老年人群肥胖指标与高尿酸血症的关系

doi:10.3969/j.issn.1003-9198.2022.10.008

摘要/Abstract

摘要： 目的研究老年人群肥胖指标与高尿酸血症(hyperuricemia,HUA)的关系,为肥胖人群HUA的筛查与管理提供依据。方法回顾性收集参加健康体检的老年人临床资料,包括受检者的年龄、身高、体质量、SBP、DBP、血尿酸、TG、HDL-C、LDL-C、腰围等资料,计算BMI、身体圆度指数(body roundness index, BRI)、相对脂肪质量指数(relative fat mass index,RFM)、脂质蓄积指数(lipid accumulation product, LAP)及内脏脂肪指数(visceral adiposity index, VAI),分析老年人不同肥胖指标与HUA的关系。结果共获取了10 582例有效的健康体检资料,HUA组与非HUA组BMI、腰围、BRI、RFM、LAP及VAI水平差异有统计学意义(P<0.05)。矫正性别、年龄、吸烟、饮酒后的多因素Logistic回归分析结果显示,腰围(OR=1.029, 95%CI:1.018~1.040)、BMI(OR=1.227, 95%CI:1.070~1.407)、LAP(OR=1.007, 95%CI:1.003~1.011)、BRI(OR=1.474, 95%CI:1.288~1.688)、RFM(OR=1.070, 95%CI:1.046~1.095)与HUA有关。老年不同性别人群LAP预测HUA的AUC均最大,高于BMI、腰围、BRI、VAI、RFM。结论不同肥胖指标在老年人群中均是HUA的危险因素,在不同性别老年人群中,LAP预测HUA的价值均最大,为HUA的管理提供了依据。

关键词: 老年人, 肥胖指标, 高尿酸血症, 脂质蓄积指数, 内脏脂肪指数

Abstract: Objective To explore the relationship between the indicators of obesity and hyperuricemia (HUA) in the elderly people aged≥ 60 years old, and to provide evidence for the screening and management of HUA. Methods The clinical data including age, height, weight, systolic blood pressure, diastolic blood pressure, blood uric acid, triglycerides, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and waist circumference (WC) were collected by reviewing the physical check report, and body mass index (BMI), body roundness index (BRI), relative fat mass index (RFM), lipid accumulation product (LAP) and visceral adiposity index (VAI) were calculated. The relationship between the obesity indicators and HUA was analyzed by Logistic regression model. Results A total of 10 582 cases were enrolled in this study. There were statistically significant differences in the levels of BMI, WC, BRI, RFM, LAP and VAI between HUA group and non-HUA group(P<0.05). Logistic regression analysis showed that WC (OR=1.029, 95%CI:1.018-1.040), BMI (OR=1.227, 95%CI:1.070-1.407), LAP (OR=1.007, 95%CI:1.003-1.011), BRI (OR=1.474, 95%CI:1.288-1.688) and RFM (OR=1.070, 95%CI:1.046-1.095) were associated with HUA. The area under the receiver operating characteristic curve of LAP in predicting HUA was greatest. Conclusions Some obesity indicators are risk factors for HUA in the elderly, and LAP has the greatest predictive value, which provides evidence for the management of HUA.

Key words: aged, obesity indicators, hyperuricaemia, lipid accumulation product, visceral adiposity index

中图分类号:

R589.7

薛建强, 刘玉萍, 倪国华, 孙平, 刘莹莹, 帅平. 老年人群肥胖指标与高尿酸血症的关系[J]. 实用老年医学, 2022, 36(10): 1006-1009.

XUE Jian-qiang, LIU Yu-ping, NI Guo-hua, SUN Ping, LIU Ying-ying, SHUAI Ping. Relationship between obesity indicators and hyperuricemia in the elderly[J]. Practical Geriatrics, 2022, 36(10): 1006-1009.

参考文献

[1] GAROFALO C, DE STEFANO T, VITA C, et al. Hyperuricaemia and chronic kidney disease[J]. G Ital Nefrol, 2018, 35(1):2018-vol1.
[2] 中华医学会内分泌学会. 中国高尿酸血症与痛风诊疗指南(2019)[J]. 中华内分泌代谢杂志, 2020, 36(1):1-13.
[3] 王荣, 汤哲, 孙菲, 等. 中国7城市老年人高尿酸血症患病率调查[J]. 中华流行病学杂志, 2018, 39(3):286-288.
[4] ZHANG S, WANG Y, CHENG J, et al. Hyperuricemia and cardiovascular disease[J]. Curr Pharm Des, 2019, 25(6):700-709.
[5] HAN T, MENG X, SHAN R, et al.Temporal relationship between hyperuricemia and obesity, and its association with future risk of type 2 diabetes[J]. Int J Obes: Lond, 2018, 42(7):1336-1344.
[6] THOMAS D M, BREDLAU C, BOSY-WESTPHAL A, et al. Relationships between body roundness with body fat and visceral adipose tissue emerging from a new geometrical model[J]. Obesity: Silver Spring, 2013, 21(11):2264-2271.
[7] WOOLCOTT O O, BERGMAN R N. Relative fat mass (RFM) as a new estimator of whole-body fat percentage-A cross-sectional study in American adult individuals[J]. Sci Rep, 2018, 8(1):10980.
[8] KAHN H S.The "lipid accumulation product" performs better than the body mass index for recognizing cardiovascular risk: a population-based comparison[J]. BMC Cardiovasc Disord, 2005, 5:26.
[9] AMATO M C, GIORDANO C, GALIA M, et al. Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk[J]. Diabetes Care, 2010, 33(4):920-922.
[10] 李林, 朱小霞, 戴宇翔, 等. 中国高尿酸血症相关疾病诊疗多学科专家共识[J]. 中华内科杂志, 2017, 56(3):235-248.
[11] ZHU Y, PANDYA B J, CHOI H K. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008[J]. Arthritis Rheum, 2011, 63(10):3136-3141.
[12] 薛建强, 贺娜, 帅平, 等. 60岁以上肾功能轻度下降体检人群的现状及影响因素分析[J]. 临床肾脏病杂志, 2022, 22(2):119-125.
[13] 刘丹丹, 崔雯霞, 李曼,等.老年人血清尿酸水平与肾小球滤过率的相关性[J].实用老年医学, 2019, 33(12):1183-1186.
[14] UEMURA N, MURAKAMI R, CHIBA Y, et al. Immunoreactivity of urate transporters, GLUT9 and URAT1, is located in epithelial cells of the choroid plexus of human brains[J]. Neurosci Lett, 2017, 659:99-103.[15] 薛建强, 刘玉萍, 孙平, 等.甲状腺功能正常的成年人尿酸与血脂、血糖、血压关系研究[J]. 大连医科大学学报, 2022, 44(1):13-17.
[16] AUNE D, NORAT T, VATTEN L J. Body mass index and the risk of gout: a systematic review and dose-response meta-analysis of prospective studies[J]. Eur J Nutr, 2014, 53(8):1591-1601.
[17] 俞匀, 唐伟, 娄青林. 老年2型糖尿病病人血清尿酸/肌酐比值与胰岛素抵抗及胰岛B细胞功能的相关性[J]. 实用老年医学, 2021, 35(4):378-381.
[18] HUANG Z P, HUANG B X, ZHANG H, et al.Waist-to-height ratio is a better predictor of hyperuricemia than body mass index and waist circumference in Chinese[J]. Ann Nutr Metab, 2019, 75(3):187-194.
[19] DONG H, XU Y, ZHANG X, et al. Visceral adiposity index is strongly associated with hyperuricemia independently of metabolic health and obesity phenotypes[J]. Sci Rep, 2017, 7(1):8822.
[20] SEIDELL J C, VISSCHER T L. Body weight and weight change and their health implications for the elderly[J]. Eur J Clin Nutr, 2000, 54(3):33-39.
[21] ZENG J, ZHANG J, LI Z, et al. Prediction model of artificial neural network for the risk of hyperuricemiaincorporating dietary risk factors in a Chinese adult study[J]. Food Nutr Res, 2020, 64. DOI: 10.29219/fnr.v64.3712.
[22] GAO Y, JIA S, LI D, et al. Prediction model of random forest for the risk of hyperuricemia in a Chinese basic health checkup test[J]. Biosci Rep, 2021, 41(4):38-59.