血尿酸水平与血脂异常关系的交叉滞后分析

尹田秀; 朱晓玥; 何志亮; 白鹤翔; 沈辰也; 蔡乐; 李若愚; 王蓓

doi:10.16462/j.cnki.zhjbkz.2024.01.003

血尿酸水平与血脂异常关系的交叉滞后分析

doi: 10.16462/j.cnki.zhjbkz.2024.01.003

东南大学公共卫生学院流行病与卫生统计学系，南京 210003

基金项目:

重大慢性非传染性疾病防控研究专项 2016YFC1305700

详细信息

通讯作者:
王蓓，E-mail：wangbeilxb@163.com

中图分类号: R181.3
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出版历程
- 收稿日期: 2023-05-10
- 修回日期: 2023-09-30
- 网络出版日期: 2024-02-05
- 刊出日期: 2024-01-10

Cross-lagged analysis of the relationship between serum uric acid and dyslipidemia

Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210003, China

Funds:

Special Research Project on Prevention and Control of Major Chronic Noncommunicable Diseases on Early Identification of Risk Factors, Early Diagnosis Technology and Pointcut of Diabetes 2016YFC1305700

More Information

Corresponding author: WANG Bei, E-mail: wangbeilxb@163.com

摘要

摘要: 目的研究血尿酸(serum uric acid, SUA)水平升高与血脂质之间的关系，为预防控制血脂异常和高尿酸血症提供依据。方法 2017年4—7月在江苏省盐城市盐都区，采用多级分层随机抽样方法，对≥18岁常住居民进行基线调查，于2022年对该队列人群进行随访；采用交叉滞后模型，探讨SUA水平与血脂之间的关系，包括总胆固醇(total cholesterol, TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol, LDL-C)、三酰甘油(triglyceride, TG)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol, HDL-C)，并且针对性别进行分层分析，探究SUA水平与血脂异常的关系是否存在性别差异。结果共有1 347名符合条件的对象纳入研究。基线TC到随访SUA的路径系数在一般人群(β=3.402, P=0.048)和男性(β=7.214，P=0.012)中差异均有统计学意义；基线SUA到随访TC的路径系数差异无统计学意义(P=0.958)。基线TG到随访SUA的路径系数在一般人群(β=2.357, P=0.011)和男性(β=3.425，P=0.011)中差异均有统计学意义；基线SUA到随访TG的路径系数差异无统计学意义(P=0.188)。基线SUA到随访HDL-C的路径系数在一般人群(β=0.002，P＜0.001)、男性(β=0.001，P＜0.001)和女性(β=0.003，P＜0.001)中差异均有统计学意义；基线HDL-C到随访SUA的路径系数差异无统计学意义(P=0.461)。基线SUA到随访LDL-C的路径系数在一般人群(β=0.002, P＜0.001)、男性(β=0.004，P＜0.001)和女性(β=0.001，P=0.015)中差异均有统计学意义；基线LDL-C到随访SUA的路径系数差异无统计学意义(P=0.436)。结论 SUA与血脂水平之间相互影响，TC、TG水平升高可能导致SUA水平升高，从而可能导致LDL-C水平升高和HDL-C水平降低。
- 交叉滞后 /
- 血脂 /
- 血尿酸 /
- 队列研究 /
- 因果关系
Abstract: Objective To study the relationship between elevated serum uric acid levels and serum lipids, and to provide evidence for the prevention and control of dyslipidemia and hyperuricemia. Methods A multi-level stratified random sampling method was used to conduct a baseline survey among permanent residents aged 18 and above in Yandu District, Yancheng City, Jiangsu Province from April to July 2017. And the cohort was followed up in 2022. The Cross-lag model was used to investigate the relationship between serum uric acid (SUA) level and blood lipid, including serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C). In addition, gender stratified analysis was conducted to explore whether there were gender differences in the relationship between SUA level and dyslipidemia. Results A total of 1 347 eligible subjects were included in the study. The path coefficients from baseline TC to follow-up SUA were statistically significant in the general population (β=3.402, P=0.048) and men (β=7.214, P=0.012). The path coefficients from baseline SUA to follow-up TC were not statistically significant (P=0.958). The path coefficients from baseline TG to follow-up SUA were statistically significant in the general population (β=2.357, P=0.011) and men (β=3.425, P=0.011). The path coefficients from baseline SUA to follow-up TG were not statistically significant (P=0.188). The path coefficients from baseline SUA to follow-up HDL-C were statistically significant in the general population (β=0.002, P < 0.001), men (β=0.001, P < 0.001), and women (β=0.003, P < 0.001). The path coefficients from baseline HDL-C to follow-up SUA were not statistically significant (P=0.461). The path coefficients of baseline SUA to follow-up LDL-C were statistically significant in the general population (β=0.002, P < 0.001), men (β=0.004, P < 0.001), and women (β=0.001, P=0.015). The path coefficients from baseline LDL-C to follow-up SUA were not statistically significant (P=0.436). Conclusions Serum uric acid and lipid levels interact with each other. The increase of TC and TG levels may lead to an increase in SUA level, the increase of SUA level may lead to an increase in LDL-C level, and the increase in SUA level may lead to a decrease in HDL-C level.
- Cross-lagged panel model /
- Blood lipids /
- Serum uric acid /
- Cohort study /
- Causal relationship

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图 1 SUA与TC水平的交叉滞后分析

SUA：血尿酸；TC：总胆固醇。
a: P＜0.05。

Figure 1. Cross-lagged analysis of SUA and TC

SUA: surem uric acid; TC: total cholesterol.
a: P < 0.05.

下载: 全尺寸图片幻灯片

图 2 SUA与TG水平的交叉滞后分析

SUA：血尿酸；TG：三酰甘油。
a: P＜0.05。

Figure 2. Cross-lagged analysis of SUA and TG

SUA: surem uric acid; TG: triglyceride.
a: P < 0.05.

下载: 全尺寸图片幻灯片

图 3 SUA与HDL-C水平的交叉滞后分析

SUA：血尿酸；HDL-C：高密度脂蛋白胆固醇。
a: P＜0.05。

Figure 3. Cross-lagged analysis of SUA and HDL-C

SUA: surem uric acid; HDL-C: high-density lipoprotein cholesterol
a: P < 0.05.

下载: 全尺寸图片幻灯片

图 4 SUA与LDL-C水平的交叉滞后分析

SUA：血尿酸；LDL-C：低密度脂蛋白胆固醇。
a: P＜0.05。

Figure 4. Cross-lagged analysis of SUA and LDL-C

SUA: surem uric acid; LDL-C: low-density lipoprotein cholesterol.
a: P < 0.05.

下载: 全尺寸图片幻灯片

图 5 SUA与TC水平的交叉滞后分析(分层分析)

SUA：血尿酸；TC：总胆固醇。
a: P＜0.05。

Figure 5. Cross-lagged analysis of SUA and TC (stratified analysis)

SUA: surem uric acid; TC: total cholesterol.
a: P < 0.05.

下载: 全尺寸图片幻灯片

图 6 SUA与TG水平的交叉滞后分析(分层分析)

SUA：血尿酸；TG：三酰甘油。
a: P＜0.05。

Figure 6. Cross-lagged analysis of SUA and TG (stratified analysis)

SUA: surem uric acid; TG: triglyceride.
a: P < 0.05.

下载: 全尺寸图片幻灯片

图 7 SUA与HDL-C水平的交叉滞后分析(分层分析)

SUA：血尿酸；HDL-C：高密度脂蛋白胆固醇。
a: P＜0.05。

Figure 7. Cross-lagged analysis of SUA and HDL-C (stratified analysis)

SUA: surem uric acid; HDL-C: high-density lipoprotein cholesterol.
a: P < 0.05.

下载: 全尺寸图片幻灯片

图 8 SUA与LDL-C水平的交叉滞后分析(分层分析)

SUA：血尿酸；LDL-C：低密度脂蛋白胆固醇。
a: P＜0.05。

Figure 8. Cross-lagged analysis of SUA and LDL-C (stratified analysis)

SUA: surem uric acid; LDL-C: low-density lipoprotein cholesterol.
a: P < 0.05.

下载: 全尺寸图片幻灯片

表 1 交叉滞后分析中受试者的基线特征

Table 1. Baseline characteristics of subjects in cross-lagged analysis

变量Variable	合计^① Total ^① (n=1 347)	男性^① Male ^① (n=543)	女性^① Female ^① (n=804)	Z/χ²值value	P值value
年龄/岁Age/years	52.0(47.0, 60.0)	53.0(46.0, 61.0)	52.0(47.0, 60.0)	1.739	0.207
BMI/(kg·m^-2)	25.3(23.2, 27.7)	25.5(23.2, 28.0)	25.3(23.2, 27.6)	0.554	0.554
SBP/mmHg^-1	135.0(124.0, 148.0)	138.0(126.0, 150.8)	133.0(122.0, 147.0)	8.835	0.003
DBP/mmHg^-1	85.0(77.0, 92.0)	86.0(79.0, 93.0)	83.5(76.0, 90.0)	16.429	0.001
TG/(mmol·L^-1)	1.4(1.0, 2.1)	1.5(1.0, 2.2)	1.3(0.9, 1.9)	9.748	0.002
TC/(mmol·L^-1)	4.8(4.2, 5.4)	4.7(4.2, 5.3)	4.9(4.2, 5.5)	8.536	0.003
HDL-C/(mmol·L^-1)	1.5(1.3, 1.8)	1.5(1.2, 1.7)	1.6(1.3, 1.8)	22.259	0.001
LDL-C/(mmol·L^-1)	2.6(2.2, 3.1)	2.6(2.1, 3.0)	2.6(2.2, 3.1)	0.977	0.323
FPG/(mmol·L^-1)	5.7(5.3, 6.1)	5.8(5.4, 6.3)	5.6(5.3, 6.1)	16.276	0.001
HbA1c/ %	5.3(5.0, 5.6)	5.3(5.0, 5.6)	5.3(5.0, 5.6)	0.112	0.738
SUA/(mmol·L^-1)	293.0(241.0, 349.0)	345.0(298.0, 398.5)	260.0(222.0, 307.0)	269.242	0.001
吸烟Smoking	289(21.5)	268(49.4)	21(2.6)	420.225	0.001
饮酒Drinking	280(20.8)	237(43.6)	43(5.3)	288.707	0.001
规律运动Regular exercise	375(27.8)	169(31.1)	206(25.6)	4.883	0.027
注：TG, 三酰甘油; TC, 总胆固醇; HDL-C, 高密度脂蛋白胆固醇; LDL-C, 低密度脂蛋白胆固醇; FPG, 空腹血糖; HbA1c, 糖化血红蛋白; SUA, 血尿酸。 ①以M(P₂₅, P₇₅)或人数(占比/%)表示。 Note: TG, triglyceride; TC, total cholesterol; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; FPG, fasting plasma glucose; HbA1c, glycosylated hemoglobin; SUA, serum uric acid. ① M(P₂₅, P₇₅) or number of people (proportion/%).

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