中国北京人群高尿酸血症与非酒精性脂肪肝的相关性研究

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摘要目的调查中国北京有关人群高尿酸血症与非酒精性脂肪肝（NAFLD）的相关性。方法选择2017年7月～2018年5月在北京市通州区潞河医院体检中心进行健康体检的6750名人群作为研究对象。收集的指标包括人群的基本资料及相应的生化指标和腹部彩超等。比较高尿酸血症者和非高尿酸血症者的基本资料、生化指标及代谢综合征和脂肪肝发生率，根据文献将血尿酸水平四分位数分层，利用二元logistic回归控制多重混杂因素后分析高尿酸血症是否是NAFLD的独立危险因素。结果男性中，高尿酸血症患者体重、体重指数（BMI）、三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、肌酐（Scr）较非高尿酸血症水平升高（P ＜ 0.05），而高密度脂蛋白胆固醇（HDL-C）水平下降（P ＜ 0.05）。女性中，高尿酸血症患者体重、BMI、丙氨酸氨基转移酶、天冬氨酰氨基酸转移酶、TG、TC、LDL-C、Scr较非高尿酸血症水平升高（P ＜ 0.05），而HDL-C水平下降（P ＜ 0.05）。无论男女高尿酸血症患者NAFLD发病率和代谢综合征都较非高尿酸血症高（P ＜ 0.05）；经过多种混杂因素矫正，血尿酸每增加50 μmol/L，女性NAFLD的发生风险增加11.2%（P ＜ 0.05）；将血尿酸水平按照四分位数进行分层后，经过多种混杂因素矫正，采用logistic回归方法发现随着血尿酸水平的增加NAFLD的发生风险逐渐增高（以血尿酸≤270 μmol/L作为参照，其血尿酸271～320 μmol/L人群，NAFLD发生风险为1.258倍（95%CI：1.012～1.563）；血尿酸321～379 μmol/L人群，NAFLD发生风险为1.523倍（95%CI：1.226～1.892）；血尿酸≥380 μmol/L人群，发生风险为1.696倍（95%CI：1.338～2.148），血尿酸与NAFLD呈正相关，是发生NAFLD的独立危险因素，而男性没有此相关性。结论血尿酸是NAFLD的独立危险因素，并且具有性别差异性，女性较男性更具有相关性。

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	张媛媛杨龙艳王岩孙荣欣付颖赵冬

关键词 ：非酒精性脂肪肝, 高尿酸血症, 性别差异, 相关性研究, 发生风险

Abstract：Objective To investigate the association between hyperuricemia and nonalcoholic fatty liver (NAFLD) in Beijing of China. Methods A total of 6750 participants who enrolled in the physical examination from July 2017 to May 2018 at the Health Checkup Center of Luhe Hospital in Tongzhou District, Beijing. The data included the basic information of the population and the corresponding biochemical indicators and abdominal color ultrasound. The differences in the basic data, biochemical indicators, metabolic syndrome, and the incidence of fatty liver between hyperuricemia and non-hyperuricemia were compared. According to the literature, the quartiles of serum uric acid level were analyzed and whether hyperuricemia was an independent risk factor for NAFLD after controlling for multiple confounders using binary logistic regression. Results In men, the body weight, body mass index (BMI), total cholesterol (TC), low density lipoprotein cholesterol (HDL-C) and creatinin (Scr) of patients with hyperuricemia were higher than those without hyperuricemia (P < 0.05), while the high density lipoprotein cholesterol (HDL-C) level was lower (P ＜ 0.05). In women with hyperuricemia, weight, BMI, alanine aminotransferase, asparagine aminotransferase, TG, TC, LDL-C, and Scr were higher than those without hyperuricemia (P ＜ 0.05), while HDL-C levels were lower (P < 0.05). The incidence of NAFLD and metabolic syndrome in both men and women with hyperuricemia was higher than that of non-hyperuricemia (P ＜ 0.05). After correction for various confounding factors, for every 50 mol/L increase in serum uric acid, the risk of occurrence of NAFLD increased by 11.2% (P ＜ 0.05). After stratifying uric acid levels according to quartile, logistic regression was used to find that the risk of nonalcoholic fatty liver increased with the increase of serum uric acid level after multiple confounding factors were corrected (blood uric acid ≤270 μmol/L as a reference, the blood uric acid in 271-320 μmol/L crowd their risk of the occurrence of NAFLD was 1.258 times (95%CI:1.012-1.563), blood uric acid in 321-379 μmol/L, the risk was 1.523 times (95%CI:1.226-1.892), the risk of occurrence was 1.696 times (95%CI: 1.338-2.148) in serum uric acid ≥380 μmol/L. Serum uric acid was positively correlated with NAFLD, which was an independent risk factor for the occurrence of NAFLD. Conclusion The uric acid is an independent risk factor for NAFLD disease and that it is gender-differentiated. Women are more relevant than men.

Key words： Nonalcoholic fatty liver Hyperuricemia Gender differences Correlation studies Occurrence risk

基金资助:北京市自然科学基金资助项目（7194282）；
北京市通州区科委科技创新专项项目（KJ2019CX014-22）。

通讯作者: 赵冬（1966.5-），女，博士，主任医师；研究方向：糖尿病及其并发症。

作者简介: 张媛媛（1987.12-），女，博士；研究方向：糖尿病和甲状腺。

引用本文:

张媛媛杨龙艳王岩孙荣欣付颖赵冬. 中国北京人群高尿酸血症与非酒精性脂肪肝的相关性研究[J]. 中国医药导报, 2020, 17(11): 111-115.
ZHANG Yuanyuan YANG Longyan WANG Yan SUN Rongxin FU Ying ZHAO Dong. Correlation analysis of hyperuricemia and nonalcoholic fatty liver in Beijing of China. 中国医药导报, 2020, 17(11): 111-115.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I11/111

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