北京市通州区中小学生血尿酸水平与影响因素分析

江南; 王双; 武昌

doi:10.16835/j.cnki.1000-9817.2021.03.028

北京市通州区中小学生血尿酸水平与影响因素分析

doi: 10.16835/j.cnki.1000-9817.2021.03.028

北京市通州区疾病预防控制中心营养与食品卫生科，101100

详细信息

作者简介:
江南(1986-)，男，北京市人，大学本科，主管医师，主要研究方向为营养与食品卫生

中图分类号: R 446 R 589.7
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- 被引次数: 0
出版历程
- 收稿日期: 2020-12-22
- 修回日期: 2021-01-20
- 网络出版日期: 2021-04-20
- 刊出日期: 2021-03-25

Analysis of serum uric acid levels and associated factors among primary and middle school students in Tongzhou District, Beijing

Department of Nutrition and Food Hygiene, Tongzhou District Center for Disease Control and Prevention, Beijing(101100), China

摘要

摘要: 目的了解北京市通州区中小学生血尿酸水平及影响因素，为青少年高尿酸血症(HUA)防控提供参考依据。方法采用多阶段分层整群抽样方法，抽取北京市通州区3个城区和3个乡镇的4所中学与4所小学共1 483名学生进行问卷调查、体格和血液检查，并对血尿酸水平及影响因素进行分析。结果通州区中小学生血尿酸水平呈偏态分布，中位值为296.0 mol/L，四分位距为96.0 mol/L，高尿酸血症总检出率为14.83%(220/1 483)。单因素分析显示，中学生、乡镇学生、男生、家庭用餐学生、高三酰甘油学生、高密度脂蛋白胆固醇较低(HDL-C)学生、肥胖学生的血清尿酸水平相对较高，差异均有统计学意义(H/U值分别为119 938，229 525，212 043，156 347，42 052，63 375，33.49，P值均 < 0.05)；高年龄段、中学生、乡镇学生、超重或肥胖以及低HDL-C的学生HUA检出率较高(χ²值分别为614.55，73.20，6.16，30.56，14.50，P值均 < 0.05)；多因素Logistic回归显示，高年龄段、男生、低HDL-C、低密度脂蛋白胆固醇较高、超重和肥胖均与HUA呈正相关(P值均 < 0.05)。结论通州区中小学生血尿酸水平及高尿酸血症检出率处于较高水平，患病风险和影响因素具有显著特征，应加强针对性防控措施。
- 尿酸 /
- 血液化学分析 /
- 高尿酸血症 /
- 回归分析 /
- 学生
Abstract: Objective To examine uric acid (UA) levels and their influencing factors among primary and middle school students in the Tongzhou District of Beijing, and to provide referential guidance for the prevention and control of hyperuricemia in teenagers. Methods A total of 1 483 students from four middle schools and four primary schools in three cities and three towns in Tongzhou District were selected for a questionnaire survey, physical examination, and blood examination using a multi-stage stratified cluster sampling method. The results of the serum uric acid (SUA) examinations were statistically analyzed and the influencing factors were evaluated. Results The UA level of the students was skewed, with a median value of 296.0 mol/L and an interquartile distance of 96.0 mol/L. The overall detection rate of hyperuricemia was 14.83% (220/1 483). Middle school students (342 μmol/L), students from villages and towns (307 μmol/L), males (309 μmol/L), family dining students (298 μmol/L), students with high levels of triglyceride (TG) (318 μmol/L), students with low levels of high-density lipoprotein cholesterol (HDL-C) (329 μmol/L), and obese students (303 μmol/L) all had statistically higher SUA levels(H/U value was 119 938, 229 525, 212 043, 156 347, 42 052, 63 375, 33.49, P < 0.05). The univariate analysis showed that the HUA detection rate was higher in older age groups, middle school students, township students, overweight or obese students, and low HDL-C students(χ²=614.55, 73.20, 6.16, 30.56, 14.50, P < 0.05). Multivariate Logistic regression showed that older age, being male, low HDL-C, high LDL-C, overweight, and obesity were risk factors for HUA(P < 0.05). Conclusion The SUA level and the detection rate of hyperuricemia among primary and middle school students in Tongzhou District were high, and the risk of disease and influencing factors had significant characteristics. Therefore, targeted prevention and control measures should be strengthened.
- Uric acid /
- Blood chemical analysis /
- Hyperuricemia /
- Regression analysis /
- Students

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表 1 北京市通州区不同组别中小学生血尿酸水平比较

Table 1. SUA level distribution of primary and middle school students in Tongzhou District, Beijing

组别	选项	人数	M(Q)/(mol·L^-1)	H/U值	P值
年份	2015	504	297(90)	1.93^a	>0.05
	2017	496	298(105)
	2019	483	293(98)
年龄/岁	6~7	332	267(76)	261.15^a	< 0.01
	8~9	334	274(75)
	10~11	370	300(84)
	12~14	447	342(106)
学段	小学	1 036	279(79)	119 938^b	< 0.01
	中学	447	342(106)
居住地	城区	815	288(83)	229 525^b	< 0.01
	乡镇	668	307(113)
性别	男	773	309(102)	212 043^b	< 0.01
	女	710	283(82)
日常进食	学校	291	284(81)	156 347^b	< 0.01
场所	家庭	1 192	298(101)
TC	高	142	305(98)	90 683^b	>0.05
	正常	1 341	295(96)
TG	高	74	318(107)	42 052^b	< 0.01
	正常	1 409	295(95)
LDL-C	高	112	310(108)	69 439^b	>0.05
	正常	1 371	295(95)
HDL-C	低	115	329(152)	63 375^b	< 0.01
	正常	1 368	294(92)
BMI	正常	992	289(87)	33.49^a	< 0.01
	超重	188	311(88)
	肥胖	303	317(133)
注：a为Kruskal-Wallis H检验；b为Mann-Whitney U检验。

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表 2 北京市通州区不同组别中小学生HUA检出率比较

Table 2. Comparison of HUA reevance ratio among primary and middle school students in Tongzhou District, Beijing

组别	选项	人数	HUA人数	χ²值	P值
年份	2015	504	73(14.48)	4.37	>0.05
	2017	496	86(17.34)
	2019	483	61(12.63)
年龄/岁	6~7	332	28(8.43)	614.55	< 0.01
	8~9	334	35(10.48)
	10~11	370	37(10.00)
	12~14	447	120(26.85)
学段	小学	1 036	100(9.56)	73.20	< 0.01
	中学	447	120(26.85)
居住地	城区	815	104(12.76)	6.16	< 0.01
	乡镇	668	116(17.37)
性别	男	773	105(13.58)	2.00	>0.05
	女	710	115(16.20)
日常进食场所	学校	291	38(13.06)	0.90	>0.05
	家庭	1 192	182(15.27)
TC	高	142	18(12.68)	0.58	>0.05
	正常	1 341	202(15.06)
TG	高	74	14(18.92)	1.03	>0.05
	正常	1 409	206(14.62)
LDL-C	高	112	23(16.96)	2.48	>0.05
	正常	1 371	197(14.66)
HDL-C	低	115	31(26.96)	14.50	< 0.01
	正常	1 368	189(13.82)
BMI	正常	992	113(11.39)	30.56	< 0.01
	超重	188	35(18.62)
	肥胖	303	72(23.76)
注：()内数字为检出率/%。

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表 3 北京市通州区中小学生HUA影响因素Logistic回归分析(n=1 483)

常量与自变量	选项	β值	标准误	Wald χ²值	P值	OR值(OR值95%CI)
常量		-3.26	0.25	165.68	< 0.01	0.04
年龄/岁	8~9	0.34	0.27	1.58	0.21	1.41(0.83~2.40)
	10~11	0.56	0.28	4.20	0.04	1.76(1.03~3.02)
	12~14	1.71	0.24	49.74	< 0.01	5.51(3.43~8.86)
性别	男	0.32	0.16	4.11	0.04	1.37(1.01~1.86)
血脂指标	低HDL-C	0.53	0.25	4.69	0.03	1.70(1.05~2.75)
	高LDL-C	0.90	0.37	5.90	0.02	2.46(1.19~5.10)
BMI	超重	0.72	0.22	10.44	< 0.01	2.06(1.33~3.20)
	肥胖	1.31	0.19	48.16	< 0.01	3.72(2.57~5.40)
注：年龄以6~7岁为参照组，性别以女为参照组，血脂指标以及BMI均以正常为参照组。

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