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

摘要： 背景　高血压是心血管疾病的主要危险因素之一，而高值血压处于高血压前期阶段，现均已成为被广泛关注的重要公共卫生问题。目前，有研究结果显示血尿酸水平升高是高值血压、高血压的危险因素，并存在性别差异，但结论尚不一致。目的　基于倾向性评分匹配探讨不同性别血尿酸与高值血压、高血压的相关性。方法　本研究利用达能营养中心膳食营养研究与宣教基金项目的调查数据，该项目采用分层整群抽样法，于2014—2016年在凉山彝族自治州西昌市、德昌县、冕宁县、盐源县设置调查点，根据彝族和非彝族聚居地分别纳入西昌市部分常住居民、德昌县6个村的全部常住居民、冕宁县8个村的全部常住居民以及盐源县平川镇部分常住居民进行现场问卷调查、体格检查以及血样采集。调查其一般人口学特征和生理生化指标，包括性别、年龄、民族、吸烟状况、饮酒状况、体质指数（BMI）、教育年限、职业、总胆固醇（TC）、三酰甘油（TG）、空腹血糖（FPG）、血压和血尿酸水平。根据血尿酸水平的四分位数（P25，P50和P75）将被调查者分为血尿酸Q1、Q2、Q3、Q4组。使用倾向性评分匹配，以实现组间协变量的平衡。使用多因素Logistic回归分析探讨匹配前后不同性别血尿酸与高值血压、高血压的相关性。结果　项目共包括3 188例被调查者，剔除不合格要求者273例，最后共纳入2 915例被调查者。2 915例被调查者中，高血压760例，高值血压1 240例，正常血压915例。经倾向性评分匹配，女性高血压和非高血压人群成功匹配248对，男性成功匹配388对；女性高值血压和正常血压人群成功匹配384对，男性成功匹配321对。多因素Logistic回归分析结果显示，女性血尿酸Q3组和Q4组高血压患病风险分别是Q1组的4.213倍〔95%CI（2.245，7.908）〕（P<0.001）、1.739倍〔95%CI（1.023，2.956）〕（P=0.041）；男性血尿酸Q4组高值血压患病风险是Q1组的1.817倍〔95%CI（1.185，2.788）〕（P=0.006），男性血尿酸Q3组和Q4组高血压患病风险分别是Q1组的2.948倍〔95%CI（1.772，4.905）〕（P<0.001）、5.852倍〔95%CI（3.309，10.351）〕（P<0.001）。结论　男性和女性高水平血尿酸人群的高血压患病风险均较高，即血尿酸水平与高血压可能存在相关性。此外，与低水平血尿酸相比，男性高水平血尿酸人群高值血压患病风险更高，而在女性中未见此相关关系。

关键词: 血尿酸, 高血压, 高值血压, 倾向性评分, 凉山地区