文章摘要
叶佩玉,赵小元,闫银坤,肖培,侯冬青,朱忠信,郁兆仓,王宏健,高爱钰,程红,米杰.儿童高尿酸血症与心血管代谢异常发生风险[J].中华流行病学杂志,2021,42(3):433-439
儿童高尿酸血症与心血管代谢异常发生风险
Association between hyperuricemia and incidence risk for cardiometabolic abnormity in children
收稿日期:2020-08-25  出版日期:2021-03-29
DOI:10.3760/cma.j.cn112338-20200825-01094
中文关键词: 儿童;高尿酸血症;心血管代谢异常;队列研究
英文关键词: Children;Hyperuricemia;Cardiometabolic abnormity;Cohort study
基金项目:国家自然科学基金(81973110,81803254)
作者单位E-mail
叶佩玉 国家儿童医学中心儿童慢病管理中心, 首都医科大学附属北京儿童医院, 北京 100045  
赵小元 首都儿科研究所流行病学研究室, 北京 100020  
闫银坤 国家儿童医学中心儿童慢病管理中心, 首都医科大学附属北京儿童医院, 北京 100045  
肖培 国家儿童医学中心儿童慢病管理中心, 首都医科大学附属北京儿童医院, 北京 100045  
侯冬青 首都儿科研究所流行病学研究室, 北京 100020  
朱忠信 北京市密云区中小学卫生保健所 101500  
郁兆仓 北京市通州区中小学卫生保健所 101100  
王宏健 北京市房山区中小学卫生保健所 102400  
高爱钰 北京市东城区中小学卫生保健所 100009  
程红 首都儿科研究所流行病学研究室, 北京 100020  
米杰 国家儿童医学中心儿童慢病管理中心, 首都医科大学附属北京儿童医院, 北京 100045 jiemi12@vip.sina.com 
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中文摘要:
      目的 了解儿童高尿酸血症与心血管代谢异常发生风险的关系。方法 研究对象来自“儿童青少年心血管与骨健康促进项目”,该项目于2017年采用分层整群抽样的方法对北京市15 391名6~16岁儿童开展基线调查,并于2019年进行随访调查。采用多因素logistic模型分析基线尿酸水平及高尿酸持续状态与高血压、高血糖、血脂异常等心血管代谢异常发生风险的关系。结果 共8 807名研究对象(男童4 376名,女童4 431名)纳入本研究,基线年龄(11.1±3.3)岁。调整混杂因素后,尿酸第三、四分位发生高血压的风险是第一分位的1.39倍(95%CI:1.11~1.75)和1.56倍(95%CI:1.19~1.81),尿酸第二、三、四分位发生高LDL-C的风险是第一分位的1.88倍(95%CI:1.16~3.05)、1.98倍(95%CI:1.23~3.17)和2.25倍(95%CI:1.42~3.57);尿酸水平每增加1个标准差,高血压和高LDL-C发生风险分别增加17%(OR=1.17,95%CI:1.97~1.27)和27%(OR=1.27,95%CI:1.11~1.45);尿酸水平每增加10 μmol/L,高血压和高LDL-C的发生风险分别增加2.1%(OR=1.021,95%CI:1.011~1.030)和2.9%(OR=1.029,95%CI:1.013~1.046);按性别分层分析,男女童之间结果基本一致。调整混杂因素后,高尿酸血症新发组和持续异常组高血压的发生风险是持续正常组的1.32倍(95%CI:1.09~1.60)和1.50倍(95%CI:1.05~2.16),高TC的发生风险是持续正常组的1.90倍(95%CI:1.38~2.60)和2.96倍(95%CI:1.58~5.52),高LDL-C的发生风险是持续正常组的1.78倍(95%CI:1.26~2.51)和2.84倍(95%CI:1.60~5.03)。结论 儿童高尿酸水平及持续高尿酸血症,可增加高血压、高TC及高LDL-C的发生风险。保持正常尿酸水平有助于心血管疾病的早期预防。
英文摘要:
      Objective To investigate the relationships between hyperuricemia and the incidence risk for cardiometabolic abnormity in children. Methods Data were obtained from School-based Cardiovascular and Bone Health Promotion Program. In 2017, a total of 15 391 children aged 6-16 years in Beijing were selected through stratified cluster sampling at baseline survey. Follow-up investigation was conducted in 2019. Logistic regression model was used to analyze the relationships of uric acid quartiles and change in uric acid levels with incidence risks for cardiometabolic abnormity (hypertension, hyperglycemia and dyslipidemia). Results A total of 8 807 children (4 376 boys, 4 431 girls) were included in the analysis, the average age of the children was (11.1±3.3) years at baseline survey. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of incidence risk for hypertension in the third and fourth quartiles of the UA were 1.39 (1.11-1.75) and 1.56 (1.19-1.81), respectively. The ORs and 95% CIs of risk for high LDL-C in the second, third and fourth quartiles were 1.88 (1.16-3.05),1.98 (1.23-3.17) and 2.25 (1.42-3.57). The uric acid level increased by one standard deviation, the risk increased by 17% for hypertension and 27% for high LDL-C. The uric acid level increased by 10 μmol/L, the risk increased by 2.1% for hypertension and 2.9% for high LDL-C. The gender-stratified analysis showed that the similar results. The ORs and 95% CIs were 1.32 (1.09-1.60) and 1.50 (1.05-2.16) for hypertension, 1.90 (1.38-2.60) and 2.96 (1.58-5.52) for high TC, 1.78 (1.26-2.51) and 2.84 (1.60-5.03) for high LDL-C in the groups of newly diagnosed hyperuricemia and persistent hyperuricemia. Conclusions Higher uric acid level was associated with increased incidence risks for hypertension, abnormal TC and LDL-C. Maintaining optimal uric acid level by children might contribute to the early prevention of cardiovascular diseases.
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