摘要目的:分析高尿酸与性别对老年人群血脂异常的交互作用。方法:本研究为横断面研究，2021年在江苏昆山周庄镇选取≥65岁的常住居民开展横断面调查，包括体格检查、血吸虫病感染史、血液生化检测（血糖、血脂、肌酐、尿酸透明质酸、γ-谷氨酰转肽酶）等。多因素logistic回归分析诸因素与血脂异常的关联；采用交互作用指数（S）、交互作用相对超额危险度（RERI）及归因交互效应百分比（AP）评价高尿酸和女性交互作用对血脂异常的关联；采用限制性立方样条回归模型分析血尿酸水平与血脂异常关联强度剂量反应关系。结果:≥65岁人群血脂异常率为31.9%（1 450/4 536）；男性和女性血脂异常率分别为23.7%（517/2 180）和39.6%（933/2 356），血脂异常率在性别之间的差异有统计学意义（ χ2=131.38， P<0.001）。多因素回归分析显示，女性、高腰围、超重肥胖、高血压、糖尿病、肾小球滤过率偏低、γ-谷氨酰转肽酶偏高、尿酸肌酐比值偏高、中性粒细胞与淋巴细胞比值偏低与血脂异常之间的关联差异均有统计学意义（均 P<0.05）。高尿酸水平（ OR=1.09，95% CI：1.07~1.12）和女性（ OR=1.12，95% CI：1.11~1.14）与血脂异常存在相加交互效应，其归因于交互效应比例为19.8%（RERI=0.74，95% CI：0.06~1.42；AP=0.20，95% CI：0.04~0.36、S=1.372，95% CI：1.02~1.84）。限制性立方样条模型显示，连续上升的血尿酸水平与血脂异常关联强度呈现非线性剂量反应关系（ χ2=101.23， P<0.001）。 结论:老年居民中血脂异常比例较高，人口学特征与身体测量指标综合影响了血脂异常率；高尿酸与女性同时存在对血脂异常存在相加交互作用。

abstractsObjective:To explore the interaction between hyperuricemia and gender on dyslipidemia in the elderly.Methods:A cross-sectional study. The permanent residents aged≥65 years in Kunshan City were selected by the cluster sampling method. The selected residents underwent physical examination and blood biochemical tests such as blood glucose, blood lipid, uric acid, hyaluronic acid, gamma glutamyltransferase and creatinine, and history of schistosomiasis infection was investigated. Multivariate logistic regression analysis was used to analyze the relationship between various factors and dyslipidemia. Synergy index (S), relative excess risk of interaction (RERI) and the attributable proportion due to interaction (AP) were used to evaluate the association between hyperuricemia and female interaction on dyslipidemia.. The dose-response relationship between serum uric acid level and dyslipidemia was analyzed by a restricted cubic spline regression model.Results:The prevalence of dyslipidemia in the elderly aged 65 years and obove was 31.9% (1 450/4 536), and it was 23.7% (517/2 180) and 39.6% (933/2 356) in men and women, respectively ( χ2=131.38, P<0.001). Multivariate regression showed that female, high waist circumference, overweight and obesity, hypertension, diabetes, low glomerular filtration rate, high gamma-glutamyltranspeptidase, high uric acid to creatinine ratio, low neutral to lymphocyte ratio were associated with dyslipidemia (all P<0.05). Additionally, additive interaction association was found between the dyslipidemia and advanced uric acid levels ( OR=1.09, 95% CI: 1.07-1.12) and female ( OR=1.12, 95% CI: 1.11-1.14), and the contribution rate of interaction effects was 19.8% (RERI=0.74, 95% CI: 0.06-1.42; AP=0.20, 95% CI: 0.04-0.36, S=1.37, 95% CI: 1.02-1.84). Non-linear dose response relationship was identified by the restricted cubic spline regression model between the continuously rising serum uric acid and dyslipidemia ( χ2=101.23, P<0.001). Conclusions:The proportion of dyslipidemia in elderly permanent residents is high. Demographics and physical measurement indicators comprehensively affected the prevalence of dyslipidemia. In addition, both hyperuric acid and female have additive interaction on dyslipidemia.