摘要目的 探讨高脂血症与高尿酸血症的关系.方法 自2012年2月1日至2017年5月31日,建立湘雅医院在职及离退休职工体检队列.基线调查时收集研究对象身高、体重、腰围、血脂、血压、血糖、肌酐、血尿酸等信息,血脂正常组为对照组,血脂异常组为暴露组,随访收集高尿酸血症发生的情况.采用多因素Cox比例风险回归模型分析高脂血症及其4种不同临床分型(高胆固醇血症、高三酰甘油血症、混合型高脂血症、低高密度脂蛋白胆固醇血症)与高尿酸血症发病的风险比(HR)和95％置信区间(95％CI).结果 共有1 553人进入随访队列,共随访5 297人年,平均随访3.4年,共收集高尿酸血症新发病例394例.高尿酸血症粗发病密度744/万人年.高脂血症组随访2 509人年,发生高尿酸血症142例,高脂血症组高尿酸血症发病密度为566/万人年,其中高胆固醇血症组、高三酰甘油血症组、混合型高脂血症组、低高密度脂蛋白胆固醇组分别随访1 431、403、580、92人年,分别发生高尿酸血症105、64、72、11例,发病密度分别为734/万人年、1 588/万人年、1 241/万人年、1 196/万人年,差异有统计学意义(P＜0.01).高脂血症及其4种临床分型:高胆固醇血症、高三酰甘油血症、混合型高脂血症、低高密度脂蛋白胆固醇血症均与高尿酸血症的发病相关,HR(95％CI)分别为1.971(1.604～2.421)、1.441(1.120～1.855)、3.103(2.309～4.169)、2.434(1.833～3.233)、2.336(1.265～4.316),P＜0.01;调整年龄、性别、体质指数、高血压、高血糖、高肌酐的影响后,HR(95％CI)分别为1.885(1.533～2.317)、1.450 (1.127～1.866)、2.881 (2.141～3.876)、2.118(1.588～2.825)、2.451(1.326～4.528) P＜0.0.结论 高脂血症及其4种不同临床分型:高胆固醇血症、高三酰甘油血症、混合型高脂血症、低高密度脂蛋白胆固醇血症均与高尿酸血症发病相关.

abstractsObjective To investigate the relationship between hyperlipidemia and hyperuricemia.Methods From February 1,2012 to May 31,2017,a physical examination queue for serving and retired employees in Xiangya Hospital was established.As the survey's baseline,height,weight,waist circumference,blood lipids,blood pressure,blood glucose,creatinine,and serum uric acid were collected.The normal group was the control group,and the dyslipidemia group was the exposure group.The occurrence of hyperuricemia was investigated during follow-up.A multivariate Cox proportional hazards regression model was used to analyze hyperlipidemia.Four different clinical types (hypercholesterolemia,hypertriglyceridemia,mixed hyperlipidemia,and low high-density lipoprotein hyperlipidemia) and hyperuricemia had an incidence of hazard ratio (HR) and confidence interval (95％CI).Results A total of 1 553 people entered the follow-up cohort.A total of 5 297 patients were followed up for an average of 3.4 years.Three hundred and ninety-four cases of hyperuricemia were collected.The density of hyperuricemia was 744/10 000 years.The hyperuricemia group was followed up for 2 509 years,with hyperuricemia occurring in 142 cases,and hyperuricemia in the hyperlipidemia group of 566/million years.The hypercholesterolemia,high triglyceride,mixed hyperlipidemia,and low-density lipoprotein groups were followed up for 1 431,403,580,92 years,respectively,and high uric acid occurred respectively.In 105,64,72 and 11 cases,the incidence of disease was 734/million years,1 588/million years,1 241/million years,1 196/million years;the difference was statistically significant (P＜ 0.01).Hyperlipidemia and its four clinical types,hypercholesterolemia,hypertriglyceridemia,mixed hyperlipidemia,and hypodic lipoproteinemia,were associated with hyperuricemia.HR (95％CI) was 1.971 (1.604-2.421),1.441 (1.120-1.855),3.103 (2.309-4.169),2.434 (1.833-3.233),2.336,respectively.(1.265-4.316),P＜ 0.01;after adjusting the influence of age,sex,body mass index,hypertension,hyperglycemia,and hyper creatinine,HR (95％CI) was 1.885 (1.533-2.317),1.450 (1.127-1.866),2.881 (2.141-3.876),2.118 (1.588-2.825),2.451 (1.326-4.528) P＜0.01.Conclusions Hyperlipidemia and its four different clinical types (hypercholesterolemia,hypertriglyceridemia,mixed hyperlipidemia,and low-density lipoproteinemia) are all associated with the onset of hyperuricemia.