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体检人群血尿酸与肾小球滤过率的相关性分析

Correlation between serum uric acid and glomerular filtration rate in people with physical examination

    摘要
  • 摘要:
      目的  调查体检人群高尿酸血症（HUA）的患病率，分析不同血尿酸（SUA）水平对肾小球滤过率的影响。
      方法  收集参加体检的2 753例患者临床资料，根据SUA水平的四分位数将研究人群分为4组，即Ⅰ组（SUA≤246.65 μmol/L）、Ⅱ组（SUA>246.65~309.30 μmol/L）、Ⅲ组（SUA>309.30~365.55 μmol/L）、Ⅳ组（SUA>365.55 μmol/L）。应用Pearson相关分析探讨估算肾小球滤过率（eGFR）与SUA等指标相关性。采用多因素Logistics回归分析研究不同水平SUA与患慢性肾脏病（CKD）的相关性。
      结果  本组2 753例人群的HUA总患病率为10.28%，男性HUA患病率为13.73%，高于女性的2.86%，差异有统计学意义（P < 0.001）。31~40岁男性HUA患病率最高，为21.15%；>70岁女性HUA的患病率最高，为7.21%。eGFR随SUA水平升高而下降，差异有统计学意义（P < 0.001）。Pearson相关分析显示，SUA水平与eGFR呈显著负相关（r=-0.186，P < 0.001）。多因素Logistic回归分析发现：未校正混杂因素时，与Ⅰ组相比，Ⅱ组、Ⅳ组患CKD的OR值分别为0.487（95%CI为0.265~0.897，P < 0.05）、2.621（95%CI为1.712~4.013，P < 0.01）；校正相关混杂因素后，与Ⅰ组相比，Ⅱ组、Ⅳ组患CKD的OR值分别为0.622（95%CI为0.305~1.272，P>0.05）、3.089（95%CI为1.735~5.500，P < 0.01）。
      结论  体检人群中男性HUA患病率高于女性。当SUA>365.55 μmol/L时，其为CKD的危险因素，患CKD风险高，建议临床考虑起始降尿酸治疗。

     

    Abstract:
      Objective  To investigate the prevalence of hyperuricemia (HUA) in people with physical examination and analyze the influence of different levels of serum uric acid (SUA) on glomerular filtration rate.
      Methods  Clinical materials of 2 753 people with physical examination were collected, and these people were divided into 4 groups according to quartile of SUA level: group Ⅰ (SUA was 246.65 μmol/L and below), group Ⅱ (SUA was greater than 246.65 and up to 309.30 μmol/L), group Ⅲ (SUA was greater than 309.30 and up to 365.55 μmol/L), and group Ⅳ (SUA was greater than 365.55 μmol/L). Pearson correlation analysis was used to explore the associations between the estimated glomerular filtration rate (eGFR) and other biochemical indicators such as SUA. Multivariate Logistics regression analysis was used to study the correlation between different levels of SUA and chronic kidney disease (CKD).
      Results  The total prevalence of HUA in 2 753 cases was 10.28%, and was 13.73% in men, which was significantly higher than 2.86% in women (P < 0.001). The prevalence of HUA was the highest in men aged 31 to 40 years old, while that was 7.21% in women aged over 70 years old. The eGFR decreased significantly with increase of SUA level (P < 0.001). Pearson correlation analysis showed that the level of SUA was negatively associated with the eGFR (r=-0.186, P < 0.001). Multivariate Logistics regression analysis showed that when confounding factors were not adjusted, the OR values of suffering from CKD in group Ⅱ and group Ⅳ were 0.487 (95%CI, 0.265 to 0.897, P < 0.05) and 2.621 (95%CI, 1.712 to 4.013, P < 0.01) respectively when compared with group Ⅰ; after adjusting for relevant confounding factors, the OR values of suffering from CKD in group Ⅱ and group Ⅳ were 0.622 (95%CI, 0.305 to 1.272, P>0.05) and 3.089 (95%CI, 1.735 to 5.500, P < 0.01) respectively when compared with group Ⅰ.
      Conclusion  The prevalence of HUA in men with physical examination is higher than that in women. SUA is a risk factor for CKD when its level is greater than 365.55 μmol/L, and the risk of suffering from CKD is high, so it is suggested that initial uric acid lowering therapy should be considered in clinic.

     

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