基于大样本健康调研数据库分析代谢综合征及其组分与痛风发病的相关性OA
Association of metabolic syndrome and its components with gout:an analysis based on a large-scale health survey database
目的:探究代谢综合征及其组分与痛风发病的相关性.方法:基于美国国民健康与营养调查(NHANES)数据库中2007-2018年的数据,纳入年龄18岁及以上、完成痛风相关问卷且具有代谢综合征诊断所需完整数据的成人调查对象28 130例,其中痛风患者1279例.采用logistic回归评估代谢综合征及其组分与痛风发病的关联,限制性立方样条模型分析代谢指标与痛风发病的非线性关系,并按年龄、性别和体重指数进行亚组分析,通过在logistic回归模型中加入乘积交互项并采用Wald检验评估各亚组间效应差异.结果:痛风患者的代谢综合征患病率远高于非痛风人群(分别为66.9%和33.3%).校正年龄、性别、体重指数、吸烟和饮酒后,代谢综合征是痛风的独立危险因素(OR=2.55,95%CI:1.55~4.20,P<0.01),尤以中心性肥胖(OR=2.44,95%CI:1.55~3.85,P<0.01)和高血压(OR=1.70,95%CI:1.04~2.78,P<0.05)最为显著.体重指数、空腹血糖与痛风发病风险呈J型关联,腰围、平均收缩压及甘油三酯呈正向加速增长关联,平均舒张压和低密度脂蛋白胆固醇与痛风发病风险呈U型关联,高密度脂蛋白胆固醇(HDL-C)与痛风发病风险呈显著非线性关联,其OR值整体随HDL-C水平升高呈下降趋势(均P<0.05).代谢综合征与痛风发病的相关性在女性中强于男性(OR值分别为5.07和2.34,交互P<0.05),糖尿病与痛风发病的相关性在50岁及以上人群(OR=4.58)和非肥胖人群(OR=5.21)中更为显著(交互均P<0.01).结论:代谢综合征是痛风发病的独立危险因素,并呈现非线性关系和人群异质性.
Objective:To investigate the association of metabolic syndrome(MetS)and its components with gout.Methods:This study utilized data from 28 130 adults aged≥18 years in the National Health and Nutrition Examination Survey(NHANES)2007-2018,among whom 1279 were identified as gout patients.Logistic regression was used to assess the associations of MetS and its components with gout.Restricted cubic spline(RCS)models were employed to examine non-linear dose-response relationships between metabolic indicators and gout.Subgroup analyses were performed by age,sex,and body mass index(BMI),with interaction effects evaluated using the Wald test by including multiplicative interaction terms in the logistic regression models.Results:The prevalence of MetS was substantially higher in individuals with gout than in those without(66.9%vs.33.3%).After adjusting for age,sex,BMI,smoking,and alcohol consumption,MetS was independently associated with gout(OR=2.55,95%CI:1.55-4.20,P<0.01),with central obesity(OR=2.44,95%CI:1.55-3.85,P<0.01)and hypertension(OR=1.70,95%CI:1.04-2.78,P<0.05)showing the strongest associations.RCS analysis revealed J-shaped associations for BMI and fasting glucose,accelerating positive associations for waist circumference,mean systolic blood pressure,and triglyceride levels,and U-shaped associations for mean diastolic blood pressure and low-density lipoprotein cholesterol(LDL-C)levels(all P<0.05).High-density lipoprotein cholesterol(HDL-C)showed a significant non-linear association,with the OR value of gout generally decreasing as HDL-C levels increased(P<0.05).Subgroup analyses indicated that the association of MetS with gout was significantly stronger in females than that in males(OR:5.07 vs.2.34,interaction P<0.05),and the association of diabetes with gout was more pronounced in those aged≥50 years(OR=4.58)and in non-obese individuals(OR=5.21)(both interaction P<0.01).Conclusion:MetS is independently associated with gout,exhibiting significant non-linear dose-response characteristics and population heterogeneity.
李建斌;刘维
天津中医药大学第一附属医院风湿免疫科 中医国家临床医学研究中心,天津 300381||天津中医药大学研究生院,天津 301617天津中医药大学第一附属医院风湿免疫科 中医国家临床医学研究中心,天津 300381||天津中医药大学研究生院,天津 301617
医药卫生
痛风代谢综合征危险因素剂量-反应关系美国国家健康与营养调查横断面研究
GoutMetabolic syndromeRisk factorDose-response relationshipNational Health and Nutrition Examination SurveyCross-sectional study
《浙江大学学报(医学版)》 2026 (4)
311-320,10
重大疑难疾病中西医临床协作项目(ZDYN-2024-B-038)天津市南开区中医药传承创新发展示范试点项目(20240204011)国家中医药管理局中西医结合与少数民族医药司政府采购服务项目(2023382)全国名老中医药专家传承工作室建设项目This study was supported by Major Difficult Diseases Integrated Traditional Chinese and Western Medicine Clinical Collaboration Project(ZDYN-2024-B-038),Tianjin Nankai District Traditional Chinese Medicine Inher-itance Innovation and Development Demonstration Pilot Project(20240204011),Government Procurement Service Project of the Department of Integrated Traditional Chinese and Western Medicine and Ethnic Medicine of the National Administration of Traditional Chinese Medicine(2023382),and National Famous Traditional Chinese Medicine Expert Inheritance Studio Construction Project
评论