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目的探讨社区居民高尿酸血症(HUA)和高血压的发病情况及其相关关系,为有效防治尿酸相关心血管疾病提供依据。方法对6273例18～75岁的桂林市象山区城市社区居民进行横断面调查,收集空腹血及晨尿进行血糖、肾功能、胰岛素和高敏C反应蛋白等检测,同时进行问卷调查和体格检查。结果在社区居民中HUA的平均患病率为23.5%,男性为28.4%,高于女性的19.7%(P<0.01)。平均高血压患病率为27.8%,其中HUA组为37.8%,正常尿酸组为24.7%(P<0.01)。高尿酸者高血压风险约为尿酸正常者的1.8倍,其中在30岁以下组约为3.3倍,在30～60岁组约为2.1倍,60岁以上组差异不明显。在第3和第4四分位尿酸水平组,高血压患病率明显增高,尤其以收缩压增高为主。用血肌酐、年龄和性别校正后,血尿酸水平与收缩压、舒张压和高敏C反应蛋白等因素有关(P<0.01)。结论高尿酸居民高血压的患病率明显增高,尤其是在年轻人群中,主要影响收缩压。尿酸可能通过微炎症反应介导高血压的发生。
Objective To investigate the incidence of hyperuricemia (HUA) and hypertension in community residents and their correlations, and to provide a basis for effective prevention and treatment of uric acid-related cardiovascular diseases. Methods A total of 6273 urban residents aged 18-75 years in Xiangshan District of Guilin city were surveyed by cross-sectional survey. Fasting blood and morning urine were collected for blood glucose, renal function, insulin and high-sensitivity C-reactive protein, and questionnaires and physical examinations were performed. Results The average prevalence of HUA in community residents was 23.5%, 28.4% in males and 19.7% in females (P <0.01). The prevalence of hypertension was 27.8%, of which 37.8% in HUA group and 24.7% in normal uric acid group (P <0.01). The risk of hypertensive patients with hypertension is about 1.8 times the normal uric acid, of which about 30 times in the age group of about 3.3 times in the 30 to 60 age group was about 2.1 times, 60 years of age was not significantly different. In the third and fourth quartiles of uric acid level group, the prevalence of hypertension was significantly increased, especially in systolic blood pressure-based. After adjusting for serum creatinine, age and gender, the level of serum uric acid was correlated with systolic blood pressure, diastolic blood pressure and high-sensitivity C-reactive protein (P <0.01). Conclusion The prevalence of hypertension in high-uric acid inhabitants is significantly higher, especially in young people, which mainly affects systolic blood pressure. Uric acid may mediate the development of hypertension through microinflammatory responses.