黔南州布依、苗、汉族部分成人高尿酸血症及相关因素分析

发布时间：2018-05-16 08:44

本文选题：HUA + 少数民族　；参考：《贵阳医学院》2015年硕士论文

【摘要】：目的:近年来随着人们生活水平的日益提高、生活行为方式的不断改变,高尿酸血症(Hyperuricemia,HUA)的检出率呈现逐年上升的趋势。血尿酸水平升高不仅与痛风有关,还可能与血压紊乱、血糖血脂代谢异常、肾功能异常等病症有关。本课题通过探讨少数民族成人HUA与代谢性疾病、饮食行为因素之间的关系,为少数民族地区HUA人群提供饮食指导、有效预防痛风及其并发症的发生。通过研究血清炎症因子白介素-1(IL-1)与HUA及其他代谢性疾病之间关系,为慢性病的预防控制提供科学指导。方法:采用随机整群抽样的方法收集贵州省黔南州都匀市两所医院2014年1月到2014年12月的体检人群资料,获得符合条件的体检资料12808份,同期采用病例对照研究方法抽取符合HUA诊断标准的布依、苗族、汉族各100例作为病例组,在3个民族中分别抽取血尿酸水平正常者各100例作为对照组。对被调查对象进行问卷调查,收集基本信息、生活方式、饮食习惯、身体测量和生化指标等资料。采用酶联免疫吸附试验检测病例对照研究对象血清中IL-1的含量。结果:(1)本次研究中共收集体检人群资料12808份,HUA的有3081例,检出率为24.06%。其中男性7837人,HUA有2701例,检出率为34.47%;女性4971人,HUA的有380例,检出率7.64%。男性HUA检出率明显高于女性,差异有统计学意义(χ2=1136.1,P=0.000)。(2)本次研究中男性与女性不同年龄段血尿酸水平表现为:女性血尿酸水平和HUA的检出率随年龄的增长而升高,而男性血尿酸水平未见随年龄增长而升高的趋势。(3)体检人群中尿酸与各生化指标之间相关性分析显示:舒张压、甘油三酯、肌酐、体质指数、低密度脂蛋白与尿酸水平呈正相关关系,高密度脂蛋白、空腹血糖与血尿酸水平呈负相关关系。(4)体检人群中HUA组SBP、DBP、BMI、BUN、CREA、TG、HDL、LDL、FPG水平与正常组之间差异有统计学意义(P0.05)。且HUA组高血压、高血糖、超重或肥胖、高甘油三脂血症的检出率均高于正常组。(5)病例对照研究中HUA组与对照组相比:在布依族、苗族SUA、SBP、DBP、CHOL、TG、CREA、腹围、BMI差异有统计学意义(P0.05);汉族SUA、DBP、CREA、CHOL、TG、BMI差异有统计学意义(P0.05)。(6)病例对照研究中人群血尿酸水平与各生化指标之间的相关分析显示:肌酐、低密度脂蛋白、腹围与尿酸水平呈正相关,空腹血糖、高密度脂蛋白与血尿酸水平呈负相关。(7)病例对照研究人群中既往病史比较显示:布依族人群中与HUA相关的是高血压、脂肪肝;苗族人群中为脂肪肝和痛风;汉族人群中为高脂血症、脂肪肝、痛风。(8)病例组与对照组饮食生活比较显示:高度酒的饮用量、啤酒饮用量(瓶)、在家用餐的频率差异有统计学意义。(9)探究食物对血尿酸水平的影响,采用二分类Logistic回归分析显示,粗粮、动物内脏、河鱼、奶类、红酸汤、菌菇类、白酒与血尿酸水平之间存在相关性(P0.05)。(10)分民族对血尿酸水平和食物进行Logistic回归分析显示,布依族食用馒头、红酸汤、禽肉类、茶叶、白酒与血尿酸水平有关;苗族食用粗粮、蔬菜酸汤、动物内脏、奶类与血尿酸水平有关;汉族食用豆腐、红酸汤、茶叶、红酒、米酒、甜饮料与血尿酸水平有关(P0.05)。(11)食物按每月食用量进行比较分析可知:在布依族人群中,病例组与对照组之间食用馒头、粗粮、动物内脏、海产品、红酸汤、白酒差异有统计学意义;在苗族人群中,病例组人群在食用动物内脏、海产品、奶类、白酒、啤酒、米酒与对照组差异有统计学意义;在汉族人群中,病例组与对照组在食用粗粮、动物内脏、菌菇类、蔬菜酸汤、白酒、啤酒上差异有统计学意义(12)各民族HUA组与对照组IL-1水平差异有统计学意义。白介素-1(IL-1)与各生化指标相关性分析可知:IL-1水平与肌酐、尿酸、BMI呈正相关关系。结论:贵州省黔南州少数民族地区体检人群的HUA检出率较高,且男性明显高于女性;HUA与高血压、高甘油三脂等多项代谢异常均有相关性;在膳食因素中食用馒头、粗粮、红酸汤是HUA的保护因素。而食用禽肉类、动物内脏、白酒是HUA的危险因素。在引起血尿酸增高的食物中不同民族略有差异,布依族以动物内脏为主,苗族以饮用米酒为主,汉族以饮用白酒为主。HUA组的IL-1水平高于对照组,相关分析提示血尿酸水平对IL-1的影响力较强。
[Abstract]:Objective: in recent years, the detection rate of Hyperuricemia (HUA) is increasing year by year with the increasing living standard and the changing of life behavior. The increase of serum uric acid level is not only related to gout, but also may be related to the disorder of blood pressure, abnormal blood lipid metabolism and abnormal renal function. The relationship between HUA and metabolic diseases and dietary behavioural factors is explored to provide dietary guidance for the HUA population in ethnic minority areas to effectively prevent gout and its complications. The relationship between serum inflammatory factor interleukins -1 (IL-1) and HUA and other metabolic diseases is studied for the prevention and control of chronic diseases. Methods: a random cluster sampling method was used to collect the data of the physical examination population from January 2014 to December 2014 in Tuyun City, Qiannan, Guizhou Province, and obtain 12808 eligible physical examination data. In the same period, a case control study was used to extract the HUA diagnostic criteria of Buyi, Miao and Han 100 cases as cases. In the group, 100 cases of normal blood uric acid in 3 nationalities were selected as the control group. The subjects were investigated by questionnaires to collect basic information, lifestyle, dietary habits, body measurement and biochemical indexes. The content of IL-1 in the serum of the subjects was detected by enzyme linked immunosorbent assay. Results: (1) There were 12808 data collected by the Chinese Communist Party, 3081 cases of HUA, of which 7837 were male and 2701 in HUA, 2701 in HUA, 4971 in women and 380 in HUA, and the detection rate of 7.64%. was significantly higher than that of women. The difference was statistically significant (2). (2) male and female were not in this study. The level of uric acid in the same age group showed that the level of uric acid and the detection rate of HUA increased with age, but the level of uric acid in men did not increase with age. (3) the correlation between uric acid and biochemical indexes in the population of physical examination showed diastolic pressure, triglyceride, creatinine, body mass index, low density lipoprotein. There was a positive correlation with uric acid level, high density lipoprotein, fasting blood glucose and blood uric acid level negative correlation. (4) HUA group SBP, DBP, BMI, BUN, CREA, TG, HDL, LDL, FPG level and normal groups were statistically significant (P0.05). And HUA group hypertension, hyperglycemia, overweight or obesity, the detection rate of hyperglycemia three lipemia are all Higher than the normal group. (5) compared with the control group, the HUA group was compared with the control group: the SUA, SBP, DBP, CHOL, TG, CREA, abdominal circumference and BMI of the Miao nationality were statistically significant (P0.05); (6) the correlation analysis between the serum uric acid level and the biochemical indexes in the case control study. Creatinine, low density lipoprotein, abdominal circumference were positively correlated with uric acid level, fasting blood glucose, high density lipoprotein and blood uric acid levels were negatively correlated. (7) a comparison of previous cases in a case control study showed that the HUA associated with the Buyi population was hypertension, fatty liver, and the Hmong population was fatty liver and gout; the Han population was higher. Lipidemia, fatty liver, gout. (8) the comparison between the case group and the control group showed that the drinking quantity of high alcohol, the amount of beer drinking (bottle), the difference in the frequency of eating at home were statistically significant. (9) to explore the effect of food on the level of uric acid, and the two classification Logistic regression analysis showed that coarse grain, animal viscera, river fish, milk, red acid soup, and bacteria There is a correlation between mushroom and blood uric acid (P0.05). (10) Logistic regression analysis of blood uric acid level and food shows that Buyi people eat steamed bread, red acid soup, poultry, tea, liquor and blood uric acid level; the Miao people eat coarse grain, vegetable sour soup, animal viscera, milk and blood uric acid level; Han food With tofu, red acid soup, tea, red wine, rice wine, sweet drink and blood uric acid level (P0.05). (11) a comparative analysis of food consumption according to monthly consumption shows that in Buyi people, there is a significant difference between the case group and the control group for eating steamed bread, coarse grain, animal viscera, seafood, red acid soup and liquor. There were significant differences between the groups in the edible animal viscera, seafood, milk, liquor, beer, rice wine and the control group. In the Han population, there was significant difference between the case group and the control group in the food coarse grain, animal viscera, mushroom, vegetable sour soup, liquor and beer (12) the difference of IL-1 level between the HUA group and the control group was statistically significant. The correlation analysis of interleukin -1 (IL-1) and various biochemical indexes showed that the level of IL-1 was positively correlated with creatinine, uric acid and BMI. Conclusion: the detection rate of HUA in the physical examination population in the minority areas of Qiannan Prefecture of Guizhou province was higher, and the male was obviously higher than that of the female; the correlation between HUA and hypertension, hyperglycerin three fat and other metabolic abnormalities were correlated; Eating steamed bread, coarse grain and red acid soup are the protection factors of HUA. While eating poultry meat, animal viscera and liquor is a risk factor for HUA. There are some differences in different ethnic groups in the food causing the increase of blood uric acid. The Buyi people mainly have animal viscera, the Miao people take drinking rice wine as the main body, and the IL-1 level of the Han group in the group of drinking liquor mainly in the.HUA group is higher than the control group. Analysis showed that serum uric acid level had a strong influence on IL-1.

【学位授予单位】：贵阳医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R589.7

【参考文献】