切换至 "中华医学电子期刊资源库"
高级检索
中华肾病研究电子杂志

中华肾病研究电子杂志 ›› 2019, Vol. 08 ›› Issue (04) : 176 -180. doi: 10.3877/cma.j.issn.2095-3216.2019.04.007

所属专题： 专题评论； 文献；

论著

基于倾向性评分的高尿酸血症相关因素分析
张国娟1, 丁宁1, 黄雯1, 姜立萍1, 王宁利2,†()   
  1. 1. 100730　首都医科大学附属北京同仁医院肾科
    2. 首都医科大学附属北京同仁医院　北京同仁眼科中心，北京市眼科研究所眼科学与视觉科学北京市重点实验室
  • 收稿日期:2019-04-09 出版日期:2019-08-28
  • 通信作者: 王宁利
  • 基金资助:
    国家重点基础研究发展计划（973计划）(2007CBS12201)

Analysis of correlated factors of hyperuricemia based on propensity score matching

Guojuan Zhang1, Ning Ding1, Wen Huang1, Liping Jiang1, Ningli Wang2,†()   

  1. 1. Department of Nephrology, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing 100730, China
    2. Beijing Tongren Eye Center, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing 100730, China
  • Received:2019-04-09 Published:2019-08-28
  • Corresponding author: Ningli Wang
  • About author:
    Corresponding author: Wang Ningli, Email:
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

张国娟, 丁宁, 黄雯, 姜立萍, 王宁利. 基于倾向性评分的高尿酸血症相关因素分析[J/OL]. 中华肾病研究电子杂志, 2019, 08(04): 176-180.

Guojuan Zhang, Ning Ding, Wen Huang, Liping Jiang, Ningli Wang. Analysis of correlated factors of hyperuricemia based on propensity score matching[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2019, 08(04): 176-180.

目的

分析我国北方内陆农村地区高尿酸血症的患病率及其相关因素，为了解高尿酸血症的危险因素提供一定的依据。

方法

以邯郸眼病研究人群为对象，采用分层、整群、概率比例抽样方法抽取调查对象，完成问卷填写、体格检查、血液及尿液相关实验室检查，根据血清尿酸值将人群分为高尿酸组及正常尿酸组，应用SPSS 22.0软件中倾向性评分匹配模块进行倾向性匹配分析。

结果

高尿酸血症总患病率2.51%(95/3 785)，男性2.75%(47/1 711)，女性2.31%(48/2 074)。高尿酸组年龄、高血压患病率、糖尿病患病率、体质量指数(BMI)、腰臀比(WHR)、C反应蛋白(CRP)、总胆固醇(TCH)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、肱踝脉搏波传导速度(baPWV)显著高于正常尿酸组；吸烟者比例、高密度脂蛋白胆固醇(HDL-C)显著低于正常尿酸组。Logistic多元回归分析提示男性、BMI增高、CRP增高、不吸烟、eGFR下降与高尿酸血症独立相关。应用倾向评分匹配分析结果显示男性、高血压、糖尿病、不吸烟、饮酒、BMI增高、WHR增高、eGFR下降、尿白蛋白肌酐比(ACR)增高是高尿酸血症的影响因素。

结论

本研究结果显示，男性、高血压、糖尿病、饮酒、肥胖、尿微量白蛋白增高与肾功能下降是高尿酸血症的相关因素。

关键词: 高尿酸血症, 患病率, 危险因素
Objective

To analyze the prevalence and related factors of hyperuricemia in the inland rural areas of northern China, so as to provide a basis for understanding the risk factors of hyperuricemia.

Methods

The data were obtained from a population of the Handan Eye Study (HES), by means of stratified, clustered, and probability proportional sampling methods to extract the respondents. Questionnaires, physical examination, and laboratory tests of blood and urine were conducted. The population was divided into two groups according to serum uric acid level: the hyperuricemia group and the normouricemia group. The propensity score matching module in the SPSS22.0 software was applied for propensity score matching analysis.

Results

The overall prevalence of hyperuricemia in this population was 2.51%(95/3 785), with 2.75%(47/1 711) in the male and 2.31%(48/2 074) in the female, respectively. The age, prevalence of hypertension, prevalence of diabetes mellitus, body mass index (BMI), waist-to-hip ratio (WHR), serum C reactive protein (CRP), serum total cholesterol (TCH), low density lipoprotein cholesterol (LDL-C), triglyceride (TG), and brachial-ankle pulse wave velocity (baPWV) were significantly higher in the hyperuricemia group than in the normouricemia group. The cigarette smoking rate and serum high density lipoprotein cholesterol (HDL-C) were significantly lower in the hyperuricemia group than in the normouricemia group. Logistic multiple regression analysis showed that male gender, increased BMI, increased CRP, non-smoking, and decreased eGFR were independently associated with hyperuricemia. The propensity score matching analysis showed that male gender, hypertension, diabetes mellitus, non-smoking, alcohol drinking, increased BMI, increased WHR, decreased eGFR, and increased urine albumin/creatinin ratio (ACR) were influence factors of hyperuricemia.

Conclusion

The results of the present study indicated that male gender, hypertension, diabetes mellitus, alcohol drinking, obesity, increased albuminuria, and decreased renal function were related factors to hyperuricemia.

Key words: Hyperuricemia, Prevalence, Risk factors
表1 高尿酸血症者与尿酸正常者一般情况及实验室指标比较[±s，例(%)]
? 高尿酸组(n＝95) 正常尿酸组(n＝3690) t/χ2值 P值
年龄(岁) 57.0±11.96 51.5±10.59 －4.84 <0.001
性别(男) 47(49.5%) 1664(45.1%) 0.717 0.397
高血压 63(66.3%) 1813(49.1%) 10.939 0.001
糖尿病 12(12.6%) 233(6.3%) 6.105 0.013
吸烟 16(16.8%) 981(26.6%) 4.631 0.033
饮酒 21(22.1%) 717(19.4%) 0.422 0.516
卒中 2(2.1%) 88(2.4%) 1.025 0.599
BMI(kg/m2) 27.4±3.97 24.7±3.68 －7.001 <0.001
WHR 0.92±0.054 0.91±0.057 －2.697 0.007
CRP(mg/L) 4.00±6.1 2.04±4.7 －3.107 0.002
ACR(mg/g) 41.30±166.7 525.4±30176.8 0.156 0.876
eGFR[ml/(min·1.73 m2)] 80.39±11.4 98.04±115.92 1.484 0.138
TCH (mmol/L) 5.16±1.10 4.62±0.95 －5.481 <0.001
LDL－C (mmol/L) 3.12±0.72 2.71±0.65 －6.052 <0.001
HDL－C (mmol/L) 1.21±0.25 1.28±0.30 0.198 0.016
TG (mmol/L) 2.01±1.11 1.51±1.08 －4.287 <0.001
ABI 1.091±0.09 1.108±0.10 1.498 0.134
TBI 0.797±1.00 0.809±0.11 1.023 0.307
baPWV(cm/s) 1731.8±420.3 1578.77±367.7 －3.985 <0.001
表2 高尿酸血症相关因素的logistic多元回归
? B S.E. Exp(B) Wald P 95%CI
男性(0/1) 1.089 0.305 2.971 12.771 <0.001 1.635～5.398
吸烟(0/1) －0.847 0.338 0.429 6.296 0.012 0.221～0.831
BMI(kg/m2) 0.097 0.02 1.102 22.791 <0.001 1.059～1.147
CRP(mg/L) 0.037 0.012 1.037 8.983 0.003 1.013～1.063
eGFR[ml/(min·1.73 m2)] －0.076 0.011 0.926 50.339 <0.001 0.907～0.946
表3 按各因素分别匹配数据后各组间尿酸值情况
变量 ? 各组UA值 t值 P值
年龄(<65岁) 匹配后 271.21±66.95 0.679 0.497
? ? 268.18±70.52 ? ?
性别(女) 匹配后 228.8±51.74 －23.843 <0.001
? ? 286.25±62.97 ? ?
高血压(有) 匹配后 252.04±62.64 －2.352 0.019
? ? 257.83±62.13 ? ?
糖尿病(有) 匹配后 262.80±68.18 2.097 0.037
? ? 249.30±74.23 ? ?
吸烟(无) 匹配后 292.48±68.12 2.888 0.004
? ? 282.58±61.45 ? ?
饮酒(无) 匹配后 277.88±60.81 －3.371 0.001
? ? 289.16±63.58 ? ?
BMI(<25 kg/cm2) 匹配后 247.68±61.01 －7.06 <0.001
? ? 264.87±66.02 ? ?
WHR(正常) 匹配后 285.2±61.94 －2.172 0.030
? ? 293.61±68.33 ? ?
CRP(<8 mg/L) 匹配后 272.72±71.50 0.647 0.518
? ? 267.42±70.42 ? ?
eGFR[<90 ml/(min·1.73 m2)] 匹配后 267.24±68.88 10.978 <0.001
? ? 238.61±57.88 ? ?
TG(<1.7 mmol/L) 匹配后 259.58±63.78 －1.536 0.125
? ? 264.95±65.46 ? ?
TC(<5.17 mmol/L) 匹配后 258.61±62.29 －0.479 0.633
? ? 262.47±75.03 ? ?
HDL－C(<1.04 mmol/L) 匹配后 266.42±66.46 1.716 0.087
? ? 258.7±42.92 ? ?
LDL－C(<3.37 mmol/L) 匹配后 262.7±64.68 －0.011 0.992
? ? 262.8±66.40 ? ?
ACR(mg/g) 匹配后 259.94±65.31 2.42 0.016
? ? 251.09±63.93 ? ?
ABI(<0.9) 匹配后 252.09±69.09 －0.242 0.809
? ? 254.02±63.79 ? ?
TBI(<0.7) 匹配后 259.53±67.76 1.315 0.189
? ? 254.17±66.78 ? ?
baPWV(<1400 cm/s) 匹配后 250.96±65.23 －1.465 0.143
? ? 255.43±63.52 ? ?
[1]
Liu H, Zhang X-M, Wang Y-L, et al. Prevalence of hyperuricemia among Chinese adults: a national cross-sectional survey using multistage, stratified sampling [J]. J Nephrol, 2014, 27(6): 653-658.
[2]
Jia Z，Zhang X，Kang S，et al.Serum uric acid levels and incidence of impaired fasting glucose and type 2 diabetes mellitus：a meta-analysis of cohort studies [J]. Diabetes Res Clin Pract, 2013, 10l(1): 88-96.
[3]
Grayson PC，Kim SY，LaValley M，et al.Hypemricemia and incident hypertension：a systematic review and meta-analysjs [J]. Arthritis Care Res (Hoboken), 2011, 63(1): 102-110.
[4]
Akpek M，Kaya MG，Uyarel H，et al.The association of serum uric acid 1evels on coronary flow in patients with STEMI undergoing primary PCI [J]. Atherosclerosis, 2011, 219(1): 334-341.
[5]
Kawashima M，Wada K，Oht H，et al. Association between asymptomatic hyperuricemia and new-onset chronic kidney disease in Japanese male workers：a long-term retrospective cohort study [J]. BMC Nephrology, 2011, 12: 31-36.
[6]
汪涛，冯学山，吴擢春．非随机化医学研究中风险比的一种估计方法[J]. 中国卫生统计，2004，21(5):38-41.
[7]
Liang YB, Friedman DS, Wong TY, et al. Rationale, design, methodology, and baseline data of a population-based study in rural China: the Handan Eye Study [J]. Ophthalmic Epidemiol, 2009，16(2): 115-127.
[8]
方圻，陈灏珠，郁知非，等．中国正常人血尿酸调查及其与血脂的关系[J]．中华内科杂志，1983，22(7):434-438.
[9]
王庆文，陈韧，杜丽川，等．原发性痛风的临床和流行病学研究[J]．中华内科杂志，2001，40(5):313-315.
[10]
古萍．广州市体检人群高尿酸血症患病情况及相关疾病分析[J]．中国热带医学，2006，6:1083-1084.
[11]
Kang DH, Chen W. Uric acid and chronic kidney disease: new understanding of an old problem [J]. Semin Nephrol, 2011, 31(5): 447-452.
[12]
Chang HY, Pan WH, Yeh WT, et al. Hyperuricemia and gout in Taiwan：results from the Nutritional and Health Survey in Taiwan (1993-96) [J]. J Rheumatol, 2001, 28(7): 1640-1646.
[13]
杜蕙，陈顺乐，王元，等．上海市黄浦区社区高尿酸血症与痛风流行病学调查[J]．中华风湿病学杂志，1998，2(2):75-78.
[14]
Mortada I. Hyperuricemia, type 2 diabetes mellitus, and hypertension: an emerging association [J]. Curr Hypertens Rep, 2017, 19(9): 69.
[15]
Sluijs I, Holmes MV, van der Schouw YT, et al. A Mendelian randomization study of circulating uric acid and type 2 diabetes [J]. Diabete, 2015, 64(8): 3028-3036.
[16]
Masuo K, Kawaguchi H, Mikami H, et al. Serum uric acid and plasma norepinephrine concentrations predict subsequent weight gain and blood pressure elevation [J]. Hypertension, 2003, 42(4): 474-480.
[17]
Johnson RJ, Nakagawa T, Jalal D, et al. Uric acid and chronic kidney disease: which is chasing which? [J]. Nephrol Dial Transplant, 2013, 28(9): 2221-2228.
[18]
Mouhamed DH, Ezzaher A, Neffati F, et al. Effect of cigarette smoking on plasma uric acid concentrations [J]. Environ Health Prev Med, 2011, 16(5): 307-312.
[1] 明昊, 肖迎聪, 巨艳, 宋宏萍. 乳腺癌风险预测模型的研究现状[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(05): 287-291.
[2] 庄燕, 戴林峰, 张海东, 陈秋华, 聂清芳. 脓毒症患者早期生存影响因素及Cox 风险预测模型构建[J/OL]. 中华危重症医学杂志(电子版), 2024, 17(05): 372-378.
[3] 黄鸿初, 黄美容, 温丽红. 血液系统恶性肿瘤患者化疗后粒细胞缺乏感染的危险因素和风险预测模型[J/OL]. 中华实验和临床感染病杂志(电子版), 2024, 18(05): 285-292.
[4] 罗文斌, 韩玮. 胰腺癌患者首次化疗后中重度骨髓抑制的相关危险因素分析及预测模型构建[J/OL]. 中华普通外科学文献(电子版), 2024, 18(05): 357-362.
[5] 贺斌, 马晋峰. 胃癌脾门淋巴结转移危险因素[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 694-699.
[6] 林凯, 潘勇, 赵高平, 杨春. 造口还纳术后切口疝的危险因素分析与预防策略[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 634-638.
[7] 杨闯, 马雪. 腹壁疝术后感染的危险因素分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 693-696.
[8] 周艳, 李盈, 周小兵, 程发辉, 何恒正. 不同类型补片联合Nissen 胃底折叠术修补食管裂孔疝的疗效及复发潜在危险因素[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 528-533.
[9] 张伟伟, 陈启, 翁和语, 黄亮. 随机森林模型预测T1 期结直肠癌淋巴结转移的初步研究[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(05): 389-393.
[10] 司楠, 孙洪涛. 创伤性脑损伤后肾功能障碍危险因素的研究进展[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(05): 300-305.
[11] 颜世锐, 熊辉. 感染性心内膜炎合并急性肾损伤患者的危险因素探索及死亡风险预测[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 618-624.
[12] 闫维, 张二明, 张克, 安欣华, 向平超. 北京市石景山区40岁及以上居民早期慢性阻塞性肺疾病异质性及影响因素分析[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 533-540.
[13] 李文哲, 王毅, 崔建, 郑启航, 王靖彦, 于湘友. 新疆维吾尔自治区重症患者急性肾功能异常的危险因素分析[J/OL]. 中华卫生应急电子杂志, 2024, 10(05): 269-276.
[14] 刘志超, 胡风云, 温春丽. 山西省脑卒中危险因素与地域的相关性分析[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 424-433.
[15] 曹亚丽, 高雨萌, 张英谦, 李博, 杜军保, 金红芳. 儿童坐位不耐受的临床进展[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 510-515.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号