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目的探讨35岁以上人群体质指数(BMI)对高尿酸血症(hyperuricemia,HUA)发病的影响。方法以2006年健康体检尿酸正常的811名北京某企业35岁以上在职及离退休职工为基线人群,调查内容包括年龄、性别、血压、血糖、血脂、尿酸、吸烟史、饮酒史等,并进行4年随访,每年随访体质指数及尿酸,至2010年有效人群609人,平均年龄(56.52±12.89)岁。结果 BMI基线为低体质量(17例)、正常(292例)、超重(242例)、肥胖(58例)人群4年内高尿酸血症累积发病人数分别为1例、32例、48例、16例,发病率分别为5.88%、10.96%、19.83%、27.59%,其发病率随着BMI的增加呈增高趋势(χ2=15.181,P=0.002);超重、肥胖人群的发病率分别是正常体重人群的1.80(1.18~2.74)和2.51(1.42~4.45)倍;低体质量人群发病率与正常人群发病率差异无统计学意义。5年均处于超重(含肥胖)的195人与均未超重的274人的累积发病率分别为24.62%、9.49%,前者是后者的2.59(1.68~4.01)倍,其中男性为1.97(1.08~3.58)倍,女性为3.40(1.71~6.73)倍。经偏回归分析,扣除年龄、性别、吸烟、饮酒、血压、血糖、血脂的影响,HUA的发病次数与超重次数以及尿酸均值与BMI均值均呈正相关(P<0.01)。结论超重或肥胖增加了高尿酸血症的发病风险,控制体质量是降低高尿酸血症流行的有效途径。
Objective To investigate the effect of body mass index (BMI) on the incidence of hyperuricemia (HUA) in people over 35 years of age. Methods Eighty-one Beijing-based on-the-job and retired staff over 35 years of age with healthy uric acid were included in this study. The survey included age and sex, blood pressure, blood glucose, blood lipid, uric acid, smoking history and drinking history. After 4 years of follow-up, body mass index and uric acid were followed up every year. By 2010, the effective population was 609, with an average age of 56.52 ± 12.89 years. Results The baseline BMI was low body mass (17 cases), normal cumulative (292 cases), overweight (242 cases) and obesity (58 cases) in 4 years. The cumulative incidences of hyperuricemia were 1 case, 32 cases, 48 cases, The incidence rates were higher in BMI patients (χ2 = 15.181, P = 0.002). The incidence rates of overweight and obesity were normal, respectively, in 16 cases (5.88%, 10.96%, 19.83%, 27.59% 1.80 (1.18-2.74) and 2.51 (1.42-4.45) times the body weight of the population. There was no significant difference between the incidence of the low body weight and the normal population. The cumulative incidence of 195 overweight (including obesity) and 274 overweight over the past five years were 24.62% and 9.49%, respectively, the former being 2.59 (1.68 to 4.01) times the latter, of whom 1.97 (1.08 ~ 3.58) times, women 3.40 (1.71 ~ 6.73) times. By partial regression analysis, age, sex, smoking, drinking, blood pressure, blood glucose, blood lipid, the incidence of HUA and the number of overweight and mean uric acid and BMI were positively correlated (P <0.01). Conclusion Overweight or obesity increased the risk of hyperuricemia. Controlling body weight was an effective way to reduce the prevalence of hyperuricemia.