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血尿酸对男性人群全因死亡的影响

摘要

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.%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。

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