肥胖和代谢因子在高尿酸血症与高血压前期关联中的中介效应

黄鑫峰; 何青; 施欢欢; 胡海平; 陆璐; 黄若酩; 张晓阳; 徐幽琼

Abstract

黄鑫峰,何青,施欢欢,胡海平,陆璐,黄若酩,张晓阳,徐幽琼.肥胖和代谢因子在高尿酸血症与高血压前期关联中的中介效应[J].Chinese journal of Epidemiology,2023,44(10):1599-1603

肥胖和代谢因子在高尿酸血症与高血压前期关联中的中介效应

Mediating effects of obesity and metabolic factors in hyperuricemia and prehypertension

Received:March 14, 2023

DOI：10.3760/cma.j.cn112338-20230314-00145

KeyWord: 高血压前期高尿酸血症肥胖代谢因子因果中介效应

English Key Word: Prehypertension Hyperuricemia Obesity Metabolic factors Causal mediation effects

FundProject:福州市科技计划（2022-S-032）

Author Name	Affiliation	E-mail
Huang Xinfeng	Fuzhou Center for Disease Control and Prevention, Fujian Medical University, Fuzhou 350004, China School of Public Health, Fujian Medical University, Fuzhou 350004, China
He Qing	Fuzhou Center for Disease Control and Prevention, Fujian Medical University, Fuzhou 350004, China School of Public Health, Fujian Medical University, Fuzhou 350004, China
Shi Huanhuan	Fuzhou Center for Disease Control and Prevention, Fujian Medical University, Fuzhou 350004, China School of Public Health, Fujian Medical University, Fuzhou 350004, China
Hu Haiping	Fuzhou Center for Disease Control and Prevention, Fujian Medical University, Fuzhou 350004, China School of Public Health, Fujian Medical University, Fuzhou 350004, China
Lu Lu	Fuzhou Center for Disease Control and Prevention, Fujian Medical University, Fuzhou 350004, China
Huang Ruoming	Fuzhou Center for Disease Control and Prevention, Fujian Medical University, Fuzhou 350004, China
Zhang Xiaoyang	Fuzhou Center for Disease Control and Prevention, Fujian Medical University, Fuzhou 350004, China School of Public Health, Fujian Medical University, Fuzhou 350004, China
Xu Youqiong	Fuzhou Center for Disease Control and Prevention, Fujian Medical University, Fuzhou 350004, China School of Public Health, Fujian Medical University, Fuzhou 350004, China	joancoco@163.com

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Abstract:

目的评估肥胖和代谢因子在高尿酸血症（HUA）与高血压前期关联中的中介效应。方法采用多阶段分层整群随机抽样方法抽取福州市5个区（县）30个镇（街）90个村（居委会）共9 399人，最终纳入研究4 754人。采用线性回归模型分析HUA与肥胖和代谢因子的关联，单因素和多因素logistic回归模型分析HUA、肥胖和代谢因子与高血压前期的关联，采用因果中介效应模型分析肥胖和代谢因子对HUA与高血压前期相关性的中介效应。结果在调整混杂因素后，HUA与TC、TG、HDL-C、LDL-C、BMI、腰围、肌酐、尿素氮均显著相关（P<0.001）；HUA、腰围、BMI和TG与高血压前期均显著相关（P<0.001）；腰围、BMI和TG对HUA与高血压前期的关联均有中介效应，OR值（95%CI）分别为1.018（1.007~1.027）、1.010（1.002~1.018）、1.010（1.003~1.017）（P<0.001），中介比例分别为7.76%、4.31%和4.31%；TC、HDL-C、LDL-C、肌酐和尿素氮对两者关联无中介效应（P>0.05）。结论腰围、BMI和TG在HUA与高血压前期的关联中均存在中介效应，对于一般人群而言，应当控制体重、腰围和高脂饮食，以降低高血压前期的发生。

English Abstract:

Objective To assess the mediating effects of obesity and metabolic factors in the relationship between hyperuricemia (HUA) and prehypertension. Methods A total of 9 399 individuals were selected using a multistage stratified whole-group random sampling method from 90 villages (neighborhood committees) in 30 towns (streets) of 5 districts (counties) in Fuzhou. A total of 4 754 study subjects were included. A linear regression model was used to analyze the association of HUA with obesity and metabolic factors. Single-factor and multi-factor logistic regression models were used to analyze the association of HUA, obesity, and metabolic factors with prehypertension. Mediating effects models were used to analyze the mediating effects of obesity and metabolic factors on the association between HUA and prehypertension. Results After adjusting for confounders, the association between HUA and cholesterol, triglycerides, HDL-C, LDL-C, BMI, waist circumference, creatinine, and urea nitrogen were significantly correlated (P<0.001). HUA, waist circumference, BMI, and triglycerides were significantly associated with prehypertension (P<0.001). Waist circumference, BMI, and triglycerides mediated the relationship between HUA and prehypertension, with OR (95%CI) of 1.018 (1.007-1.027), 1.010 (1.002-1.018), and 1.010 (1.003-1.017) (P<0.001), with mediating proportions of 7.76%, 4.31%, and 4.31% respectively. No mediating effect of cholesterol, HDL-C, LDL-C, creatinine, and urea nitrogen was found on the relationship (P>0.05). Conclusions Waist circumference, BMI, and triglycerides all had mediating effects in the association between HUA and prehypertension. For the general population, weight control, waist circumference, and a high-fat diet should be used to reduce the occurrence of prehypertension.

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