中国全科医学 ›› 2024, Vol. 27 ›› Issue (03): 293-299.DOI: 10.12114/j.issn.1007-9572.2023.0290

• 论著 • 上一篇    下一篇

我国中老年人群血清尿酸/高密度脂蛋白胆固醇比值与代谢综合征的相关性研究

吴瑞鹏1, 彭成1, 袁丙坤1, 章梦君2, 李文源3,*()   

  1. 1510515 广东省广州市,南方医科大学卫生管理学院
    2510515 广东省广州市,南方医科大学公共卫生学院
    3510515 广东省广州市,南方医科大学南方医院
  • 收稿日期:2023-04-04 修回日期:2023-08-08 出版日期:2024-01-20 发布日期:2023-10-23
  • 通讯作者: 李文源

  • 作者贡献:吴瑞鹏负责文章的构思与设计、数据收集与整理、统计学处理、结果的分析与解释、论文撰写;彭成、袁丙坤负责文章修订,监督管理;章梦君负责文献、资料、图表整理;李文源负责研究的实施和可行性分析、文章的质量控制及审校。
  • 基金资助:
    广东省重点领域研发计划(2019B020227004)

Correlation between Serum Uric Acid to High-density Lipoprotein Cholesterol Ratio and Metabolic Syndrome in Middle-aged and Elderly Population in China

WU Ruipeng1, PENG Cheng1, YUAN Bingkun1, ZHANG Mengjun2, LI Wenyuan3,*()   

  1. 1School of Health Services Management, Southern Medical University, Guangzhou 510515, China
    2School of Public Health, Southern Medical University, Guangzhou 510515, China
    3Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
  • Received:2023-04-04 Revised:2023-08-08 Published:2024-01-20 Online:2023-10-23
  • Contact: LI Wenyuan

摘要: 背景 我国中老年人群代谢综合征(MS)患病率逐年攀升,血清尿酸(SUA)/高密度脂蛋白胆固醇(HDL-C)比值(UHR)与多种代谢性疾病密切相关,但在中老年人群中,关于UHR与MS关联的研究较少。 目的 探讨中国中老年人群UHR与MS之间的相关性,并评估UHR对MS的预测价值。 方法 本研究采用2015年中国健康与养老追踪调查(CHARLS)公开数据,纳入9 233名研究对象。收集研究对象一般资料、体格检查指标和血生化检查指标。计算研究对象UHR。依据是否患有MS将研究对象分为非MS组(n=7 006)与MS组(n=2 227),同时按UHR四分位数水平将研究对象分为Q1组(UHR≤7.32%,n=2 308)、Q2组(7.32%<UHR≤9.45%,n=2 307)、Q3组(9.45%<UHR≤12.20%,n=2 310)、Q4组(UHR>12.20%,n=2 308)。采用Pearson相关性分析探究UHR与代谢指标的相关性;采用多因素Logistic回归分析探讨UHR与MS的关系。分别绘制总体和不同性别研究对象UHR预测MS发生风险的受试者工作特征(ROC)曲线并计算ROC曲线下面积(AUC)。 结果 研究对象平均年龄(60.3±9.6)岁,MS组女性比例、年龄、城镇比例、高血压史比例、糖尿病史比例、血脂异常史比例、服用降脂药比例、糖化血红蛋白、C反应蛋白、三酰甘油(TG)、总胆固醇(TC)、空腹血糖(FPG)、SUA、收缩压(SBP)、舒张压(DBP)、BMI、腰围(WC)、UHR高于非MS组,HDL-C、低密度脂蛋白胆固醇(LDL-C)、估算的肾小球滤过率(eGFR)低于非MS组,两组受教育程度、吸烟情况、饮酒情况比较,差异有统计学意义(P<0.05)。随着UHR水平的上升,Q1~Q4组MS、中心性肥胖、高血糖、高血压、高TG血症、低HDL-C血症检出率呈上升趋势(P趋势<0.01);Q1~Q4组BMI、WC、SBP、DBP、TG、HDL-C、LDL-C、TC、FPG、eGFR、C反应蛋白水平比较,差异均有统计学意义(P<0.01)。Pearson相关性分析结果显示,UHR与TG、FPG、DBP、SBP、BMI、WC均呈正相关(P<0.01),与HDL-C呈负相关(P<0.01)。按性别分层后,男性、女性UHR与TG、FPG、DBP、SBP、BMI、WC均呈正相关(P<0.01),与HDL-C呈负相关(P<0.01)。多因素Logistic回归分析结果显示,与Q1组相比,男性Q4组(OR=3.385,95%CI=1.778~6.444,P<0.01)和女性Q4组(OR=2.886,95%CI=1.991~4.184,P<0.01)MS患病风险增加。ROC曲线分析结果显示,研究对象UHR预测MS的AUC为0.735(95%CI=0.723~0.746),男性群体UHR预测MS的AUC为0.773(95%CI=0.757~0.790),女性群体UHR预测MS的AUC为0.750(95%CI=0.735~0.766)。 结论 中国中老年人群UHR水平与MS呈正向关联,UHR与MS及其组分密切相关,UHR可能是MS的危险因素且对中老年群体MS发生风险有良好的预测价值。

关键词: 代谢综合征, 尿酸, 高密度脂蛋白胆固醇, 中国健康与养老追踪调查, 中年人, 老年人, 预测

Abstract:

Background

The prevalence of metabolic syndrome (MS) among the middle-aged and elderly population in China increases with age, serum uric acid to high density lipoprotein cholesterol ratio (UHR) is closely associated with various metabolic diseases, however, there are few studies on the relationship between UHR and MS in middle-aged and elderly people.

Objective

To explore the correlation between UHR and MS in middle-aged and elderly people in China, and evaluate the predictive value of UHR for MS.

Methods

This study used public data from the 2015 China Health and Retirement Longitudinal Survey (CHARLS) and included 9 233 subjects. General data, physical examination indexes and blood biochemical examination indexes were collected from the study subjects and their UHR was calculated. The subjects were divided into the non-MS group (n=7 006) and MS group (n=2 227) according to whether they had MS. At the same time, the subjects were divided into the Q1 group (UHR≤7.32%, n=2 308), Q2 group (7.32%<UHR≤9.45%, n=2 307), Q3 Group (9.45%<UHR≤12.20%, n=2 310) and Q4 group (UHR>12.20%, n=2 308) according to the level of the quartiles of UHR. Pearson correlation analysis was used to explore the correlation between UHR and metabolic indexes. The relationship between UHR and MS was studied by multivariate Logistic regression analysis. The receiver operating characteristic (ROC) curves for the risk of MS predicted by UHR in the overall and by different genders were plotted separately and the areas under the ROC curve (AUC) were calculated.

Results

The average age of the subjects was (60.3±9.6) years. The proportion of females, age, urban household proportion, history of hypertension, diabetes and dyslipidemia, proportion of taking lipid-lowering drugs, glycated hemoglobin, C-reactive protein, triglyceride (TG), total cholesterol (TC), fasting plasma glucose (FPG), SUA, systolic blood pressure (SBP), diastolic blood pressure (DBP), BMI, waist circumference (WC) and UHR in the MS group were higher than the non-MS group, while HDL-C, low-density lipoprotein cholesterol (LDL-C) and estimated glomerular filtration rate (eGFR) were lower than those in the non-MS group, and there were statistically significant differences in education level, smoking and alcohol consumption between the two groups (P<0.05). With the increase of UHR level, the detection rates of MS, central obesity, hyperglycemia, hypertension, hypertriglyceridemia and low HDL-C in Q1-Q4 groups showed an increasing trend (Ptrend<0.01). There were significant differences in BMI, WC, SBP, DBP, TG, HDL-C, LDL-C, TC, FPG, eGFR and C-reactive protein among Q1-Q4 groups (P<0.01). The results of Pearson correlation analysis showed that UHR was positively correlated with TG, FPG, DBP, SBP, BMI and WC (P<0.01), and negatively correlated with HDL-C (P<0.01). After gender stratification, UHR in males and females were positively correlated with TG, FPG, DBP, SBP, BMI and WC (P<0.01), and negatively correlated with HDL-C (P<0.01). Multivariate Logistic regression analysis showed that compared with the Q1 group, there was an increased risk of MS prevalence in the male Q4 group (OR=3.385, 95%CI=1.778-6.444, P<0.01) and female Q4 group (OR=2.886, 95%CI=1.991-4.184, P<0.01). ROC curve analysis showed that the AUC for UHR predicting MS for the study population was 0.735 (95%CI=0.723-0.746), the AUC for UHR predicting MS for male group was 0.773 (95%CI=0.757-0.790). the AUC for UHR predicting MS for female group was 0.750 (95%CI=0.735-0.766) .

Conclusion

There was a positive correlation between the increased UHR level and risk of MS among the middle-aged and elderly population in China, UHR closely correlates to MS and its components, UHR might serve as a risk factor and demonstrated good predictive value for MS in middle-aged and elderly people.

Key words: Metabolic syndrome, Uric acid, High density lipoprotein cholesterol, China Health and Retirement Longitudinal Study, Middle-aged, Aged, Forecasting