薛白 高汝钦 刘丽

[摘要] 目的 探讨高尿酸血症对糖尿病发病的影响，为预防糖尿病提供科学依据。 方法 本研究采用队列研究的方法，选择参加2009年7月基线调查并且在2012年12月被随访到的有完整尿酸及糖尿病资料的35～74岁青岛市常驻居民为研究对象，共2177人纳入本次研究。利用非条件Logistic回归计算优势比。用Bruzzi等定义的公式估计人群归因危险度。 结果 同时控制混杂因素后，高尿酸血症史的OR值为1.497，多因素人群归因危险度为6.71%。 结论 高尿酸血症史是糖尿病的独立危险因素，青岛市糖尿病的发生部分归因于高尿酸血症史。

[关键词] 队列研究；糖尿病；高尿酸血症；人群归因危险度

[中图分类号] R155.5 [文献标识码] A [文章编号] 1673-7210（2018）08（c）-0042-04

[Abstract] Objective To investigate the effect of hyperuricemia on diabetes attack， and provide scientific basis for the work of prevention. Methods Cohort study was conducted in this study. Subjects were selected to participate in the baseline survey in July 2009. A three-year follow-up was conducted for those who met the conditions. The follow-up ended in December 2012. Eventually 2177 people aged 35 to 74 that had lived in Qingdao for years were included in the study. Non-conditional Logistic regression analysis was used to calculate the advantage ratio. The population attributable risk was estimated by using the formula defined by Bruzzi. Results After controlling for confounding factors， the OR value of hyperuricemia was 1.497. The attributional risk of multifactorial population was 6.71%. Conclusion Hyperuricemia is a risk factor for diabetes， and diabetes is caused in part by a history of hyperuricemia in Qingdao.

[Key words] Cohort study； Diabetes； Hyperuricemia； Population attributable risk

近年來，糖尿病已然成为公共卫生领域的巨大威胁。2015年，美国糖尿病学会（ADA）公布的数据显示，2014～2035年全球罹患糖尿病的人数将由3.87亿增至5.92亿[1-2]。糖尿病发病诱因及影响因素研究迫在眉睫。关于高尿酸血症与高血糖的相关性分析最早出现于1923年。尿酸做为嘌呤核苷酸代谢的终产物，当嘌呤代谢紊乱、排泄出现异常时血中的浓度就会升高[3]。经过多项临床动物试验以及人群流行病学研究，发现高水平尿酸是引发高血压、脑卒中、心肌梗死以及痛风的独立危险因素。然而，高水平尿酸对糖尿病的影响仍有争议[4-7]。本研究通过开展3年随访工作，研究尿酸与糖尿病发生的相关性，通过计算多因素人群归因危险度，拟合糖尿病多项危险因素的基础上，估计整个人群中由于高尿酸血症史的存在而引发的糖尿病人数占所有发病人数的比例，为制定糖尿病预防控制策略奠定理论基础。……