CAJ | 학술논문

目的：探讨血尿酸（SUA）水平对男性人群全因死亡的影响。方法采取前瞻性队列研究方法，以2006-2007年度参加开滦集团健康体检的81110名男性职工为研究对象，排除既往有心肌梗死、脑卒中、恶性肿瘤病史及肾小球滤过率（eGFR）＜30 ml/（min·1.73 m2）、服用对SUA有影响的药物者；进行统一问卷调查、血液生化检查，平均随访（47.5±4.3）个月，依据2006-2007年度SUA值将研究对象五等分，采用Cox比例风险模型分析SUA对男性人群全因死亡的影响。结果（1）至2010-2011年度随访结束，不同SUA五分位组死亡例数分别为315、278、243、292、341，对应全因死亡率分别为2.43%、2.36%、1.96%、2.42%、2.92%。（2）单因素Cox比例风险回归模型分析显示，以SUA第三分位组为参照，第一、二、四、五分位组发生全因死亡的HR值（95%CI）分别为1.32（1.11～1.56）、1.19（1.00～1.41）、1.20（1.01～1.43）、1.41（1.19～1.66）。（3）多因素Cox比例风险回归模型分析显示，校正年龄、SBP、DBP、BMI、TG、TC、HDL-C、LDL-C、FPG、高敏C反应蛋白、吸烟史、饮酒史、文化程度、职业、经济收入后，以SUA第三分位组为参照，第一、二、四、五分位组发生全因死亡的HR值（95%CI）分别为1.26（1.06～1.51）、1.20（1.01～1.44）、1.25（1.05～1.49）、1.42（1.19～1.68）。结论 SUA为全因死亡的独立危险因素，该值过高或过低都将增加全因死亡的发病风险，其五分位组全因死亡率呈“U”形曲线。
목적：탐토혈뇨산（SUA）수평대남성인군전인사망적영향。방법채취전첨성대렬연구방법，이2006-2007년도삼가개란집단건강체검적81110명남성직공위연구대상，배제기왕유심기경사、뇌졸중、악성종류병사급신소구려과솔（eGFR）＜30 ml/（min·1.73 m2）、복용대SUA유영향적약물자；진행통일문권조사、혈액생화검사，평균수방（47.5±4.3）개월，의거2006-2007년도SUA치장연구대상오등분，채용Cox비례풍험모형분석SUA대남성인군전인사망적영향。결과（1）지2010-2011년도수방결속，불동SUA오분위조사망례수분별위315、278、243、292、341，대응전인사망솔분별위2.43%、2.36%、1.96%、2.42%、2.92%。（2）단인소Cox비례풍험회귀모형분석현시，이SUA제삼분위조위삼조，제일、이、사、오분위조발생전인사망적HR치（95%CI）분별위1.32（1.11～1.56）、1.19（1.00～1.41）、1.20（1.01～1.43）、1.41（1.19～1.66）。（3）다인소Cox비례풍험회귀모형분석현시，교정년령、SBP、DBP、BMI、TG、TC、HDL-C、LDL-C、FPG、고민C반응단백、흡연사、음주사、문화정도、직업、경제수입후，이SUA제삼분위조위삼조，제일、이、사、오분위조발생전인사망적HR치（95%CI）분별위1.26（1.06～1.51）、1.20（1.01～1.44）、1.25（1.05～1.49）、1.42（1.19～1.68）。결론 SUA위전인사망적독립위험인소，해치과고혹과저도장증가전인사망적발병풍험，기오분위조전인사망솔정“U”형곡선。
Objective To explore the association between serum uric acid (SUA) and all-cause mortality in men. Methods In this prospective cohort study,data being used was derived from the Kailuan study cohort. A total of 81 110 male workers who had taken part in the Kailuan physical examination were enrolled. Subjects with previous myocardial infarction,stroke,cancer, eGFR<30 ml/(min·1.73 m2)accidental deaths and those ever used drugs that seemed to have showed an effect on blood uric acid,were excluded. All the information was gathered from a unified questionnaire,measured by blood biochemistry and with the mean period of follow up as(47.5±4.3) months. Based on the 2006-2007 SUA value,observed objects were divided into five groups,with multivariate Cox proportional hazard regression analysis used to estimate the relationship between SUA and all-cause mortality in men. Results 1)At the end of the follow-up period in 2010-2011, the number of deaths were 315,278,243,292 and 341 among the different SUA quinte,with incidence rates of all-cause mortality as 2.43%,2.36%,1.96%,2.42%and 2.92%,respectively. 2)Data from the Single factor Cox proportional hazard regression analysis showed that,when comparing with the third quinte,HR values of the all-cause mortality were 1.32(1.11-1.56),1.19(1.00-1.41),1.20(1.01-1.43)and 1.41(1.19-1.66)in other four groups,respectively. 3)When factors were adjusted for age, systolic blood pressure,diastolic blood pressure,body mass index,triglyceride,total cholesterol, high-density lipoprotein cholesterol, low density lipoprotein cholesterol, fasting glucose, high-sensitivity C-reactive protein,smoking history and history of drinking,education,profession, economy,etc.,results from the Multiple Cox proportional hazard regression analysis showed the HR values of the all-cause mortality were 1.26(1.06-1.51),1.20(1.01-1.44),1.25(1.05-1.49),1.42 (1.19-1.68) in other four groups,respectively,comparing to the third quinte. Conclusion Using SUA as the independent risk factor of all-cause mortality,the exceptional levels of SUA were associated with an increasing risk for all-cause mortality while the association of SUA with all-cause mortality appeared an“U”shaped curve.