金昌队列人群痛风发病危险因素的Cox回归分析

何彩丽; 程宁; 荣右明; 李海燕; 李娟生; 丁蛟; 胡晓斌; 蒲宏全; 任晓卫; 白亚娜

Abstract

何彩丽,程宁,荣右明,李海燕,李娟生,丁蛟,胡晓斌,蒲宏全,任晓卫,白亚娜.金昌队列人群痛风发病危险因素的Cox回归分析[J].Chinese journal of Epidemiology,2017,38(7):897-901

金昌队列人群痛风发病危险因素的Cox回归分析

Risk factors of gout in Jinchang cohort:a Cox regression analysis

Received:January 13, 2017

DOI：10.3760/cma.j.issn.0254-6450.2017.07.010

KeyWord: 痛风发病队列研究 Cox回归分析

English Key Word: Gout Incidence Cohort study Cox regression analysis

FundProject:兰州大学中央高校基本科研业务费专项资金（862176）；国家自然科学基金（81673248）

Author Name	Affiliation	E-mail
He Caili	Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
Cheng Ning	Basic Medical College, Lanzhou University, Lanzhou 730000, China
Rong Youming	Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
Li Haiyan	Workers'Hospital of Jinchuan Group Co, Ltd, Jinchang 737100, China He Caili and Cheng Ning are the first authors who contributed equally to the article
Li Juansheng	Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
Ding Jiao	Workers'Hospital of Jinchuan Group Co, Ltd, Jinchang 737100, China He Caili and Cheng Ning are the first authors who contributed equally to the article
Hu Xiaobin	Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
Pu Hongquan	Workers'Hospital of Jinchuan Group Co, Ltd, Jinchang 737100, China He Caili and Cheng Ning are the first authors who contributed equally to the article
Ren Xiaowei	Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
Bai Yana	Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China	baiyana@lzu.edu.cn

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Abstract:

目的了解金昌队列人群痛风的发病状况及影响因素，为制订痛风的防治措施提供科学依据。方法采用前瞻性队列研究方法，以金昌队列基线资料中未患痛风的人群作为研究对象，于2013年1月24日至2015年11月24日完成随访问卷调查、体格检查和实验室检测。采用Cox 回归模型分析金昌队列人群中痛风发病的影响因素，并用对数线性模型分析各影响因素之间的交互作用。结果 33 153例随访人群中新发痛风病例277例，痛风发病率为0.8%，男性整体上高于女性，但在60岁以后男女性痛风发病率相当。多因素Cox 回归分析结果显示，年龄在40岁以上（40~59岁：HR=2.982， 95%CI：1.503~5.981； 60~91岁：HR=2.588， 95%CI：1.107~6.049）、大量酒精摄入（HR=2.234， 95%CI：1.128~4.427）、肥胖（HR=2.204， 95%CI：1.216~3.997）、糖尿病（HR=2.725， 95%CI：1.500~4.950）和高尿酸（HR=5.963， 95%CI：3.577~9.943）是痛风发病的危险因素，每周豆类摄入 ≥ 250 g（HR=0.528， 95%CI：0.345~0.808）和经常体育锻炼（HR=0.499， 95%CI：0.286~0.869）是痛风发病的保护性因素。对数线性模型交互作用分析结果显示，各影响因素之间存在二阶效应。结论年龄、豆类、酒类、体育锻炼、肥胖、糖尿病和高尿酸是痛风发病的重要影响因素。培养良好的生活饮食习惯，定期进行体检，有利于预防和控制该职业人群痛风病的发生。

English Abstract:

Objective To explore the incidence and risk factors of gout in Jinchang cohort and provide scientific evidence for the prevention and control of gout. Methods People without gout detected by baseline survey in Jinchang cohort were selected as study subjects. All the subjects were followed up through questionnaire interview, physical examination as well as laboratory test from January 24, 2013 to November 24, 2015. Cox regression model was used to analyze the risk factors for gout in Jinchang cohort. In addition, log-linear model was used to analyze the interaction between risk factors. Results A total of 33 153 subjects were followed up, and there were 277 newly diagnosed gout cases in the cohort. The overall incidence of gout was 0.8%. The incidence of gout in males was higher than that in the females, but the incidence of gout in males and females was similar after the age of 60 years. Cox regression analysis showed that age >40 years (at age 40 to 59 years:HR=2.982, 95%CI:1.503-5.981; at age 60 to 91 years:HR=2.588, 95%CI:1.107-6.049), alcohol abuse (HR=2.234, 95%CI:1.128-4.427), obesity (HR=2.204, 95%CI:1.216-3.997), diabetes (HR=2.725, 95%CI:1.500-4.950) and high uric acid (HR=5.963, 95%CI:3.577-9.943) were risk factors for gout, while weekly beans intake ≥ 0.25 kg (HR=0.528, 95%CI:0.345-0.808) and regular physical exercise (HR=0.499, 95%CI:0.286-0.869) were protective factors for gout. The analysis with log-linear model showed that there were two order effects between the risk factors. Conclusions Age, beans intake, alcohol abuse, physical exercises, obesity, diabetes and high uric acid were important factors influencing the incidence of gout. It is important to have healthy lifestyle and dietary habits, receive regular health examination to prevent and control the incidence of gout in this cohort.

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