目的 探讨血清尿酸与高密度脂蛋白胆固醇的比值(UHR)与超重/肥胖人群高血压的相关性及其判别能力。方法 纳入2021-01-01至2024-09-30在中国中医科学院西苑医院参加健康体检的超重/肥胖的成年人,以是否罹患高血压作为分组依据,比较基线水平;运用R 4.2.0和Empower RCH 4.1分析UHR与超重/肥胖人群高血压患病率的相关性;此外,依据性别、年龄、是否吸烟、是否饮酒、是否患有2型糖尿病、是否患有其他心脑血管疾病、是否存在高血压家族史进行亚组分析,以判断研究结果的稳健性;运用受试者工作特征(ROC)曲线评估并比较UHR对超重/肥胖人群高血压的判别效能。结果 共纳入超重/肥胖体检数据1624例,Logistic回归校正性别、年龄、吸烟史、饮酒史、家族史、BMI等10种可能造成偏倚的混杂因素后,超重/肥胖个体的UHR每上升1个单位,其高血压患病比值增至原来的1.0143倍,超重/肥胖个体的0.01 UHR每上升1个单位,其高血压患病比值则增至原来的4.14倍;高水平UHR组别的高血压患病比值是低水平UHR组别的45.17倍。亚组分析显示,UHR与高血压患病的正相关关系在女性、中老年及合并心脑血管疾病的人群中关联强度更高。ROC曲线显示,UHR区分超重/肥胖人群高血压曲线下面积(AUC)为0.814(95%CI:0.7901~0.8375),其最佳截断值为324.813。结论 在超重肥胖人群中UHR与高血压呈显著的非线性正相关,且对该人群高血压具有良好的区分效能。
Abstract
Objective To investigate the correlation between the ratio of serum uric acid to high-density lipoprotein cholesterol (UHR) and hypertension in overweight/obese individuals, as well as its discriminatory capability of UHR. Methods A total of 1624 overweight/obese adults who participated in health check-ups at Xiyuan Hospital of China Academy of Chinese Medical Sciences from January 1, 2021 to September 30, 2024 were included.. Participants were grouped based on hypertension status, and baseline levels were compared. R 4.2.0 and Empower RCH 4.1 were used to analyze the correlation between UHR and hypertension prevalence in overweight/obese individuals. Additionally, subgroup analyses were conducted based on gender, age, smoking status, alcohol consumption, presence of type 2 diabetes, other cardiovascular/cerebrovascular diseases, and family history of hypertension to assess the robustness of the research results. Receiver operating characteristic (ROC) curves were used to evaluate and compare the discriminatory efficacy of UHR for hypertension in overweight/obese individuals. Results A total of 1624 overweight/obese physical examination cases were included. After adjusting for 10 potential confounding factors, including gender, age, smoking history, drinking history, family history, and BMI via logistic regression, the following results were observed. The odds of hypertension increased by 1.0143 times (OR=1.0143) for each unit increase in UHR. After scaling UHR by a factor of 0.01, a one-unit increase in the scaled measure was associated with an odds ratio of 4.14 for hypertension. The high UHR group had 45.17 times higher odds of hypertension compared to the low UHR group (OR=45.17). Subgroup analysis revealed that the positive association between UHR and hypertension was stronger in females, middle-aged and older adults, and those with cardiovascular and cerebrovascular diseases. ROC curve analysis showed that the area under the curve (AUC) for UHR in discriminating hypertension in the overweight/obese population was 0.814 (95% CI: 0.7901-0.8375), with an optimal cutoff value of 324.813. Conclusions In overweight/obese individuals, UHR is significantly and non-linearly correlated with hypertension, and it has good discriminatory efficacy for hypertension in this population.
关键词
高血压 /
尿酸与高密度脂蛋白胆固醇比值 /
超重/肥胖 /
相关性研究
Key words
hypertension /
ratio of serum uric acid to high-density lipoprotein cholesterol /
overweight/obese /
correlation study
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基金
北京薪火传承3+3项目(2023-SZ-A51);国家重点研发计划子课题(2018YFC2000600);中国中医科学院科技创新工程(CI2021A03005);中国中医科学院西苑医院具有知识产权的医疗机构制剂和中药新药的研发与转化专项任务(XYZY0301-16)
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