儿童高尿酸血症与心血管代谢异常发生风险

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

Abstract

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].Chinese journal of Epidemiology,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

Received:August 25, 2020

DOI：10.3760/cma.j.cn112338-20200825-01094

KeyWord: 儿童高尿酸血症心血管代谢异常队列研究

English Key Word: Children Hyperuricemia Cardiometabolic abnormity Cohort study

FundProject:国家自然科学基金（81973110，81803254）

Author Name	Affiliation	E-mail
Ye Peiyu	Department of Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
Zhao Xiaoyuan	Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China
Yan Yinkun	Department of Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
Xiao Pei	Department of Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
Hou Dongqing	Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China
Zhu Zhongxin	Beijing Miyun Primary and Secondary School Health Center, Beijing 101500, China
Yu Zhaocang	Beijing Tongzhou Primary and Secondary School Health Center, Beijing 101100, China
Wang Hongjian	Beijing Fangshan Primary and Secondary School Health Center, Beijing 102400, China
Gao Aiyu	Beijing Dongcheng Primary and Secondary School Health Center, Beijing 100009, China
Cheng Hong	Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China
Mi Jie	Department of Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China	jiemi12@vip.sina.com

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Abstract:

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。

English Abstract:

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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