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背景:沿海居民血尿酸的影响因素如何?血尿酸与代谢综合征防治切点如何?目前尚无中国人资料。目的:明确山东沿海20岁以上女性血尿酸与代谢综合征的关系。设计:随机、分层、整群抽样调查。单位:青岛大学医学院附属医院内分泌科。对象:于2004-05/10对山东沿海五市(青岛、日照、烟台、威海和东营)常住女性居民进行调查。年龄20～80岁,常住5年及5年以上,以家庭为单位的自然人群。方法:采用入户调查和现场调查相结合的方式,第1天填写调查问卷,第2天清晨采空腹血做血尿酸检测,对尿酸值高于正常的第3天复查并进行痛风和高尿酸血症的防治教育。主要观察指标:①一般情况调查:包括健康状况、饮食、体力活动、劳动强度和经济情况。②营养调查:分食物摄入频率调查和膳食调查两部分。③测量身高、体质量、腰围、臀围、血压、体质量指数。④测定空腹血糖、血尿酸、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、尿素氮、肌酐含量。结果:①随着血尿酸浓度的升高,收缩压、舒张压、脉压、体质量指数、腰围、腰臀比、尿素氮、肌酐、三酰甘油、总胆固醇也逐渐升高,血尿酸280～319μmol/L、血尿酸320～349μmol/L、血尿酸>350μmol/L(高尿酸血症)三组上述指标均明显高于血尿酸<280μmol/L组(P<0.05～0.01),而高密度脂蛋白胆固醇随血尿酸浓度的升高而降低(P均<0.01)。②高血压、脂代谢紊乱、超重和肥胖、糖代谢紊乱及代谢综合征的患病率随着尿酸值的升高而升高;与血尿酸<280μmol/L组比较,血尿酸280～319μmol/L、血尿酸320～349μmol/L和高尿酸血症组发生代谢综合征的OR值分别为2.29(95%CI:1.81～2.89),4.15(95%CI:3.10～5.55),4.96(95%CI:3.85～6.39)。③非条件Logistic多元逐步回归分析显示年龄、高血压、食贝类量、尿素氮、肌酐、三酰甘油、腰臀比、轻体力活动为女性高尿酸血症独立的危险因子,高密度脂蛋白胆固醇为保护因素。结论:山东沿海女性代谢综合征患病率随血尿酸值的升高而升高,血尿酸超过280μmol/L应作为代谢综合征防治切点。控制代谢综合征,减少贝类等含高嘌呤海产品的摄入是预防高尿酸血症的发生的措施之一。临床医师应警惕高尿酸血症致病作用。
Background: What are the influencing factors of serum uric acid in coastal residents? How are the control points of blood uric acid and metabolic syndrome? There is no Chinese information available yet. Objective: To clarify the relationship between serum uric acid and metabolic syndrome in women over the age of 20 in Shandong coastal areas. Design: randomized, stratified, cluster sampling survey. Unit: Department of Endocrinology, Affiliated Hospital of Qingdao University Medical College. Target: On May 05, 2004, a survey was conducted on the resident women living in five cities along the coast of Shandong (Qingdao, Rizhao, Yantai, Weihai and Dongying). Age 20 to 80 years old, 5 years living and more than 5 years to the family as a unit of the natural population. Methods: A combination of household survey and on-the-spot investigation was used. The questionnaire was filled in on the first day and the serum uric acid was taken on the second day in fasting blood. On the third day after uric acid level was higher than normal, gout and hyperuricemia Prevention and treatment of blood disease education. MAIN OUTCOME MEASURES: ① General Survey: Including health status, diet, physical activity, labor intensity and economic situation. ② nutrition survey: sub-food intake frequency survey and dietary survey in two parts. ③ measurement of height, body mass, waist circumference, hip circumference, blood pressure, body mass index. ④ determination of fasting blood glucose, serum uric acid, total cholesterol, triglyceride, high density lipoprotein cholesterol, urea nitrogen, creatinine levels. Results: With the increase of blood uric acid concentration, systolic blood pressure, diastolic blood pressure, pulse pressure, body mass index, waist circumference, waist-hip ratio, urea nitrogen, creatinine, triglyceride and total cholesterol also increased gradually. ~ 319μmol / L, serum uric acid 320 ~ 349μmol / L, serum uric acid> 350μmol / L (hyperuricemia) were significantly higher than those of serum uric acid <280μmol / L group The density lipoprotein cholesterol decreased with the increase of serum uric acid concentration (all P <0.01). ② The prevalence of hypertension, lipid metabolism, overweight and obesity, glucose metabolism disorder and metabolic syndrome increased with the rise of uric acid value. Compared with serum uric acid <280μmol / L group, serum uric acid 280 ~ 319μmol / L, respectively. The OR of metabolic syndrome in 320 ~ 349μmol / L group and hyperuricemia group were 2.29 (95% CI: 1.81-2.89), 4.15 (95% CI: 3.10-5.55) and 4.96 CI: 3.85 ~ 6.39). (3) Unconditional Logistic regression analysis showed that age, hypertension, shellfish intake, urea nitrogen, creatinine, triglyceride, waist-hip ratio and light physical activity were independent risk factors for hyperuricemia in women. High density lipoprotein Cholesterol as a protective factor. Conclusion: The prevalence of metabolic syndrome in Shandong coastal women increases with the increase of serum uric acid. Serum uric acid exceeding 280 μmol / L should be used as a control point for metabolic syndrome. Control of metabolic syndrome, reduce the intake of shellfish and other high-purine-containing seafood is one of the measures to prevent the occurrence of hyperuricemia. Clinicians should be wary of the pathogenesis of hyperuricemia.