Factors of Asymptomatic Hyperuricemia[J]. Medical Recapitulate, 2020, 26(23): 4745-4748, 4753. doi: 10.3969/j.issn.1006-2084.2020.23.031
[15]	刘甜, 王禹川, 刘梅林. 高尿酸血症与高血压关系的研究进展[J]. 中国医药, 2021, 16(6): 935-938. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYG202106033.htm LIU T, WANG Y C, LIU H L. Research progress on the relationship between hyperuricemia and hypertension[J]. China Medicine, 2021, 16(6): 935-938. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYG202106033.htm
[16]	扎米热·库尔班, 徐菲莉, 范朋凯, 等. 新疆地区人群高尿酸血症与糖脂代谢相关疾病的关联性研究[J]. 国际检验医学杂志, 2019, 40(7): 778-782. https://www.cnki.com.cn/Article/CJFDTOTAL-GWSQ201907004.htm ZAMIRE K E B, XU F L, FAN P K, et al. Relationship between hyperuricemia and related diseases of glucose and lipid metabolism in Xinjiang population[J]. International Journal of Laboratory Medicine, 2019, 40(7): 778-782. https://www.cnki.com.cn/Article/CJFDTOTAL-GWSQ201907004.htm
[17]	ALI N, PERVEEN R, RAHMAN S, et al. Prevalence of hyperuricemia and the relationship between serum uric acid and obesity: a study on Bangladeshi adults[J]. PLoS One, 2018, 13(11): e0206850. DOI: 10.1371/journal.pone.0206850.
[18]	HUANG Z P, HUANG B X, ZHANG H, et al. Waist-to-height ratio is a better pedictor of hyperuricemia than body mass index and waist circumference in Chinese[J]. Ann Nutr Metab, 2019, 75(3): 187-194.
[19]	丁存涛, 李静, 诸国华, 等. 老年原发性高血压患者血尿酸与代谢综合征各组分相关关系研究[J]. 中华老年心脑血管病杂志, 2018, 20(1): 20-23. https://www.cnki.com.cn/Article/CJFDTOTAL-LNXG201801007.htm DING C T, LI J, ZHU G H, et al. Relationship between serum level of uric acid and components of metabolic syndrome in elderly essential hypertensive patients[J]. Chinese Journal of Geriatric Heart Brain and Vessel Diseases, 2018, 20(1): 20-23. https://www.cnki.com.cn/Article/CJFDTOTAL-LNXG201801007.htm
[20]	吴子瑜, 郭太林, 何岩燕. 老年人群体重指数、血清尿酸水平与高尿酸血症的相关性研究[J]. 现代医药卫生, 2022, 38(23): 3997-4000, 4005. https://www.cnki.com.cn/Article/CJFDTOTAL-XYWS202223007.htm WU Z Y, GUO T L, HE Y Y. Correlation between body mass index, serum uric acid level and hyperuricemia in the elderly[J]. Journal of Modern Medicine & Health, 2022, 38(23): 3997-4000, 4005. https://www.cnki.com.cn/Article/CJFDTOTAL-XYWS202223007.htm