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目的分析北上海社区65岁及以上人群(其中女性绝经期后10年)血清尿酸水平与心血管疾病危险因素和亚临床靶器官损害相关指标间的关系,探讨排除雌激素干预作用下,其间的相关性和性别差异。方法选取北上海3个社区中年龄≥65岁的居民903例,年龄65~93岁,男414例,女489例。入选者均进行血清尿酸水平测定,以及心血管危险因素和亚临床靶器官损害指标的评估。比较不同性别入选者的心血管危险因素、亚临床靶器官损害相关指标和心血管相关疾病患病率,比较不同性别不同年龄组(65~<70岁组、70~80岁组、>80岁组)的血清尿酸水平和高尿酸血症患病率。分析血清尿酸水平与心血管疾病危险因素和亚临床靶器官损害相关指标间的关系。结果男性吸烟、饮酒构成比,血清肌酐和尿酸水平,舒张压,以及高血压患病率均显著高于女性(P值分别<0.01、0.05);高密度脂蛋白和低密度脂蛋白水平、估算肾小球滤过率(eGFR)、二尖瓣舒张早期流速/二尖瓣瓣环舒张早期运动幅度(E/EA)和糖尿病患病率均显著低于女性(P值均<0.01)。65~<70岁、70~80岁、>80岁男性的血清尿酸水平和65~<70岁、70~80岁男性的高尿酸血症患病率均显著高于同年龄女性(P值均<0.01),>80组男性的高尿酸血症患病率显著低于同年龄女性(P<0.01)。65~<70岁、70~80岁、>80岁女性的血清尿酸水平和高尿酸血症患病率依次升高,不同年龄间的差异均有统计学意义(P值均<0.05)。所有入选者、男性入选者和女性入选者的血清尿酸水平与年龄(β值分别为1.91、1.65、1.82)、BMI(β值分别为3.56、3.89、3.73)均呈正相关(P值分别<0.001、0.05),与高密度脂蛋白水平(β值分别为-56.97、-41.27、-30.39)、血糖水平(β值分别为-6.44、-8.11、-5.62)均呈负相关(P值均<0.001)。所有入选者中,血清尿酸水平与左心室质量指数(LVMI,r=0.12,P<0.001)呈正相关,与eGFR(r=-0.35,P<0.001)呈负相关;男性入选者中,血清尿酸水平与LVMI(r=0.13,P=0.01)、E/EA(r=0.12,P=0.02)均呈正相关,与eGFR(r=-0.34,P<0.001)呈负相关;女性入选者中,血清尿酸水平与LVMI(r=0.11,P=0.02)、尿微量白蛋白/尿肌酐比值(r=0.12,P=0.012)均呈正相关,与eGFR(r=-0.36,P<0.001)呈负相关。结论在北上海社区65岁及以上人群中,女性的血清尿酸水平和高尿酸血症患病率随着年龄增长而显著升高,血清尿酸水平与心脏和肾脏靶器官损害相关指标具有相关性。
Objective To analyze the relationship between serum uric acid level and risk factors of cardiovascular disease and subclinical target organ damage in people over the age of 65 in Shanghai and above (including 10 years after menopause) in North Shanghai community. To explore the relationship between serum uric acid level and related indicators of subclinical target organ damage, Relevance and gender differences. Methods A total of 903 residents aged ≥ 65 years from 3 communities in north Shanghai were selected, aged from 65 to 93 years, including 414 males and 489 females. Participants were measured serum uric acid levels, as well as cardiovascular risk factors and assessment of subclinical target organ damage. To compare the risk factors of cardiovascular risk, the target organ damage of subclinical target and the prevalence of cardiovascular related diseases in different sexes, and compare the different age groups (65 ~ <70 years old, 70 ~ 80 years old,> 80 years old Group) serum uric acid levels and the prevalence of hyperuricemia. The relationship between serum uric acid level and risk factors of cardiovascular disease and the related indicators of subclinical target organ damage were analyzed. Results Male smoking, drinking alcohol composition ratio, serum creatinine and uric acid levels, diastolic blood pressure, and the prevalence of hypertension were significantly higher in women than in women (P <0.01, 0.05, respectively); high-density lipoprotein and low-density lipoprotein Glomerular filtration rate (eGFR), mitral early diastolic velocity / mitral annular early diastolic amplitude (E / EA) and prevalence of diabetes were significantly lower than those in women (all P <0.01). The prevalence of serum uric acid in 65 ~ <70 years old, 70 ~ 80 years old,> 80 years old men and 65 ~ <70 years old men were significantly higher than those in the same age group <0.01). The prevalence of hyperuricemia in> 80 males was significantly lower than that in females of the same age (P <0.01). The serum uric acid level and the prevalence of hyperuricemia in 65 ~ <70 years old, 70 ~ 80 years old, and> 80 years old women successively increased, with statistical significance (P <0.05). Serum uric acid levels were positively correlated with age (β = 1.91, 1.65, 1.82, respectively) and BMI (β = 3.56, 3.89, 3.73, respectively) for all enrollees, male enrollees and female enrollees , 0.05) and negatively correlated with high density lipoprotein (β values were -56.97, -41.27, -30.39 respectively) and blood glucose levels (β values were -6.44, -8.11, -5.62, respectively) 0.001). Serum uric acid levels were positively correlated with left ventricular mass index (LVMI, r = 0.12, P <0.001) and negatively correlated with eGFR (r = -0.35, P <0.001) The levels were positively correlated with LVMI (r = 0.13, P = 0.01), E / EA (r = 0.12, P = 0.02) and negatively correlated with eGFR Serum uric acid levels were positively correlated with LVMI (r = 0.11, P = 0.02) and urinary albumin / creatinine ratio (r = 0.12, P = 0.012) Related. Conclusions The serum uric acid level and the prevalence of hyperuricemia in women aged 65 and over in North Shanghai community were significantly increased with age. Serum uric acid levels were correlated with those related to heart and kidney target organ damage.