超重或肥胖与高血压的交互作用对老年人发生高尿酸血症的影响

摘要

目的 探讨超重或肥胖与高血压的交互作用对老年人发生高尿酸血症的影响.方法 选取高尿酸血症老年患者271例作为观察组,尿酸正常老年人280例作为对照组.收集并比较两组人群人口学资料和临床资料.采用非条件logistic回归模型分析老年人群发生高尿酸血症的影响因素以及超重或肥胖与高血压的交互作用.结果 高尿酸组TG及TC水平、超重或肥胖者比例、高血压和非酒精性脂肪性肝病检出率均高于对照组(P<0.05).多因素分析结果显示,性别、年龄、超重或肥胖、超重或肥胖合并高血压、TG、非酒精性脂肪性肝病是老年高尿酸血症发生的影响因素(P<0.05);超重或肥胖与高血压对老年高尿酸血症的发生有相加交互作用,协同效应指数S=1.41,两者的归因交互效应百分比为19.1%.结论 男性、年龄大、超重或肥胖、超重或肥胖合并高血压、高TG水平、有非酒精性脂肪性肝病的老年人易发生高尿酸血症,而超重或肥胖与高血压共同存在时可增加患病风险.%Objective To investigate the effect of interaction between overweight /obesity and hypertension on the incidence of senile hyperuricemia.Methods A total of 271 elderly patients with hyperuricemia were selected as hyperuricemia group ,while 280 elders with normal uric acid as control group.The demographic and clinical data of the two groups were collected and were compared.The factors affecting the incidence of hyperuricemia in the elderly and the interaction between overweight /obesity and hypertension were analyzed by using unconditional logistic regression model.Results The levels of TG and TC,the proportion of overweight/obese cases,the detection rate of hypertension or nonalcoholic fatty liver disease ( NAFLD) in the hyperuricemia group were higher than those in the control group (P<0.05).The result of multivariate analysis showed that gender ,age,overweight or obesity,overweight or obesity complicated with hypertension,TG and NAFLD were the influencing factors of incidence of hyperuricemia in the elderly (P<0.05);overweight/obese and hypertension had a positive interaction with the incidence of hyperuricemia in the elderly (synergistic effect index,S=1.41>1),and the attributable proportion due to interaction was 19.1%.Conclusion Hyperuricemia usually occurs in the male elderly ,very elderly,and elderly with overweight or obese,with overweight/obese complicated with hypertension,with high TG level,or suffering NAFLD.The co-existence of overweight/obesity and hypertension might increase the risk of suffering hyperuricemia.