背景:近年来研究发现,高尿酸血症和痛风与糖尿病、冠心病、高血压及脑血管疾病的发生和发展关系密切.对其进行深入研究和早期干预,对上述疾病一级和二级预防均有重要意义.目的:明确山东沿海20岁以上居民高尿酸血症与痛风的患病情况及其影响因素.设计:随机、分层、整群抽样调查.单位:青岛大学医学院附属医院内分泌科.对象:调查范围为山东省沿海城市,包括青岛、日照、烟台、威海、东营.抽取年龄20～80岁本地常住(≥5年)居民,以家庭为单位的自然人群为调查对象.方法:采用随机、分层、整群抽样的方法,入户调查青岛、烟台、威海、日照、东营长住居民约5 000人高尿酸血症与痛风的患病情况.采用Sysmex chemix-180型全自动生化分析仪测定血尿酸、血脂、血糖、血肌酐,试剂购自日本西斯美康公司,其中血尿酸批内和批间CV分别为1.77%和2.32%.尿酸值高于正常者,在第3天再次抽空腹血进行复查.率的比较采用x2检验,两组间均数比较用t检验,多组间均数比较用方差分析,因变量与自变量的相关分析用logistic回归分析.主要观察指标:高尿酸血症患病率、血尿酸水平、高尿酸血症患者痛风发生率,以及高尿酸血症影响因素分析结果.结果:计划调查5 500人,实调查5 003人,应答率为90.96%,其中男性2395人(47.87%);女性2 608人(52 13%).①高尿酸血症的患病率13.19%,按照2000年山东人口标化率为13.27%;其中男性患病率高于女性(18.32%,8.56%,x2=108.52,P＜0.01),男性发病风险为女性2.5倍(OR=2.5).痛风的患病率为1.14%,标化率为1.10%;其中男性患病率高于女性(1.94%,0.42%,x2=30.38,P＜O.01),男性发病风险为女性5.3倍(OR=5.3).②正常人群男性血尿酸水平高于女性[(343.40±84.54),(258.90±70.90)μmol/L,t=48.03,P＜0.01].男性高尿酸血症患者血尿酸水平明显高于女性[(469.43±48.08),(399.73±104.91)μmol/L,t=11.70,P＜0.01].男性痛风患者血尿酸水平高于女性[(502.44±106.76),(403.48±52 72)μmol/L,t=2.07,P＜O.05].③高尿酸血症患者痛风的发生率为8.64%.④女性50岁以后高尿酸血症和痛风的患病率随年龄的增加而增高,70岁以上为高发年龄;而男性60岁以前随年龄的增加而增高,50～59岁为高发年龄段,60岁以后又随年龄的增加而增高.且女性高尿酸血症和痛风的平均年龄比男性分别晚7.5和8.5岁.⑤非条件logistic多元逐步回归分析显示饮酒频率、饮酒量、食贝类量及频率、尿素氮、血肌酐、三酰甘油、总胆固醇、体质量指数、腰臀比为男性高尿酸血症独立的危险因子,OR=1.016～30217,95%CI (1.010～1.023)～(9.955～214.869);而高密度脂蛋白胆固醇和重体力劳动为保护因素,OR=0.492,95%CI 0.339～0.713,OR=0.755,95%CI 0.575～0.991.年龄、高血压、食贝类量、尿素氮、血肌酐、三酰甘油、腰臀比、轻体力活动为女性高尿酸血症独立的危险因子,OR=1.022～27.34,95%CI(1.006～1.040)～(9.955～214.869);同样高密度脂蛋白胆固醇为保护因素,OR=O.428,95%CI0.223～0.820.结论:①高尿酸血症和痛风患病率存在性别差异.②山东沿海居民高尿酸血症和痛风患病危险因素包括贝类等海产品高摄入、低体力活动、腹型肥胖、肾功能减退、代谢综合征有关,其中男性还与饮酒情况,女性还与年龄有关.③男性在各年龄段均是高尿酸血症和痛风患病的危险阶段,而女性则重点在50岁以后.
揹景:近年來研究髮現,高尿痠血癥和痛風與糖尿病、冠心病、高血壓及腦血管疾病的髮生和髮展關繫密切.對其進行深入研究和早期榦預,對上述疾病一級和二級預防均有重要意義.目的:明確山東沿海20歲以上居民高尿痠血癥與痛風的患病情況及其影響因素.設計:隨機、分層、整群抽樣調查.單位:青島大學醫學院附屬醫院內分泌科.對象:調查範圍為山東省沿海城市,包括青島、日照、煙檯、威海、東營.抽取年齡20～80歲本地常住(≥5年)居民,以傢庭為單位的自然人群為調查對象.方法:採用隨機、分層、整群抽樣的方法,入戶調查青島、煙檯、威海、日照、東營長住居民約5 000人高尿痠血癥與痛風的患病情況.採用Sysmex chemix-180型全自動生化分析儀測定血尿痠、血脂、血糖、血肌酐,試劑購自日本西斯美康公司,其中血尿痠批內和批間CV分彆為1.77%和2.32%.尿痠值高于正常者,在第3天再次抽空腹血進行複查.率的比較採用x2檢驗,兩組間均數比較用t檢驗,多組間均數比較用方差分析,因變量與自變量的相關分析用logistic迴歸分析.主要觀察指標:高尿痠血癥患病率、血尿痠水平、高尿痠血癥患者痛風髮生率,以及高尿痠血癥影響因素分析結果.結果:計劃調查5 500人,實調查5 003人,應答率為90.96%,其中男性2395人(47.87%);女性2 608人(52 13%).①高尿痠血癥的患病率13.19%,按照2000年山東人口標化率為13.27%;其中男性患病率高于女性(18.32%,8.56%,x2=108.52,P＜0.01),男性髮病風險為女性2.5倍(OR=2.5).痛風的患病率為1.14%,標化率為1.10%;其中男性患病率高于女性(1.94%,0.42%,x2=30.38,P＜O.01),男性髮病風險為女性5.3倍(OR=5.3).②正常人群男性血尿痠水平高于女性[(343.40±84.54),(258.90±70.90)μmol/L,t=48.03,P＜0.01].男性高尿痠血癥患者血尿痠水平明顯高于女性[(469.43±48.08),(399.73±104.91)μmol/L,t=11.70,P＜0.01].男性痛風患者血尿痠水平高于女性[(502.44±106.76),(403.48±52 72)μmol/L,t=2.07,P＜O.05].③高尿痠血癥患者痛風的髮生率為8.64%.④女性50歲以後高尿痠血癥和痛風的患病率隨年齡的增加而增高,70歲以上為高髮年齡;而男性60歲以前隨年齡的增加而增高,50～59歲為高髮年齡段,60歲以後又隨年齡的增加而增高.且女性高尿痠血癥和痛風的平均年齡比男性分彆晚7.5和8.5歲.⑤非條件logistic多元逐步迴歸分析顯示飲酒頻率、飲酒量、食貝類量及頻率、尿素氮、血肌酐、三酰甘油、總膽固醇、體質量指數、腰臀比為男性高尿痠血癥獨立的危險因子,OR=1.016～30217,95%CI (1.010～1.023)～(9.955～214.869);而高密度脂蛋白膽固醇和重體力勞動為保護因素,OR=0.492,95%CI 0.339～0.713,OR=0.755,95%CI 0.575～0.991.年齡、高血壓、食貝類量、尿素氮、血肌酐、三酰甘油、腰臀比、輕體力活動為女性高尿痠血癥獨立的危險因子,OR=1.022～27.34,95%CI(1.006～1.040)～(9.955～214.869);同樣高密度脂蛋白膽固醇為保護因素,OR=O.428,95%CI0.223～0.820.結論:①高尿痠血癥和痛風患病率存在性彆差異.②山東沿海居民高尿痠血癥和痛風患病危險因素包括貝類等海產品高攝入、低體力活動、腹型肥胖、腎功能減退、代謝綜閤徵有關,其中男性還與飲酒情況,女性還與年齡有關.③男性在各年齡段均是高尿痠血癥和痛風患病的危險階段,而女性則重點在50歲以後.
배경:근년래연구발현,고뇨산혈증화통풍여당뇨병、관심병、고혈압급뇌혈관질병적발생화발전관계밀절.대기진행심입연구화조기간예,대상술질병일급화이급예방균유중요의의.목적:명학산동연해20세이상거민고뇨산혈증여통풍적환병정황급기영향인소.설계:수궤、분층、정군추양조사.단위:청도대학의학원부속의원내분비과.대상:조사범위위산동성연해성시,포괄청도、일조、연태、위해、동영.추취년령20～80세본지상주(≥5년)거민,이가정위단위적자연인군위조사대상.방법:채용수궤、분층、정군추양적방법,입호조사청도、연태、위해、일조、동영장주거민약5 000인고뇨산혈증여통풍적환병정황.채용Sysmex chemix-180형전자동생화분석의측정혈뇨산、혈지、혈당、혈기항,시제구자일본서사미강공사,기중혈뇨산비내화비간CV분별위1.77%화2.32%.뇨산치고우정상자,재제3천재차추공복혈진행복사.솔적비교채용x2검험,량조간균수비교용t검험,다조간균수비교용방차분석,인변량여자변량적상관분석용logistic회귀분석.주요관찰지표:고뇨산혈증환병솔、혈뇨산수평、고뇨산혈증환자통풍발생솔,이급고뇨산혈증영향인소분석결과.결과:계화조사5 500인,실조사5 003인,응답솔위90.96%,기중남성2395인(47.87%);녀성2 608인(52 13%).①고뇨산혈증적환병솔13.19%,안조2000년산동인구표화솔위13.27%;기중남성환병솔고우녀성(18.32%,8.56%,x2=108.52,P＜0.01),남성발병풍험위녀성2.5배(OR=2.5).통풍적환병솔위1.14%,표화솔위1.10%;기중남성환병솔고우녀성(1.94%,0.42%,x2=30.38,P＜O.01),남성발병풍험위녀성5.3배(OR=5.3).②정상인군남성혈뇨산수평고우녀성[(343.40±84.54),(258.90±70.90)μmol/L,t=48.03,P＜0.01].남성고뇨산혈증환자혈뇨산수평명현고우녀성[(469.43±48.08),(399.73±104.91)μmol/L,t=11.70,P＜0.01].남성통풍환자혈뇨산수평고우녀성[(502.44±106.76),(403.48±52 72)μmol/L,t=2.07,P＜O.05].③고뇨산혈증환자통풍적발생솔위8.64%.④녀성50세이후고뇨산혈증화통풍적환병솔수년령적증가이증고,70세이상위고발년령;이남성60세이전수년령적증가이증고,50～59세위고발년령단,60세이후우수년령적증가이증고.차녀성고뇨산혈증화통풍적평균년령비남성분별만7.5화8.5세.⑤비조건logistic다원축보회귀분석현시음주빈솔、음주량、식패류량급빈솔、뇨소담、혈기항、삼선감유、총담고순、체질량지수、요둔비위남성고뇨산혈증독립적위험인자,OR=1.016～30217,95%CI (1.010～1.023)～(9.955～214.869);이고밀도지단백담고순화중체력노동위보호인소,OR=0.492,95%CI 0.339～0.713,OR=0.755,95%CI 0.575～0.991.년령、고혈압、식패류량、뇨소담、혈기항、삼선감유、요둔비、경체력활동위녀성고뇨산혈증독립적위험인자,OR=1.022～27.34,95%CI(1.006～1.040)～(9.955～214.869);동양고밀도지단백담고순위보호인소,OR=O.428,95%CI0.223～0.820.결론:①고뇨산혈증화통풍환병솔존재성별차이.②산동연해거민고뇨산혈증화통풍환병위험인소포괄패류등해산품고섭입、저체력활동、복형비반、신공능감퇴、대사종합정유관,기중남성환여음주정황,녀성환여년령유관.③남성재각년령단균시고뇨산혈증화통풍환병적위험계단,이녀성칙중점재50세이후.
BACKGROUND: Recent studies have found that hyperuricemia and gout are closely correlated with the occurrence and development of diabetes, coronary heart disease, hypertension and cerebrovascular diseases. It is of significance to investigate their prevalence so as to find way of early interventions.OBJECTIVE: To determine the prevalence and risk factors of gout and hyperuricemia among residents above 20 years old in Shandong coastal area.DESIGN: A randomized, stratified cluster sampling survey.SETTING: Department of Endocrinology, Affiliated Hospital of Qingdao University Medical College.PARTICIPANTS: A random, stratified cluster sampling was conducted in Shandong coastal area including Qingdao,Yantai, Weihai, Rizhao and Dongying. Residents lived in these areas for 5 years or more, aged between 20 to 80 years, were selected, and they were surveyed by family as a unit.METHODS: A randomized, stratified cluster sampling survey was conducted. The prevalence of gout and hyperuricemia were investigated among about 5 000 residents in Qingdao, Yantai, Weihai, Rizhao and Dongying. The serum uric acid, lipids, glucose and creatinine were detected with Sysmex chemix-180 total automatic biochemical analyzer. Those with uric acid higher than reference level were reexamined by collecting fasting blood sample on the third day. The comparison between rates was taken with the Chi-square test, means between two groups with the t test, means between multiple groups with analysis of variance, correlation between dependent and independent variables with logistic regression analysis.MATN OUTCOME MEASURES: Prevalance of hyperuricemia; Level of serum uric acid; Prevalence of gout in patients with hyperuricemia; Influencing factor of hyperuricemia.RESULTS: This investigation planned to include 5 500 subjects while in fact 5 003 subjects were investigated and the response rate was 91%, in which males were 2 395 (47.87%) and females were 2 608 (52.13%). ① The prevalence of hyperuricemia was 13.19% with standardized rate of 13.27% according to the Shandong population in 2000; The pevalence was higher in males than in females (18.32%, 8.56%, x2=108.52, P＜ 0.01). The risk in males was 2.5 times higher than that in females (OR =2.5). The prevalence of gout was 1.14% with standardized rate of 1.10%; and the prevalence in males was higher than that in females (1.94%, 0.42%, x2=30.38, P ＜ 0.01). The risk in males was 5.3 times higher than that in females (OR =5.3). ②The average value of serum uric acid in normal males was higher than in normal females [(343.40±84.54), (258.90±70.90) μmol/L, t =48.03, P ＜ 0.01]. It was obviously higher in male patients with hyperuricemia than in female ones [(469.43±48.08), (399.73±104.91) μmol/L, t =11.70, P ＜ 0.01]. It was higher in male patients with gout than in female ones [(502.44±106.76), (403.48±52.72) μmol/L, t =2.07, P ＜ 0.05]. ③The prevalence of gout in patients with hyperuricemia was 8.34%. ④ The prevalence of hyperuricemia and gout were climbing up with age after 40 years old in females and those elder than 70 years old were of high risk; while in males,the prevalence of hyperuricemia and gout increased with age before 60 years old and those aged 50-59 years were of high risk, yet after 60 years, it climbed up with age again. Nevertheless, the mean ages of hyperuricemia and gout in females were older than male. The average episode ages of hyperuricemia and gout in females were later than in males respectively by 7.5 and 8.5 years. ⑤ Non-conditional Logistic regression analysis showed that drinking frequency,drinking quantity, the quantity and frequency of seashell intake, BUN, Cr, TG, TC, BMI and WHR were the independent risk factors of male patients with hyperuricemia [OR =1.016-30.217, 95%C/ (1.010-1.023)-(9.955-214.869)]; while HDL-C and heavy physical labour were the protective factors (OR =0.492, 95%C/ 0.339-0.713; OR =0.755, 95% CI 0.575-0.991).As for females, age, hypertension, the quantity of seashell food intake, BUN, Cr, TG, WHR and light physical labour were the independent risk factors of hyperuricemia [OR =1.022-27.34, 95%CI (1.006-1.040)-(9.955-214.869)]. Similarly, HDL-C was a protective factor (OR =0.428, 95%CI0.223-0.820).CONCLUSION: ① The prevalence of hyperuricemia and gout are different between genders: ② The risk factors of hyperuricemia and gout among residents in Shandong coastal area include the high intake of marine products such as seashell foods, less physical activity, abdominal obesity and kidney insufficiency, as well as the existence of metabolic syndrome. Drinking is also involved in the increased prevalence in males, and age in females. ③ Higher risk for hyperuricemia and gout are noticed in all age groups in males, whereas in females after 50 years old.
