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血清尿酸水平与亚临床靶器官损害的相关性研究：北上海社区心血管病研究
The relationship of serum uric acid with target organ damage in the elderly：The Northern Shanghai Study

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DOI:
作者:
王凯
kaiwang
作者单位:
上海市第十人民医院
shanghai tenth people's hospital
关键词:
老年人；心血管危险因素；靶器官损害；高尿酸血症
Elderly; Cardiovascular risk factor; Target organ damage; Hyperuricemia
摘要:
背景和目的：血清尿酸水平与心血管事件和亚临床靶器官损害关系密切。既往研究显示其相关性存在性别差异，而这种差异是否是与雌激素作用有关目前尚不明确。本研究拟在65岁以上（绝经期后10年）的城市社区居民中探讨血清尿酸水平与靶器官损害之间的关系，旨在排除雌激素生理性波动情况下，研究两者的相关性及其性别差异。方法：在北上海10家社区入组912名老年居民（年龄>65岁），每位入选者均进行血清尿酸检测及心血管危险因素和亚临床靶器官损害指标的评估，并采用SPSS 13. 0 统计软件包进行统计分析。其中9名入选者未获得血清标本故未纳入本次统计。结果：903名入选者中，老年男性血清尿酸水平显著高于女性（374.1±89.4vs.310.8±74.8μmol/l，p<0.001）。血清尿酸和高尿酸血症患病率在女性中均随着年龄的增长而显著升高（p=0.009；p=0.003），而男性中则无此趋势。多元线性回归分析显示年龄、体重指数、血脂及血糖在所有入选者及男女亚组中均与血清尿酸水平显著相关。相关性分析显示在所有入选者及男女亚组中，血清尿酸水平和心脏受损指标（左心室质量指数r=0.12，p<0.001）及肾脏受损指标（肾小球滤过率r=-0.35，p<0.001；尿微量白蛋白/尿肌酐r=0.006，p=0.006）均有显著相关性。结论：在北上海社区老年人中，女性血清尿酸水平和高尿酸血症患病率随着年龄增长而显著上升，男性并未呈现这一趋势。血清尿酸水平与心脏及肾脏靶器官损害具有显著相关性。
Abstract： Aim: The aim of the present study was to investigate the association of TODs with SUA in the Chinese elderly population. Methods: 903 community-dwelling participants were recruited from 10 communities in the northern Shanghai. A framework of cardiovascular health survey, including assessment of all cardiovascular risk factors and target organ damages (TODs), as well as SUA measurement, was performed for each participant. Results: Men, as compared with women, had significantly higher SUA (374.1±89.4vs. 310.8±74.8μmol/l, p<0.001).In women, SUA level and the prevalence of hyperuricemia increased significantly with ageing, but not in men. In multiple linear regression analyses, SUA was significantly associated with age, body mass index and plasma glucose in all participants, men and women (p<0.001). Similarly, SUA was significantly associated with cardiac TODs such as left ventricular mass index (r=0.12; p<0.001) and renal TODs such as estimated glomerular filtration rate (r=-0.35; p<0.001) and urinary microalbumin/creatinine ratio (r=0.006; p=0.006), in all participants and gender subgroup analysis (p<0.001). Conclusion: In the elderly women from the northern Shanghai, the SUA and the prevalence of hyperuricemia were significantly increased with ageing, but not in men. SUA was significantly associated with age, obesity and plasma glucose, as well as with cardiac and renal TODs, but not with vascular TODs.

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