血脂异常和丙氨酸氨基转移酶升高对高尿酸血症患病的交互作用
Interaction of dyslipidemia and elevated alanine aminotransferase on hyperuricemia
卢双艳 1普惠婕 1陈洁 1李梦启 1张梅 1刁翌 1李贵涛 1周佳 1王松梅 1孙承欢 1叶爱芳 2毛勇1
作者信息
- 1. 昆明医科大学公共卫生学院,云南省昆明 650500
- 2. 云南省安宁市中医医院健康管理中心,云南省安宁 650300
- 折叠
摘要
目的 探讨血脂异常和丙氨酸氨基转移酶(ALT)升高的交互作用对高尿酸血症(HUA)患病的影响,为HUA的防治提供科学依据.方法 于2020年5月-2021年6月,采用多阶段分层随机抽样法抽取安宁市4 725名45～95岁居民为调查对象,进行问卷调查、体格检查和实验室检测.采用SAS 9.4软件进行t检验、秩和检验、x2检验、单因素和多因素logistic回归分析.采用多因素logistic回归相乘模型和相加模型分析血脂异常和ALT升高的交互作用对HUA患病的影响.结果 4 725名调查对象中,HUA患者1 681例(35.58％),血脂异常患者1 667例(35.28％),ALT升高者397例(8.40％),血脂异常与ALT升高共患率为3.70％(175/4725).多因素logistic回归分析结果显示,调整混杂因素后,血脂异常(OR=2.328,95％CI:1.775～3.053)和 ALT升高(OR=2.060,95％CI:1.363～3.114)均与 HUA 患病高风险相关(P＜0.01).交互作用分析显示,血脂异常与ALT升高对于HUA患病不存在相乘交互效应(OR=1.870,95％CI:0.943～3.710);但存在相加交互效应,有血脂异常合并ALT升高人群的HUA患病风险是无血脂异常且无ALT升高人群的6.079倍(OR=6.079,95％CI:4.459～8.287).调整混杂因素后,交互作用相对超额危险度比、交互作用归因比、交互作用指数和纯因子归因交互作用百分比分别为 3.392(95％CI:1.521～5.264)、55.800％(95％CI:40.700％～70.900％)、3.011(95％CI:1.921～4.721)和66.787％(95％CI:43.972％～72.238％).结论 血脂异常和ALT升高对HUA患病可能存在相加交互效应,改善血脂与控制ALT水平可能会协同预防HUA的发生.
Abstract
Objective To explore the interaction between dyslipidemia and elevated alanine aminotransferase(ALT)on hyperuricemia(HUA),and provide the scientific basis for the prevention and treatment of HUA.Methods From May 2020 to June 2021,the multi-stage stratified random sampling method was used to select 4 725 residents(45-95 years old)from Anning city as the subjects.The investigation was performed with the questionnaire,physical examination and laboratory test.The t test,rank sum test,x2 test and uni-variate and multivariate logistic regression analysis were used to analyze the data.Multivariate logistic regression multiplication model and addition model were used to analyze the interaction of dyslipidemia and elevated alanine aminotransferase on hyperuricemia disease.The used software was SAS 9.4.Results Among 4 725 subjects,there were 1 681 cases with HUA(35.58％),1 667 cases with dyslipidemia(35.28％),and 397 cases with elevated ALT levels(8.40％).The co-occurrence rate of dyslipidemia and elevated ALT levels was 3.70％(175/4 725).The multivariate logistic regression analysis showed that after adjusting confounding factors,the dyslipidemia(OR=2.328,95％CI:1.775-3.053)and ALT elevation(OR=2.060,95％CI:1.363-3.114)were related to the increased risk of HUA.Interaction analysis showed that there was no multiplicative interaction between dyslipidemia and ALT elevation on HUA disease(OR=1.870,95％CI:0.943-3.710);but there was the additive interaction.The risk of HUA disease in the subjects with both of elevated ALT and dyslipidemia was 5.079 times higher than that in subjects without both of elevated ALT and dyslipidemia(OR=6.079,95％CI:4.459-8.287).After adjusting confounding factors,relative excess risk ratio,attribution ratio and index of interaction,and percentage of pure factor-attributable interactions were 3.392(95％CI:1.521-5.264),55.800％(95％CI:40.700％-70.900％),3.011(95％CI:1.921-4.721)and 66.787％(95％CI:43.972％-72.238％),respectively.Conclusion Dyslipidemia and elevated ALT may have additive interaction on HUA disease.Improving blood lipid and controlling ALT level may collaboratively prevent HUA.
关键词
血脂异常/丙氨酸氨基转移酶/高尿酸血症/交互作用Key words
Dyslipidemia/Alanine aminotransferase/Hyperuricemia/Interaction引用本文复制引用
基金项目
昆明医科大学老龄化健康管理科技创新团队建设项目(CXTD202103)
出版年
2024
NETL
NSTL
万方数据