牟伦盼等

[摘要] 目的 探讨男性肥胖患者中血尿酸（SUA）与体脂分布及代谢综合征（MS）的相关性。 方法 选取2012—2014年门诊就诊的133例肥胖患者，体重指数（BMI）均>25.0 kg/m2，均未经降血糖、降血脂、利尿、降压、抗尿酸药物治疗。测定血清胰岛素及生化指标，用CT在脐水平测定腹部脂肪分布。结果 直线相关分析显示SUA与BMI、腰围、内脏脂肪、内脏脂肪/皮下脂肪比值、空腹血糖、HOMA-IR、甘油三酯、血肌酐、收缩压、舒张压呈正相关，相关系数分别为0.361、0.446、0.634、0.360、0.193、0.287、0.477、0.259、0.280、0.181；多元逐步回归分析显示对SUA影响最大的因素依次为内脏脂肪面积、甘油三酯，标准化回归系数分别为0.533、0.183；内脏脂肪蓄积随血尿酸水平升高明显增加，更高的4分位数血尿酸对应更高的内脏脂肪面积（P<0.05）。MS组SUA水平高于非MS组者[（434.6±69.6）umol/L vs（367.0±104.9）umol/L，P<0.01]；Spearman秩相关分析显示SUA水平随MS组分数增加而增高（P<0.01）。结论 SUA水平与内脏脂肪蓄积相关；代谢综合征患者SUA水平更高。

[关键词] 血尿酸； 内脏脂肪面积； 代谢综合征

[中图分类号] R473.74 [文献标识码] A [文章编号] 1674-0742（2014）10（b）-0011-03

Relation Between Serum Uric Acid Level and Body Fat Distribution， Metabolic Syndrome in Obesity

MOU Lunpan1 JIANG Jianjia1 SU Jinbo1 SUN Bingqing2 LIN Zhenzhong3

1.Department of Endocrinology， Quanzhou First Hospital Affiliated to Fujian Medical University， Quanzhou， Fujian Province， 362000， China；2.Imaging Department， Quanzhou First Hospital Affiliated to Fujian Medical University， Quanzhou， Fujian Province， 362000， China；3. Clinical Laboratory， Quanzhou First Hospital Affiliated to Fujian Medical University， Quanzhou， Fujian Province， 362000， China

[Abstract] Objective We investigated the relationship between serum uric acid （SUA） and body fat distribution， metabolic syndrome（MS） in obese men. Methods 133 cases of obese outpatients from year 2012 to 2014， with body mass index（BMI）≥25.0 Kg/m2， were enrolled in the study. These patients have never been given hypoglycemic， hypolipidemic， hydragogue， anti-hypertensive or anti-hyperuricemic agents. Body fat distribution was measured by computed tomography （CT） scanning at the umbilical level. Serum insulin and other biochemical parameters were also measured. Results Linear correlation analysis showed that SUA is positively correlated with BMI， waist circumference， visceral fat area， the ratio of visceral fat area with subcutaneous fat area， fasting plasma glucose， HOMA-IR， serum triglyceride， serum creatinine， systolic and diastolic blood pressure， and the above parameter of correlation coefficient was 0.361， 0.446， 0.634， 0.360， 0.193， 0.287， 0.477， 0.259， 0.280， 0.181， respectively. Stepwise multiple regression analysis showed that visceral fat area， and serum triglyceride were significant explanatory variables for SUA levels， and the standardized regression coefficient was 0.533， 0.183 respectively. Visceral fat accumulation increased significantly with the increase of uric acid. A higher quartile of SUA showed a higher visceral fat area （P<0.05）. The SUA was significantly higher in metabolic syndrome group than that in the non-metabolic syndrome group （434.6±69.6 umol/l vs 367.0±104.9umol/l， P<0.01）. In Spearman rank correlation analysis， the SUA was elevated with increasing metabolic syndrome characteristics （P<0.01）. Conclusion The present study indicated that SUA is significantly associated with visceral fat accumulation. Patients with metabolic syndrome revealed a higher SUA.

[Key words] Serum uric acid； Visceral fat area； Metabolic syndrome

高尿酸血症因嘌呤代谢紊乱及（或）尿酸排泄障碍引起，常与各种生活方式相关性疾病伴随出现。流行病学研究显示高尿酸血症是动脉粥样硬化性心血管疾病的危险因子[1-2]。代谢综合征（Metabolic Syndrome，MS）全球指南将高尿酸血症表述为与MS征相关的代谢紊乱[3]。MS是一些代谢异常的集合，主要包括高血压、高血糖、血脂紊乱和肥胖，可以明显增加心脑血管事件的发生。腹型肥胖据腹部脂肪蓄积部位不同可区分为内脏型肥胖与皮下型肥胖。该研究旨在探讨血尿酸水平与体脂蓄积及代谢综合症发病的相关性，以2012—2014年首次就诊该院内分泌科的男性肥胖患者133例为研究对象，现报道如下。

1 对象与方法

1.1 研究对象