目的 探讨四川省川东北地区6～17岁儿童青少年高尿酸血症(HUA)患病情况及其相关影响因素,为早期防治提供科学依据。方法 采用回顾性研究的方法,收集川北医学院附属医院2017年1月1日—2021年12月31日15 739例6～17岁儿童青少年的临床资料,分析HUA患病情况,根据高尿酸血症诊断标准,将调查对象分为无高尿酸组(12 565例)、高尿酸组(3 174例)。采用多因素Logistic回归分析HUA患病影响因素。结果 四川省川东北地区6～17岁儿童青少年HUA总体患病率为20.17%(3 174/15 739),其中男生患病率为26.53%(2 492/9 392),女生患病率为10.75%(682/6 347)。HUA患病率近5年总体呈增长趋势,其中2019—2020年增长较快;随着年龄的增长患病率呈上升趋势,以12岁为界点,男生在12岁及以后HUA患病率明显增加。多因素Logistic回归分析显示,男性(OR=2.308,95%CI:1.310~4.065,P=0.004)、年龄增长(OR=1.129,95%CI:1.019~1.251,P=0.020)、超重/肥胖(OR=1.080,95%CI:1.014~1.150,P=0.016)、血肌酐升高(OR=1.028,95%CI:1.008~1.049,P=0.006)、甘油三酯升高(OR=1.546,95%CI:1.133~2.108,P=0.006)、血钙升高(OR=12.723,95%CI:1.783~90.801,P=0.011)是HUA发生的独立危险因素。结论 四川省川东北地区6～17岁儿童青少年HUA患病率较高,男生高于女生,其患病率随年龄增长而增加;HUA患病与性别、年龄、体质量指数、血肌酐、甘油三酯、血钙水平密切相关。
Abstract
Objective To investigate the prevalence of hyperuricemia (HUA) and its related factors in children and adolescents aged 6 - 17 years in Northeast Sichuan Province, so as to provide scientific basis for early prevention and treatment. Methods A retrospective study was conducted to collect the clinical data of 15 739 children and adolescents aged 6 - 17 years from January 1st, 2017 to December 31st, 2021 in the Affiliated Hospital of North Sichuan Medical College to analyze the prevalence of HUA. According to the diagnostic criteria of hyperuricemia, the participants were divided into no hyperuricemia group (n=12 565) and hyperuricemia group (n=3 174). Multivariate Logistic regression was used to analyze the influencing factors of HUA prevalence. Results The overall prevalence of HUA among children and adolescents aged 6 - 17 years in northeast Sichuan Province was 20.17% (3 174/15 739), with 26.53% (2 492/9 392) among boys and 10.75% (682/6347) among girls. The prevalence of HUA has shown an overall increasing trend in the past 5 years, with a faster increase in 2019—2020; the prevalence tended to increase with age, with 12 years old as the cut-off point, the prevalence of HUA increased significantly in boys aged 12 years or order. Multifactorial Logistic regression analysis showed that males (OR＝2.308, 95%CI:1.310 - 4.065, P=0.004), increasing age(OR＝1.129, 95%CI:1.019 - 1.251, P=0.020), overweight/obesity (OR＝1.080, 95%CI: 1.014 - 1.150, P=0.016), higher serum creatinine level(OR＝1.028, 95%CI:1.008 - 1.049,P=0.006), higher triglycerides level(OR＝1.546, 95%CI: 1.133 - 2.108,P=0.006), and higher serum calcium level(OR＝12.723, 95%CI:1.783 - 90.801,P=0.011) were risk factors for the development of HUA. Conclusions The prevalence of HUA in children and adolescents aged 6 - 17 years in Northeast Sichuan is higher in boys than in girls, and the prevalence increases with age. HUA is closely related to gender, age, body mass index, serum creatinine, triglyceride and serum calcium levels.
关键词
儿童 /
青少年 /
高尿酸血症 /
患病率
Key words
children /
adolescents /
hyperuricemia /
prevalence
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参考文献
[1] Zhang Y,Qiu H. Dietary magnesium intake and hyperuricemia among US Adults[J]. Nutrients, 2018,10(3):296.
[2] Dai C, Wang C,Xia F, et al. Age and gender-specific reference intervals for uric acid level in children aged 5~14 years in southeast Zhejiang Province of China: Hyperuricemia in children may need redefinition[J]. Front Pediatr, 2021,9:560-720.
[3] Aoki Y, Sofue T, Kawakami R, et al. Prevalence and factors related to hypouricemia and hyperuricemia in schoolchildren:Results of a large-scale cross-sectional population-based study conducted in Japan[J]. Sci Rep, 2022,12(1):17848.
[4] 叶佩玉,赵小元,闫银坤,等.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.
Ye PY, Zhao XY, Yan YK, et al. Association between hyperuricemia and incidence risk for cardiometabolic abnormity in children[J]. Chin J Epidemiol, 2021,42(3):433-439.(in Chinese)
[5] Huang J, Ma ZF, Zhang Y, et al. Geographical distribution of hyperuricemia in mainland China:A comprehensive systematic review and meta-analysis[J]. Global Health Research and Policy, 2020,5(1):52.
[6] 胡亚美,江载芳,申昆玲,等.诸福堂实用儿科学[M].8版.北京:人民卫生出版社,2015:2885.
[7] 中国肥胖问题工作组季成叶. 中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准[J]. 中华流行病学杂志, 2004,25(2):97-102.
Ji CY,China Working Group on Obesity. Classification criteria for overweight and obesity screening body mass index values in Chinese school-age children and adolescents[J].Chin J Epidemiol ,2004,25(2):97-102.(in Chinese)
[8] Wei Y, Zhu J, Wetzstein SA. Plasma and water fluoride levels and hyperuricemia among adolescents: A cross-sectional study of a nationally representative sample of the United States for 2013-2016[J]. Ecotoxicol Environ Saf, 2021,208:111670.
[9] Lee JH. Prevalence of hyperuricemia and its association with metabolic syndrome and cardiometabolic risk factors in Korean children and adolescents: Analysis based on the 2016-2017 Korea National Health and Nutrition Examination Survey[J]. Korean J Pediatr, 2019,62(8):317-323.
[10] Rao J, Ye P, Lu J, et al. Prevalence and related factors of hyperuricaemia in Chinese children and adolescents:A pooled analysis of 11 population-based studies[J]. Ann Med, 2022,54(1):1608-1615.
[11] Howard AG, Attard SM, Herring AH, et al. Socioeconomic gradients in the Westernization of diet in China over 20 years[J]. SSM Popul Health, 2021,16:100943.
[12] Zhang C, Li L, Zhang Y, et al. Recent advances in fructose intake and risk of hyperuricemia[J]. Biomed Pharmacother, 2020,131:110795.
[13] Liu R, Han C, Wu D, et al. Prevalence of hyperuricemia and gout in mainland China from 2000 to 2014: A systematic review and Meta-analysis[J]. Biomed Res Int, 2015,2015:762820.
[14] 蔡蓉蓉,董洋洋,周金玉,等.银川市儿童青少年血清尿酸水平与心血管危险因素及其聚集的关系[J].卫生研究, 2022,51(1):56-62.
Cai RR,Dong YY,Zhou JY,et al.Relationship between serum uric acid levels and cardiovascular risk factors and their aggregation in children and adolescents in Yinchuan[J].Hygiene Res,2022,51(1):56-62.(in Chinese)
[15] Hsia S, Chou I, Kuo C, et al. Survival impact of serum uric acid levels in children and adolescents[J]. Rheumatol Int, 2013,33(11):2797-2802.
[16] Alvim RO, Siqueira JH, Zaniqueli D, et al. Influence of muscle mass on the serum uric acid levels in children and adolescents[J]. Nutr Metab Cardiovas,2020,30(2):300-305.
[17] Ghamri RA, Galai TA, Ismail RA, et al. Prevalence of hyperuricemia and the relationship between serum uric acid concentrations and lipid parameters among King Abdulaziz University Hospital patients[J]. Niger J Clin Pract, 2022,25(4):439-447.
[18] Tsushima Y, Nishizawa H, Tochino Y, et al. Uric acid secretion from adipose tissue and its increase in obesity[J]. J Biol Chem, 2013,288(38):27138-27149.
[19] Cheang C, Law S, Ren J, et al. Prevalence of hyperuricemia in patients with severe obesity and the relationship between serum uric acid and severe obesity: A decade retrospective cross-section study in Chinese adults[J]. Front Public Health, 2022,10:986954.
[20] 王诗涵,袁涛.儿童及青少年高尿酸血症和痛风的危险因素、病因及诊治策略[J].中华临床营养杂志, 2021,29(3):163-170.
Wang SH,Yuan T.Risk factors, etiology and management strategies of hyperuricemia and gout in children and adolescents[J]. Chin J Clin Nutr, 2021,29(3):163-170.(in Chinese)
[21] Lu J, Sun W, Cui L, et al. A cross-sectional study on uric acid levels among Chinese adolescents[J]. Pediatric Nephrol, 2020,35(3):441-446.
[22] Russo E, Viazzi F, Pontremoli R, et al. Association of uric acid with kidney function and albuminuria: The Uric Acid Right for heArt Health (URRAH) Project[J]. J Nephrology, 2022,35(1):211-221.
[23] Liu M, Chu Q, Yang C, et al. The paradoxical relation between serum uric acid and outcomes of hip fracture in older patients after surgery: A 1-year follow-up study[J]. Surgery, 2022,172(5):1576-1583.
[24] Pan K, Tu R, Yao X, et al. Associations between serum calcium, 25(OH)D level and bone mineral density in adolescents[J]. Adv Rheumatol, 2021,61(1):16.
基金
四川省卫生健康委重点研究项目(19ZD006);四川省基层卫生事业发展研究课题(SWFZ22-C-94);南充市社会科学研究“十四五”规划(NC23B166)
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