关键词: 血尿酸, 高血压, 高值血压, 倾向性评分, 凉山地区

Abstract: Background　Hypertension is one of the main risk factors of cardiovascular diseases.Prehypertension，an early warning sign for hypertension，has become a widely concerned major public health problem.Recently，some studies have shown that elevated serum uric acid level is a risk factor of prehypertension and hypertension with sex-specific differences，but the conclusions are not consistent.Objective　To perform a propensity-matched analysis of sex-specific correlations of serum uric acid with prehypertension and hypertension.Methods　Data about general demographic and physiological and biochemical parameters（including sex，age，nationality，smoking prevalence，drinking prevalence，body mass index，years of education，occupation，total cholesterol，triacylglycerol，fasting plasma glucose，blood pressure and serum uric acid） were collected from the survey（consisting of a field questionnaire investigation，physical examination and blood sample analysis） supported by the project of Dietary Nutrition Research and Education Fund of Danone Institute.Subjects were a stratified cluster sample selected during 2014—2016 from the areas inhabited by the Yi and non-Yi people of Xichang City and three counties（Dechang，Mianning and Yanyuan） of Liangshan Yi Autonomous Prefecture，including part of permanent residents from Xichang and from Pingchuan Town of Yanyuan，and all permanent residents from 6 villages of Dechang and from 8 villages of Mianning.They were divided into Q1，Q2，Q3 and Q4 groups based on the quartile of serum uric acid levels （P25，P50 and P75）.Propensity score matching was used to achieve a balance of covariates between groups.Multivariate Logistic regression analysis was used to explore sex-specific correlations of serum uric acid with prehypertension and hypertension before and after matching.Results　A total of 3 188 subjects were surveyed.After excluding 273 ineligible cases，other 2 915 were included for final analysis，including 760 with hypertension，1 240 with prehypertension and 915 with normal blood pressure.By the propensity score matching，248 pairs of hypertension and non-hypertension women were successfully matched，and 388 male pairs were successfully matched；384 pairs of prehypertension and normal blood pressure women were successfully matched，and 321 pairs of men were successfully matched.Multivariate Logistic regression analysis showed that in women，the risk of hypertension was 4.213 times higher in Q3 group 〔95%CI （2.245，7.908）〕（P<0.001），and was 1.739 times higher in Q4 group 〔95%CI （1.023，2.956）〕（P=0.041） compared with that of Q1 group.In men，the risk of prehypertension in Q4 group was 1.817 times higher 〔95%CI （1.185，2.788）〕（P=0.006） compared with that of Q1 group.The risk of hypertension was 2.948 times higher in Q3 group 〔95%CI （1.772，4.905）〕（P<0.001），and was 5.852 times higher in Q4 group 〔95%CI （3.309，10.351）〕（P<0.001） compared with that of Q1 group.Conclusion　Both men and women with elevated serum uric acid had a higher risk of hypertension，which indicates that there may be a correlation between serum uric acid and hypertension.In addition，men with high serum uric acid had a higher risk of prehypertension，but similar result was not found in women.

Key words: Serum uric acid, Hypertension, Prehypertension, Propensity score, Liangshan area