中青年人群血尿酸水平与非酒精性脂肪性肝病及颈动脉粥样硬化的相关性

徐琦; 赵冬晖; 张玲玲; 王旭; 王泰蓉

doi:10.7619/jcmp.20220338

中青年人群血尿酸水平与非酒精性脂肪性肝病及颈动脉粥样硬化的相关性

Correlations of serum uric acid level with non-alcoholic fatty liver disease and carotid atherosclerosis in young and middle-aged people

摘要

摘要:
目的探讨健康体检中不同性别的中青年人群血尿酸(SUA)水平与非酒精性脂肪性肝病(NAFLD)及颈动脉粥样硬化(CAS)的相关性。
方法选取2021年3-6月参加健康体检的在职职工1 274例为研究对象。观察不同性别、年龄段的中青年人群SUA水平及高尿酸血症(HUA)检出率; 分析SUA水平与血糖、血脂水平的相关性; 按照SUA水平四分位进行分组, 分析不同SUA水平与血糖升高、脂肪代谢异常、NAFLD和CAS的相关性。
结果除60~64岁年龄段外, 其他各年龄段男性SUA水平均高于女性, 差异有统计学意义(P < 0.01);各年龄段男性HUA检出率均高于女性, 其中≤40岁、41~49岁的男性与女性HUA检出率差异有统计学意义(P < 0.01);中青年男性SUA水平随年龄增长呈递减趋势, 女性则呈递增趋势。SUA水平与空腹血糖(FBG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)呈显著正相关(r=0.113、0.092、0.130、0.431、0.202, P≤0.001), 与高密度脂蛋白胆固醇(HDL-C)呈显著负相关(r=-0.365, P < 0.001)。进一步按照SUA水平四分位进行分组, 随着SUA水平的升高, TC、TG、HDL-C、LDL-C逐渐趋向异常, 特别是第四分位(Q₄组)与第一分位(Q₁组)的差异有统计学意义(P < 0.05)。多因素Logistic回归分析显示, 随着SUA水平的升高, 脂代谢异常、NAFLD、CAS的患病风险均增高; 校正其他因素后, 以Q₁组为参照组, 男性Q₄组的脂代谢异常和NAFLD患病风险分别增加221.5%(OR=3.215, 95%CI为2.154~4.798)、216.3%(OR=3.163, 95%CI为1.999~5.005), 男性Q₃组的CAS患病风险增加87.9%(OR=1.879, 95%CI为1.031~3.426);女性Q₄组的脂代谢异常患病风险增加169.8%(OR=2.698, 95%CI为1.105~6.587)。
结论中青年人群SUA水平与FBG、脂代谢异常、NAFLD和CAS患病率均显著相关, 且男性患病风险显著高于女性。

Abstract:
Objective To explore the correlations of serum uric acid (SUA) level with non-alcoholic fatty liver disease (NAFLD) and carotid atherosclerosis (CAS) in young and middle-aged people with different genders in physical examination.
Methods A total of 1 274 incumbent employees with physical examination from March to June 2021 were selected as research objects.The SUA levels and the detection rates of hyperuricemia (HUA) in young and middle-aged people with different gender and age were observed; the correlations of SUA level with blood glucose and blood lipid level were analyzed; according to the quartile of SUA level, the correlations of different SUA levels with elevated blood glucose, abnormal fat metabolism, NAFLD and CAS were analyzed.
Results Except for age group of 60 to 64 years, the SUA levels of men in other age groups were significantly higher than those of women (P < 0.01);the detection rates of HUA in men in other age groups were higher than those in women, and the significant differences were observed between men and women in the age groups of ≤40 years and 41 to 49 years (P < 0.01);the SUA levels in young and middle-aged men showed decreasing trend with age growing, while that of women increased.SUA level was positively correlated with fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C)(r=0.113, 0.092, 0.130, 0.431, 0.202, P≤0.001), and negatively correlated with high density lipoprotein cholesterol (HDL-C)(r=-0.365, P < 0.001).Further grouping was conducted according to the quartile of SUA level.With the increase of SUA level, TC, TG, HDL-C and LDL-C gradually tended to be abnormal, the difference between the fourth quartile (Q₄ group) and the first quartile (Q₁ group) was statistically significant (P < 0.05).Multivariate Logistic regression analysis showed that the risk of abnormal lipid metabolism, NAFLD and CAS increased significantly with the increase of SUA level; after adjusting for other factors, taking group Q₁ as the reference group, the risk of abnormal lipid metabolism and NAFLD in male Q₄ group increased by 221.5%(OR=3.215, 95%CI, 2.154 to 4.798) and 216.3%(OR=3.163, 95%CI, 1.999 to 5.005) respectively, and the risk of CAS in male Q₃ group increased by 87.9%(OR=1.879, 95%CI, 1.031 to 3.426);the risk of abnormal lipid metabolism in female Q₄ group increased by 169.8%(OR=2.698, 95%CI, 1.105 to 6.587).
Conclusion Different SUA levels in middle-aged and young people are significantly correlated with FBG, abnormal lipid metabolism, NAFLD and the prevalence of CAS.The risk of men is significantly higher than that of women.

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