社区视角下老年人群高尿酸血症与慢性代谢性疾病的相关性分析

顾汝英; 李娟; 陈燕; 王朝昕

doi:10.16766/j.cnki.issn.1674-4152.003617

社区视角下老年人群高尿酸血症与慢性代谢性疾病的相关性分析

doi: 10.16766/j.cnki.issn.1674-4152.003617

顾汝英^1, ,,
李娟¹,
陈燕¹,
王朝昕²

1.
复旦大学上海医学院闵行区虹桥社区卫生服务中心，上海 201103
2.
海南医学院管理学院，海南海口 570216

基金项目:

国家重点研发计划项目 2022YFC3601505

详细信息

通讯作者:
顾汝英，E-mail: ruying_gu@163.com

中图分类号: R589.7
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出版历程
- 收稿日期: 2024-03-11
- 网络出版日期: 2024-11-19

Correlation analysis between hyperuricemia and chronic metabolic diseases in the elderly population from the community perspective

1.
Minhang District Hongqiao Community Healthcare Center, Shanghai Medical College,Fudan University, Shanghai 201103, China

摘要

摘要: 目的分析社区老年人群高尿酸血症(HUA)患病现状，探讨HUA界值及血尿酸水平与慢性代谢性疾病的相关性。方法该研究为横断面研究，以2023年上海闵行区2个社区参与体检的1 508例老年人为研究对象。主要观察指标为血清尿酸、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血脂检测、身高、体重、腰围、血压等。HUA定义为血清尿酸男性＞420 μmol/L，女性＞360 μmol/L。结果该人群HUA总体粗患病率为26.8%(404/1 508, 95% CI：24.6%~29.1%)，男性为24.7%(182/736)，女性为28.8%(222/772)。男女性患病率均随年龄增长呈上升趋势，并且HUA组慢性代谢性疾病患病率均显著高于非HUA组。女性HUA患者不同尿酸水平合并慢性代谢性疾病比例差异无统计学意义。多因素回归分析显示，高血压(OR_男=1.847, 95% CI: 1.209~2.820；OR_女=1.519, 95% CI: 1.009~2.288)、高TG(OR_男=1.296, 95% CI: 1.100~1.527；OR_女=1.619, 95% CI: 1.316~1.991)是HUA的危险因素，BMI与尿酸水平呈正相关关系。结论社区老年人群HUA患病率较高。高血压、高TG是HUA的危险因素。血尿酸＞360 μmol/L的女性均合并较高比例的慢性代谢性疾病，建议女性血尿酸控制目标水平＜360 μmol/L。
- 高尿酸血症 /
- 老年人 /
- 慢性代谢性疾病 /
- 相关因素
Abstract: Objective To analyze the current status of hyperuricemia (HUA) in the elderly population in the community, explore the critical value of HUA, and the correlation between serum uric acid levels and chronic metabolic diseases. Methods A cross-sectional study was conducted on 1 508 elderly individuals who participated in physical examinations in two communities in Minhang District, Shanghai in 2023. The main outcome measures were serum uric acid, fasting plasma glucose (FPG), glycated haemoglobin (HbA1c), and blood lipid detection. Height, weight, waist circumference, and blood pressure were also measured. HUA was defined as serum uric acid >420 μmol/L in males and >360 μmol/L in females. Results The estimated prevalence in this population was 26.8% (404/1 508, 95% CI: 24.6%-29.1%) overall, 24.7% (182/736) in males and 28.8% (222/772) in females. The prevalence of males and females increased with age, and the incidence of chronic metabolic diseases in HUA groups was significantly higher than those in non-HUA groups. There was no statistically significant difference in the proportion of chronic metabolic diseases among females with different serum uric acid levels in HUA. Multivariate regression analysis showed that hypertension (OR_male=1.847, 95% CI: 1.209-2.820; OR_female=1.519, 95% CI: 1.009-2.288), high values of TG (OR_male=1.296, 95% CI: 1.100-1.527; OR_female=1.619, 95% CI: 1.316-1.991) were the strong risk factors for HUA, and BMI was positively correlated with uric acid levels. Conclusion The prevalence of HUA among the elderly population in the Community is relatively high. Hypertension and high values of TG are strong risk factors for HUA. Females with serum uric acid > 360 μmol/L are associated with a higher proportion of chronic metabolic diseases. It is recommended to control the target level of serum uric acid in Females to be less than 360 μmol/L.
- Hyperuricemia /
- The aged /
- Chronic metabolic diseases /
- Related factor

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表 1 不同性别组基线资料比较

Table 1. Comparison of general data for different gender groups

项目	男性(n=736)	女性(n=772)	统计量	P值
年龄(x±s，岁)	71.37±6.07	71.16±6.59	0.644^a	0.520
腰围(x±s，cm)	89.14±8.53	85.11±8.68	9.079^a	＜0.001
BMI(x±s)	24.53±2.86	24.51±3.40	0.143^a	0.887
SBP(x±s，mmHg)	140.85±18.69	144.26±18.55	-3.416^a	0.001
DBP(x±s，mmHg)	77.00±9.85	75.82±10.28	2.276^a	0.023
UA(x±s，μmol/L)	357.79±83.90	320.76±85.53	8.481^a	＜0.001
FPG(x±s，mmol/L)	7.86±2.24	7.77±2.36	0.778^a	0.436
HbA1c(x±s，%)	7.35±1.50	7.17±1.39	2.434^a	0.015
TC(x±s，mmol/L)	4.51±1.05	5.06±1.09	-9.988^a	＜0.001
TG(x±s，mmol/L)	1.49±1.06	1.64±0.90	-2.804^a	0.005
HDL-C(x±s，mmol/L)	1.40±0.40	1.60±0.40	-9.620^a	＜0.001
LDL-C(x±s，mmol/L)	2.65±1.01	3.02±1.14	-6.625^a	＜0.001
HUA[例(%)]	182(24.7)	222(28.8)	3.117^b	0.077
高血压[例(%)]	516(70.1)	537(69.6)	0.054^b	0.816
糖尿病[例(%)]	699(95.0)	729(94.4)	0.221^b	0.638
血脂异常[例(%)]	178(24.2)	249(32.3)	12.086^b	0.001
代谢综合征[例(%)]	414(56.3)	472(61.1)	3.718^b	0.054
超重或肥胖[例(%)]	407(55.3)	421(54.5)	0.089^b	0.765
注：^a为t值，^b为χ²值

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表 2 不同人口学特征HUA的粗患病率比较[%(95% CI)]

Table 2. Comparison of prevalence of HUA with different demographic characteristics [% (95% CI)]

年龄段(岁)	例数	男性患病率	女性患病率	χ²值	P值
60~69	628	23.1(18.4~28.4)	21.6(17.3~26.4)
70~79	728	23.6(19.4~28.3)	33.9(29.0~39.0)
≥80	152	36.5(25.6~48.5)	35.9(25.3~47.6)
合计	1 508	24.7(21.6~28.0)	28.8(25.6~32.1)	3.117	0.077
χ²值		6.134	15.021
P值		0.047	0.001

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表 3 男性HUA组与非HUA组患慢性代谢性疾病资料比较[例(%)]

Table 3. Comparison of data on chronic metabolic diseases between male HUA group and non-HUA group [cases (%)]

组别	例数	高血压	糖尿病	血脂异常	代谢综合征	超重或肥胖
HUA	182	148(81.3)	168(92.3)	54(29.7)	129(70.9)	116(63.7)
非HUA	554	368(66.4)	531(95.8)	124(22.4)	285(51.4)	291(52.5)
χ²值		14.499	3.597	3.968	21.027	6.963
P值		＜0.001	0.058	0.046	＜0.001	0.008

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表 4 女性HUA组与非HUA组患慢性代谢性疾病资料比较[例(%)]

Table 4. Comparison of data on chronic metabolic diseases between female HUA group and non-HUA group [cases (%)]

组别	例数	高血压	糖尿病	血脂异常	代谢综合征	超重或肥胖
HUA	222	178(80.2)	211(95.0)	97(43.7)	175(78.8)	164(73.9)
非HUA	550	359(65.3)	518(94.2)	152(27.6)	297(54.0)	257(46.7)
χ²值		16.600	0.224	18.663	41.038	47.008
P值		＜0.001	0.636	＜0.001	＜0.001	＜0.001

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表 5 不同尿酸水平组女性HUA患者慢性代谢性疾病患病率比较[例(%)]

Table 5. Prevalence of chronic metabolic diseases in female HUA patients in groups with different uric acid levels [cases (%)]

尿酸分组(μmol/L)	例数	高血压	糖尿病	血脂异常	代谢综合征	超重及肥胖
360~	131	101(77.1)	124(94.7)	54(41.2)	95(72.5)	95(72.5)
420~	58	45(77.6)	54(93.1)	28(48.3)	50(86.2)	47(81.0)
480~	19	18(94.7)	19(100.0)	8(42.1)	17(89.5)	13(68.4)
540~	14	14(100.0)	14(100.0)	7(50.0)	13(92.9)	9(64.3)
χ²值		7.022	2.227	1.066	7.958	2.625
P值		0.071	0.527	0.785	0.047	0.453

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表 6 男性HUA的多因素logistic回归分析

Table 6. Multivariate logistic regression analysis of HUA in male

变量	B	SE	Waldχ²	P值	OR(95% CI)
BMI	0.067	0.032	4.354	0.037	1.069(1.004~1.138)
HbA1c	-0.221	0.070	9.989	0.002	0.801(0.699~0.919)
TG	0.259	0.084	9.567	0.002	1.296(1.100~1.527)
高血压	0.613	0.216	8.055	0.005	1.847(1.209~2.820)

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表 7 女性HUA的多因素logistic回归分析

Table 7. Multivariate logistic regression analysis of HUA in female

变量	B	SE	Waldχ²	P值	OR(95% CI)
年龄	0.045	0.106	20.842	0.001	1.046(1.019~1.073)
BMI	0.119	0.027	19.613	＜0.001	1.126(1.069~1.187)
TG	0.482	0.106	20.842	＜0.001	1.619(1.316~1.991)
HDL-C	-0.863	0.289	8.924	0.003	0.422(0.240~0.743)
高血压	0.418	0.209	4.007	0.045	1.519(1.009~2.288)

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