基于分类树模型的高尿酸血症危险因素分析

摘要

目的 构建高尿酸血症发病风险的分类树模型,利用分类树模型CRT法筛选高尿酸血症的危险因素,以便采取有效的防治措施降低高尿酸血症发病率.方法 采用整群抽样方法选取2012年7—11月在桂林医学院附属医院体检中心体检且资料完整的体检者(均为汉族)6241例,进行横断面调查,包括问卷调查、身体测量、实验室检查及肝脏超声检查.高尿酸血症发病风险的分类树模型,采用分类树模型CRT法筛选高尿酸血症的危险因素.结果 共检出高尿酸血症患者1035例,高尿酸血症患病率为16.6％(男23.1％,女9.4％),男性高尿酸血症患病率高于女性(P<0.01).高尿酸血症发病风险的分类树模型共5层,筛选出7个解释变量:年龄、性别(男性)、体质指数(BMI)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)和非酒精性脂肪性肝病(NAFLD),其中TG、BMI、NAFLD是高尿酸血症的主要危险因素.结论 年龄、性别(男性)、BMI、TG、LDL-C、FPG和NAFLD是高尿酸血症的危险因素,应提倡患者养成科学的生活方式,积极控制体质量、血脂、血糖,治疗NAFLD,以降低高尿酸血症发病率.%Objective To develop a classification regression tree model for screening the risk factors of hyperuricemia, so as to provide a reference for delivering effective prevention and treatment measures to reduce the incidence of the disease.Methods A cross-sectional survey consisting of a questionnaire survey, physical measurements, laboratory test and color Doppler ultrasound of the liver was conducted in 6241 Han nationality (3271 males and 2970 females) with integrative data selected from those who underwent physical examination in Physical Examination Center of Affiliated Hospital of Guilin Medical University between July and November 2012 by cluster sampling. A classification regression tree model was developed and employed to screen the risk factors of hyperuricemia in these participants.Results A total of 1035 participants (755 males, 280 females) with hyperuricemia were found, accounting for 16.6％ (1035/6241). Compared with the females, males had a higher prevalence of hyperuricemia〔23.1％ (755/3271) vs. 9.4％ (280/2970)〕 (P<0.01). The classification regression tree model had 5-layer and detected 7 potential risk factors of hyperuricemia〔 age, male, BMI, TG, LDL-C, FPG, and non-alcoholic fatty liver disease (NAFLD)〕. TG, BMI and NAFLD were the most important risk factors for hyperuricemia.Conclusion Age, male, BMI, TG, LDL-C, FPG, and NAFLD are significantly risk with hyperuricemia. Therefore, in order to effectively decrease the incidence of hyperuicemia, it is suggested that a scientific lifestyle should be developed, weight, blood pressure and blood glucose should be well controlled, and treatment for NAFLD should be done positively.