关键词: 高尿酸血症, 人体质量指数, 腰围, 颈围, 肥胖症, 上海, 浦东新区

Abstract: Background　The prevention and treatment of chronic diseases〔including hyperuricemia（HUA）〕in communities are a kind of comprehensive management for such diseases.Many factors，such as obesity，metabolic disorders，cardiovascular disease，cerebrovascular disease，and chronic kidney disease are associated with the risk of increased HUA.However，previous studies linking obesity to HUA have shown different results.Objective　To assess the association between diverse measures of obesity〔body mass index（BMI），waist circumference（WC） and neck circumference（NC）〕and HUA in the elderly in Puxing Community.Methods　Elderly（65-99 years old） people（n=4 364） were recruited from the Puxing Community，Pudong New District，Shanghai.All of them participated in the free physical examination delivered by the Puxing Community Health Center during April to June，2015.A cross-sectional survey was used to collected the data concerning BMI，WC and NC，and other factors associated with HUA〔history of smoking and drinking，hypertension，diabetes，levels of uric acid（UA）fasting plasma glucose（FPG），total cholesterol（TC），triacylglycerol（TG），urea，creatinine（Cr），total bilirubin，ALT and estimated glomerular filtration rate （eGFR）〕．They were divided into high sUA group（n=610） and normal UA group（n=3 754） according to the level of UA （UA>420 μmol/L in men and postmenopausal women was defined as the diagnostic criterion for HUA）．And personal characteristics of both groups were compared.By BMI，the participants were stratified into underweight，normal weight，overweight，and obesity.On the basis of the quartile of WC，they were assigned to A1（WC<82.2 cm for men，<78.0 cm for women），A2（82.2 cm≤WC<88.5 cm for men，78.0 cm≤WC<85.0 cm for women），A3（88.5 cm≤WC<94.0 cm for men，85.0 cm≤WC<92.0 cm for women），A4（WC≥94.0 cm for men，≥92.0 cm for women）．They were also divided into 4 groups according to the quartile of NC，B1（NC<35.0 cm for men，<31.0 cm for women），B2（35.0 cm≤NC<37.0 cm for men，31.0 cm≤NC<33.0 cm for women），B3（37.0 cm≤NC<38.0 cm for men，33.0 cm≤NC<35.0 cm for women），B4（NC≥38.0 cm for men，≥35.0 cm for women）．The relationships of HUA prevalence with BMI，WC and NC were analyzed by sex.Multivariable Logistic regression analyses were also performed to investigate the relationships of HUA prevalence with BMI，WC and NC.Results　The average age，history of hypertension，BMI，WC，NC，systolic and diastolic blood pressure，UA，TG，urea，SCr，total bilirubin，ALT and eGFR，prevalence of overweight and obesity，abdominal obesity，increased NC，hypertension，and decreased eGFR were significant different between high UA group and normal UA group （all P<0.05）．The prevalence of HUA significantly increased with the growth of age，BMI，WC，and NC in both men and women（P<0.05）.After adjusting for sex，age，smoking，drinking，TC，TG，total bilirubin，ALT，hypertension，and diabetes，multivariate Logistic regression analyses of the models established with the BMI，WC and NC data showed that BMI，WC and NC were all associated with HUA（P<0.001）．The prevalence of HUA increased by 42%，38%，29%，respectively，with every 1-standard deviation（3.4 kg/m2） increase in BMI，every 1-standard deviation（9.5 cm） increase in WC，and every 1-standard deviation（3.3 cm） increase in NC.After further adjusting for WC and NC，multivariable Logistic regression analyses found that BMI was associated with HUA（P<0.05）．In addition，male，TG，decreased eGFR，hypertension and diabetes were associated with HUA（P<0.05）．Conclusion　BMI，WC and NC were all associated with HUA.But after adjusting for the latter two，BMI was found to be associated with HUA.Compared with WC and NC，BMI might have a stronger association with HUA.

Key words: Hyperuricemia, Body mass index, Waist circumference, Neck circumference, Obesity, Shanghai, Pudong New District