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目的研究天津市体检人群基线尿酸(UA)水平与2年后发生代谢综合征(MS)及其组分异常的相关性,为探讨MS组分的构成提供科学依据。方法采取历史回顾性队列研究方法,收集2011年和2013年均在天津市第一中心医院健康体检中心接受体检的3 825人的体检结果,包括体格检查(体重和血压)、生化指标测定结果(UA、甘油三酯、高密度脂蛋白胆固醇水平等)及用药史等。分析基线(2011年)UA水平与2013年发生MS及其组分异常的相关性,并运用工作特征曲线(ROC)确定基线UA预测MS发生的切点值。结果基线无MS的1 566人中2年内有141人新发生MS,累计发病率为9.0%,其中男性为12.0%,女性为4.5%。相关性分析结果显示,无论男女,基线UA水平与2013年随访时TG水平和BMI的相关程度最高(男性r值分别为0.209和0.243,女性r值分别为0.307和0.353),有统计学意义(P<0.01)。随着基线UA水平的升高,2013年男性肥胖、高甘油三酯血症发病率逐渐升高(P趋势值<0.01);同时,女性肥胖、高甘油三酯血症、高血压、低高密度脂蛋白血症和MS的发病率也逐渐升高(P趋势值<0.01)。多元logistic回归分析显示,基线UA是肥胖(男性:OR=2.06,95%CI:1.37~3.08;女性:OR=2.55,95%CI:1.56~5.63)、高甘油三酯血症(男性:OR=2.63,95%CI:1.66~4.15;女性OR=3.91,95%CI:1.36~11.30)及女性MS(OR=2.01,95%CI:1.32~3.68)发生的独立预测因子。在女性中,ROC曲线确定基线UA预测MS发生的最佳切点值为285.15μmol/L。结论在天津市体检人群中,基线UA水平与2年后MS的发生及其组分异常密切相关,并且基线UA是女性发生MS的独立预测因子,建议把UA作为女性MS的组分之一。
Objective To study the correlation between baseline UA level and metabolic syndrome (MS) and its component abnormalities in physical examination population in Tianjin, and to provide a scientific basis for exploring the composition of MS components. Methods A historical retrospective cohort study was conducted to collect the physical examination results of 3 825 people who received physical examinations at the First People ’s Hospital of Tianjin Center for Health Examination in 2011 and 2013, including physical examination (weight and blood pressure), biochemical indexes ( UA, triglycerides, high-density lipoprotein cholesterol, etc.) and medication history. The baseline (2011) UA level was correlated with the occurrence of MS and its component anomalies in 2013 and the operating characteristic curve (ROC) was used to determine the baseline cutoff values for baseline UA-predicted MS. Results Of the 1 566 people without baseline MS, 141 were new to MS within 2 years, with a cumulative incidence of 9.0%, of whom 12.0% were men and 4.5% were women. Correlation analysis showed that both men and women had the highest correlation between baseline UA level and BMI at 2013 follow-up (male r values were 0.209 and 0.243, female r values were 0.307 and 0.353, respectively), with statistical significance ( P <0.01). The prevalence of obesity and hypertriglyceridemia increased gradually with the increase of baseline UA level in 2013 (P trend <0.01). At the same time, obesity, hypertriglyceridemia, hypertension, The incidence of HDL and MS also gradually increased (P trend <0.01). Multivariate logistic regression analysis showed that baseline UA was obese (male: OR = 2.06, 95% CI: 1.37-3.08; female: OR 2.55, 95% CI: 1.56-5.63), hypertriglyceridemia = 2.63, 95% CI: 1.66 to 4.15; female OR = 3.91, 95% CI: 1.36 to 11.30) and female MS (OR = 2.01, 95% CI: 1.32 to 3.68). In women, the best cut point for the occurrence of MS at Baseline UA predicted by ROC curve was 285.15 μmol / L. Conclusion Baseline UA levels are closely related to MS occurrence and its component abnormalities after 2 years in Tianjin physical examination population. Baseline UA is an independent predictor of MS in women. It is suggested that UA should be considered as one of the components of female MS.