摘要目的:了解体检人群中脂质蓄积指数（LAP）与高尿酸血症的关系。方法:本研究为横断面研究，基于一项回顾性队列研究的基线数据进行分析，采用整群抽样的方法纳入2012年1至12月在中南大学湘雅医院健康管理中心体检、年龄≥18岁且研究变量无缺失的体检者44 294例，计算体检人群最小腰围，确定体检人群LAP计算标准。以LAP为观察变量，高尿酸血症为结局变量，将LAP按照四分位数间距分为4组（Q 1~Q 4组），Q 1<10.56 cm·mmol/L、10.56 cm·mmol/L≤Q 2<20.79 cm·mmol/L、20.79 cm·mmol/L≤Q 3<38.94 cm·mmol/L、Q 4≥38.94 cm·mmol/L。采用logistic回归分析方法分别构建5个模型，模型1未调整任何混杂因素，模型2仅调整年龄和性别，模型3进一步调整体重指数、高血压、高血脂、肌酐、肾小球滤过率；模型4进一步调整教育水平、职业、健康保险、吸烟、饮酒、饮食评分、体育锻炼情况；模型5进一步调整痛风家族史、糖尿病家族史、高血压家族史。分析不同LAP水平与高尿酸血症的关系。 结果:体检人群男性和女性的最小腰围分别为58 cm和53 cm。高尿酸血症的总检出率为13.4%，其中女性为5.94%、男性为19.40%。未调整混杂因素时（模型1），女性LAP的Q 2到Q 4组发生高尿酸血症的风险分别是Q 1组的1.76倍（95% CI：1.42~2.17）、5.08倍（95% CI：4.20~6.14）、12.58倍（95% CI：10.43~15.18），男性分别为1.68倍（95% CI：1.43~1.96）、2.74倍（95% CI：2.36~3.18）、5.32倍（95% CI：4.62~6.14）。按照性别分层并调整混杂因素后（模型5），这种风险仍然存在，与LAP的Q 1组相比，Q 4组女性发生高尿酸血症的风险高8.28倍（95% CI：2.50~27.38），男性高3.31倍（95% CI：1.57~6.95）。 结论:LAP升高与高尿酸血症的发生风险呈正相关，在女性中表现尤其明显。

abstractsObjective:To understand the relationship between lipid accumulation product (LAP) and hyperuricemia in physical examination population.Methods:This was a cross-sectional study. The analysis was based on baseline data from a retrospective cohort study. Total of 44 294 people who received physical examination in the Health Management Center of Xiangya Hospital of Central South University from January to December 2012 were selected as subjects with whole-group sampling method. All the subjects aged ≥18 years with complete study variables. The minimum waist circumference of the subjects was calculated to determine the criteria for calculating LAP in those population. With LAP as the observed variable and hyperuricemia as the outcome variable, LAP was divided into four groups according to the interquartile interval (Q 1-Q 4 groups): group Q 1<10.56 cm·mmol/L, 10.56 cm·mmol/L≤Q 2<20.79 cm·mmol/L, 20.79 cm·mmol/L≤Q 3<38.94 cm·mmol/L, Q 4≥38.94 cm·mmol/L. Five models were constructed with logistic regression analysis. No confounding factors was adjusted in Model 1, model 2 was adjusted for age and gender; and model 3 was further adjusted for body mass index, hypertension, hyperlipidemia, creatinine and glomerular filtration rate; model 4 was further adjusted education level, occupation, health insurance, smoking, drinking, diet scores and physical exercise; model 5 was further adjusted the family history of gout, diabetes and hypertension. And the relationship between different LAP levels and hyperuricemia was analyzed. Results:In this study, the minimum waist circumference in the physical examination population was 58 cm and 53 cm for men and women, respectively. The total incidence of hyperuricemia was 13.4% in this population, 5.94% for women and 19.40% for men. When the confounding factors were not adjusted (model 1), the risk of hyperuricemia in women′s LAP Q 2 to Q 4 groups was 1.76 times (95% CI: 1.42-2.17), 5.08 times (95% CI: 4.20-6.14) and 12.58 times (95% CI: 10.43-15.18), and it was 1.68 times (95% CI: 1.43-1.96), 2.74 times (95% CI: 2.36-3.18), and 5.32 times (95% CI: 4.62-6.14) in men, respectively. After gender stratification and adjustment for confounding factors (model 5), the risk still existed, compared with that in Q 1 group of LAP, the risk of hyperuricemia in women in Q 4 group was 8.28 times higher (95% CI: 2.50-27.38) and 3.31 times higher in men (95% CI: 1.57-6.95). Conclusion:The risk of hyperuricemia in health examination population increases with LAP, especially in women.