广西壮族自治区35~74岁壮族居民高尿酸血症与饮食模式的关系

裴恒妍; 唐小芬; 曾小云; 黄东萍; 刘顺; 江宇; 仇小强; 谢艺红

doi:10.16462/j.cnki.zhjbkz.2025.03.014

广西壮族自治区35~74岁壮族居民高尿酸血症与饮食模式的关系

doi: 10.16462/j.cnki.zhjbkz.2025.03.014

1.
广西医科大学公共卫生学院流行病与卫生统计学系，南宁 530021
2.
广西医科大学公共卫生学院卫生检验与检疫教研室，南宁 530021
3.
广西医科大学公共卫生学院儿少卫生与妇幼保健学教研室，南宁 530021

裴恒妍和唐小芬为共同第一作者

基金项目:

国家重点研发计划 2017YFC0907103

国家自然科学基金 81960619

广西自然科学基金 2022GXNSFAA035623

详细信息

通讯作者:
谢艺红，E-mail: gxxieyihong@163.com

中图分类号: R589.7;R181
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出版历程
- 收稿日期: 2024-05-21
- 修回日期: 2024-10-26
- 网络出版日期: 2025-04-11
- 刊出日期: 2025-03-10

Study on the association between the risk of hyperuricemia and dietary patterns among aged 35-74 years Zhuang Minority residents in Guangxi

1.
Department of Epidemiology and Health Statustics, School of Public Health, Guangxi medical University, Nanning 530021, China
2.
Department of Health Inspection and Quarantine, School of Public Health, Guangxi medical University, Nanning 530021, China
3.
Department of Hygiene of Children and Adolescents & Maternal and Child Health, School of Public Health, Guangxi Medical University, Nanning 530021, China

PEI Hengyan and TANG Xiaofen contributed equally to this article

Funds:

National Key Research and Development Program of China 2017YFC0907103

National Natural Science Foundation of China 81960619

Natural Science Foundation of Guangxi 2022GXNSFAA035623

More Information

Corresponding author: XIE Yihong, E-mail: gxxieyihong@163.com

摘要

摘要: 目的探讨2018―2019年广西壮族自治区(简称广西)35~74岁壮族居民高尿酸血症(hyperuricemia, HUA)患病与饮食模式之间的关系，为HUA的管理和痛风等慢性病防控提供科学依据。方法采用横断面研究，基于广西少数民族自然人群慢性病前瞻性队列人群开展问卷调查和体格检查，并采集血液、尿液标本进行实验室检测。根据14种常见食物的摄入情况，采用因子分析识别其饮食模式，并通过二分类logistic回归分析模型分析HUA与饮食模式的关系。结果共纳入11 134名壮族居民，其中男性4 977人(44.70%)，女性6 157人(55.30%)，HUA患病率为17.47%(男性为30.88%，女性为6.63%)。研究对象以小学及以下文化程度(55.83%)和农村居民(87.80%)为主。通过因子分析共识别出4种饮食模式，其累积贡献率为46.36%。多因素分析结果显示，在调整性别、文化程度、居民类型、高血压、冠心病、慢性肾脏病、肝功能、血脂和BMI等有统计学意义的指标后，与杂粮面食模式相比，水产禽蛋模式是HUA的保护因素(aOR=0.82, 95% CI: 0.70~0.96, P=0.012)；与不饮酒者相比，适量饮酒(aOR=1.44, 95% CI: 1.17~1.79, P < 0.001)和过量饮酒(aOR=1.74, 95% CI: 1.50~2.03, P < 0.001)是HUA的危险因素；与基本不喝汤相比，喝汤1~2次/周(aOR=0.75, 95% CI: 0.63~0.90, P=0.002)和≥3次/周(aOR=0.87, 95% CI: 0.75~1.00, P=0.043)是HUA的保护因素。结论 2018―2019年广西35~74岁壮族居民HUA患病率较高，HUA患病风险与饮食模式、饮酒密切相关，应加强饮食指导，宣传和倡导健康饮食模式，减少HUA患病风险。
- 高尿酸血症 /
- 患病率 /
- 饮食模式
Abstract: Objective To explore the association between the risk of hyperuricemia (HUA) and the dietary patterns among aged 35-74 years Zhuang minority residents in Guangxi Zhuang Autonomous Region from 2018 to 2019, to provide scientific evidences for the health management of HUA, the prevention and control of gout and other non-communicable chronic diseases. Methods A cross-sectional study with structured questionnaire, physical examination, and laboratory test for blood and urine samples was conducted based on the Guangxi Ethnic Minorities Cohort of Chronic Diseases. Factor analysis was performed to detect the dietary patterns based on 14 types of food intake. A binomial logistic regression was used to explore the association between the risk of HUA and dietary patterns. Results A total of 11 134 aged 35-74 years Zhuang minority adults were included. Among them, 4 977 (44.70%) were males and 6 157 (55.30%) were females. The prevalence of HUA was 17.47% (30.88% for males and 6.63% for females). Most study subjects had only primary school or lower education (55.83%), and 87.80% were rural residents. Four dietary patterns have been identified in the factor analysis and their cumulative variance contribution rate were 46.36%. After adjusted for gender, education level, area of residence, hypertension, history of coronary heart disease, history of chronic kidney disease, liver function, blood lipids and body mass index, the dietary pattern of aquatic and poultry and eggs was a protective factor for HUA when compared to multigrain pasta pattern (aOR=0.82, 95% CI: 0.70-0.96, P=0.012). Compared to non-drinkers, moderate (aOR=1.44, 95% CI: 1.17-1.79, P < 0.001) and excessive alcohol consumption (aOR=1.74, 95% CI: 1.50-2.03, P < 0.001) were risk factors for HUA. Compared to those who do not drink soup, drinking soup 1-2 times (aOR=0.75, 95% CI: 0.63-0.90, P=0.002) and drinking soup ≥3 times a week (aOR=0.87, 95% CI: 0.75-1.00, P=0.043) was a protective factor for HUA. Conclusions The prevalence of HUA was relative high among aged 35-74 years Zhuang minority residents from 2018 to 2019. The risk of HUA was closely related to dietary pattern and alcohol consumption. Healthy dietary patterns should be advocated and strengthened to reduce the risk of HUA.
- Hyperuricemia /
- Prevalence /
- Dietary patterns

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图 1 不同性别、年龄组高尿酸血症患病率

Figure 1. Prevalence of hyperuricemia by gender and age group

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表 1 广西壮族自治区11 134名35~74岁壮族居民基本情况、行为方式及常见慢性病

Table 1. Basic information and common chronic disease history of 11 134 aged 35-74 years Zhuang minority adults in Guangxi Zhuang Autonomous Region

变量Variable	调查人数 Total population^①	HUA患病人数 Number of patients with HUA^①	OR值value (95% CI)^②	P值 value
性别Gender
女Female	6 157(55.30)	408(20.98)	1.00
男Male	4 977(44.70)	1 537(79.02)	6.30(5.60~7.08)	< 0.001
年龄组/岁Age group/ years
35~＜45	1 973(17.72)	342(17.58)	1.00
45~＜55	3 407(30.60)	598(30.75)	1.02(0.88~1.18)	0.839
55~＜65	2 974(26.71)	485(24.94)	0.93(0.80~1.09)	0.343
65~74	2 780(24.97)	520(26.73)	1.10(0.94~1.28)	0.227
文化程度Education level
小学及以下Primary school or lower	6 216(55.83)	832(42.78)	1.00
初中Middle school	3 294(29.58)	666(34.24)	1.64(1.47~1.83)	< 0.001
高中Senior high school	1 270(11.41)	336(17.27)	2.33(2.02~2.69)	< 0.001
大专及以上College or above	354(3.18)	111(5.71)	2.96(2.33~3.74)	< 0.001
职业Occupation
行政管理/专业技术人员Administrative/technical staffs	284(2.55)	85(4.37)	1.00
农民Farmer	6 465(58.06)	1 085(55.78)	0.47(0.36~0.61)	< 0.001
工人Workers	1 122(10.08)	256(13.16)	0.69(0.52~0.92)	0.013
个体户Self-employed	449(4.03)	55(2.83)	0.33(0.22~0.48)	< 0.001
家务/其他Housework/other	1 477(13.27)	205(10.54)	0.38(0.28~0.51)	< 0.001
离休/退休Retired	1 337(12.01)	259(13.32)	0.56(0.42~0.75)	< 0.001
居民类型Area of residence
农村居民Rural	9 776(87.80)	1 596(82.06)	1.00
城镇居民Urban	1 358(12.20)	349(17.94)	1.77(1.55~2.02)	< 0.001
婚姻状况Marital status
已婚Married	9 840(88.38)	1 726(88.74)	1.00
丧偶Widowed	969(8.70)	131(6.74)	0.74(0.61~0.89)	0.002
分居/离婚Separated/divorced	190(1.71)	45(2.31)	1.46(1.04~2.05)	0.029
未婚Not married	135(1.21)	43(2.21)	2.20(1.52~3.17)	< 0.001
家庭年收入/万元Annual household income/10 000 yuan
< 1	2 297(20.63)	370(19.02)	1.00
1~＜3	4 111(36.92)	687(35.32)	1.05(0.91~1.20)	0.533
≥3	4 726(42.45)	888(45.66)	1.21(1.05~1.38)	0.006
饮酒Alcohol consumption
不饮酒None	9 512(85.43)	1 358(69.82)	1.00
适量饮酒Moderate alcohol consumption	523(4.70)	161(8.28)	2.67(2.20~3.24)	< 0.001
过量饮酒Excessive alcohol consumption	1 099(9.87)	426(21.90)	3.80(3.32~4.35)	< 0.001
喝汤频率Frequency of drinking soup
基本不喝None	2 260(20.30)	458(23.55)	1.00
≤3次/月≤3 times/month	1 364(12.25)	248(12.75)	0.87(0.74~1.04)	0.125
1~2次/周1-2 times/week	2 042(18.34)	306(15.73)	0.69(0.59~0.81)	< 0.001
≥3次/周≥3 times/week	5 468(49.11)	933(47.97)	0.81(0.72~0.92)	< 0.001
高血压Hypertension
无病史且本次检测血压正常 Not being diagnosed as hypertension and the blood pressure was normal	6 860(61.61)	971(49.93)	1.00
无病史但本次检测收缩压≥140 mmHg和(或)舒张压≥90 mmHg Not being diagnosed as hypertension but systolic blood pressure ≥140 mmHg and (or) diastolic blood pressure ≥90 mmHg	2 547(22.88)	545(28.02)	1.65(1.47~1.86)	< 0.001
有高血压病史且正在治疗 Being diagnosed as hypertension and currently with medication	1 353(12.15)	327(16.81)	1.93(1.68~2.23)	< 0.001
有高血压病史但目前未治疗 Being diagnosed as hypertension but currently without medication	374(3.36)	102(5.24)	2.27(1.79~2.88)	< 0.001
冠心病Coronary heart disease
无No	11 005(98.84)	1 903(97.84)	1.00
有Yes	129(1.16)	42(2.16)	2.31(1.58~3.33)	< 0.001
脑卒中Stroke
无No	11 009(98.88)	1 915(98.46)	1.00
有Yes	125(1.12)	30(1.54)	1.50(0.98~2.24)	0.055
糖尿病Diabetes
无No	10 754(96.59)	1 859(95.58)	1.00
有Yes	380(3.41)	86(4.42)	1.40(1.09~1.78)	0.007
慢性肾脏病Chronic kidney disease
否No	10 462(93.96)	1 702(87.51)	1.00
是Yes	672(6.04)	243(12.49)	2.92(2.47~3.44)	< 0.001
肝功能Liver function
正常Normal	10 323(92.72)	1 690(86.89)	1.00
异常Abnormal	811(7.28)	255(13.11)	2.34(2.00~2.74)	< 0.001
血脂Dyslipidemia
正常Normal	7 817(70.21)	1 020(52.44)	1.00
异常Abnormal	3 317(29.79)	925(47.56)	2.58(2.33~2.85)	< 0.001
BMI
正常Normal weight	663(5.95)	56(2.88)	1.00
偏瘦Lose weight	5 709(51.28)	707(36.35)	0.65(0.49~0.87)	0.031
超重Overweight	3 682(33.07)	833(42.83)	2.07(1.85~2.31)	< 0.001
肥胖Obesity	1 080(9.70)	349(17.94)	3.38(2.91~3.92)	< 0.001
注：HUA，高尿酸血症。 ①以人数(占比/%)表示；②患HUA组与非HUA组相比的OR值。 Note: HUA, hyperuricemia. ① Number of people (proportion/%); ② OR value of HUA group compared with non-HUA group.

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表 2 研究对象14类食物的摄入频率

Table 2. Food intake frequency of the study population

食物类别 Food types	不吃/极少吃 Do not eat/rarely eat^①	≤3次/月 ≤3 times/month^①	1~2次/周 1-2 times/week^①	3~4次/周 3-4 times/week^①	5~6次/周 5-6 times/week^①	每天都吃 Eat every day^①
大米Rice	37(0.33)	16(0.14)	40(0.36)	21(0.19)	105(0.94)	10 915(98.03)
面食Cooked wheaten food	4 748(42.64)	3 071(27.58)	1 711(15.37)	802(7.20)	423(3.80)	379(3.40)
杂粮Grains	4 320(38.80)	3 777(33.93)	1 774(15.93)	627(5.63)	198(1.78)	438(3.93)
甜食Desserts	7 642(68.64)	2 162(19.42)	819(7.36)	333(2.99)	87(0.78)	91(0.82)
畜肉类及制品Livestock meat and its products	340(3.05)	653(5.86)	1 518(13.63)	2 051(18.42)	1 886(16.94)	4 686(42.09)
家禽及制品Poultry meat and its products	446(4.01)	1 689(15.17)	3 088(27.73)	2 721(24.44)	1 738(15.61)	1 452(13.04)
水产/海鲜品Aquatic/seafood products	1 674(15.04)	2 370(21.29)	3 425(30.76)	2 196(19.72)	960(8.62)	509(4.57)
蛋类及制品Eggs and its products	2 313(20.77)	2 477(22.25)	3 037(27.28)	1 802(16.18)	874(7.85)	631(5.67)
新鲜蔬菜Fresh vegetables	57(0.51)	117(1.05)	229(2.06)	265(2.38)	360(3.23)	10 106(90.77)
新鲜水果Fresh fruit	728(6.54)	1 576(14.15)	2 229(20.02)	1 862(16.72)	1 155(10.37)	3 584(32.19)
坚果类Nuts	5 686(51.07)	3 210(28.83)	1 330(11.95)	500(4.49)	177(1.59)	231(2.07)
腌制品Pickled products	6 415(57.62)	2 969(26.67)	1 058(9.50)	363(3.26)	144(1.29)	185(1.66)
乳类及制品Dairy and dairy product	8 460(75.98)	1 480(13.29)	570(5.12)	271(2.43)	109(0.98)	244(2.19)
凉茶/饮料类Herbal tea/beverage	8 077(72.54)	1 850(16.62)	665(5.97)	273(2.45)	111(1.00)	158(1.42)
注：①以人数(占比/%)表示。 Note: ① Number of people (proportion/%).

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表 3 广西壮族自治区35~74岁壮族居民4种饮食模式各类食物因子载荷

Table 3. Food factor loads of four dietary patterns of aged 35-74 years Zhuang Minority adults in Guangxi Zhuang Autonomous Region

食物类别 Food types	畜肉蔬果模式 Meat and vegetables and fruits dietary pattern	杂粮面食模式 Multigrain pasta dietary pattern	杂食模式 Omni- vorous dietary pattern	水产禽蛋模式 Aquatic and poultry and eggs dietary pattern	食物类别 Food types	畜肉蔬果模式 Meat and vegetables and fruits dietary pattern	杂粮面食模式 Multigrain pasta dietary pattern	杂食模式 Omni- vorous dietary pattern	水产禽蛋模式 Aquatic and poultry and eggs dietary pattern
大米Rice	0.084 5	-0.506 2	0.209 8	0.077 9	蛋类及制品Eggs and its products	-0.061 9	0.171 7	0.159 9	0.666 5
面食Cooked wheaten food	0.037 9	0.710 2	0.259 6	0.114 8	新鲜蔬菜Fresh vegetables	0.641 6	-0.131 9	-0.064 9	0.026 8
杂粮Grains	-0.006 2	0.740 0	0.177 3	0.096 6	新鲜水果Fresh fruit	0.430 9	0.035 5	0.237 5	0.315 9
甜食Desserts	-0.087 1	0.318 4	0.426 0	0.110 5	坚果类Nuts	-0.172 4	0.058 5	0.567 5	0.203 8
畜肉类及制品Livestock meat and its products	0.724 2	0.034 1	-0.024 5	0.058 2	腌制品Pickled products	-0.216 1	-0.162 1	0.538 7	0.209 1
家禽及制品Poultry meat and its products	0.312 5	0.017 6	-0.002 5	0.667 6	乳类及制品Dairy and dairy product	0.216 0	0.241 0	0.576 0	-0.011 1
水产/海鲜品Aquatic/seafood products	0.038 4	-0.041 6	0.047 3	0.795 6	凉茶/饮料类Herbal tea/beverage	0.225 5	0.020 1	0.635 7	-0.106 2

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表 4 广西壮族自治区35~74岁壮族居民HUA影响因素的多因素logistic回归分析

Table 4. Multivariate logistic regression analysis of factors influencing HUA in aged 35-74 years Zhuang Minority adults in Guangxi Zhuang Autonomous Region

变量Variable	β值 value	Wald χ² 值value	aOR值value (95% CI)	P值 value
性别Gender
女Female	1.00	1.00	1.00
男Male	1.61	541.77	5.03(4.39~5.76)	< 0.001
文化程度Education level
小学及以下Primary school or lower	1.00	1.00	1.00
初中Middle school	0.08	1.32	1.08(0.95~1.23)	0.250
高中Senior high school	0.23	7.46	1.26(1.07~1.48)	0.006
大专及以上College or above	0.47	11.53	1.59(1.22~2.08)	< 0.001
饮酒Alcohol consumption
不饮酒None	1.00	1.00	1.00
适量饮酒Moderate alcohol consumption	0.37	11.42	1.44(1.17~1.79)	< 0.001
过量饮酒Excessive alcohol consumption	0.56	51.11	1.74(1.50~2.03)	< 0.001
喝汤频率Frequency of drinking soup
基本不喝None	1.00	1.00	1.00
≤3次/月≤3 times/month	0.03	0.08	1.03(0.85~1.24)	0.779
1~2次/周1-2 times/week	-0.28	9.80	0.75(0.63~0.90)	0.002
≥3次/周≥3 times/week	-0.14	4.10	0.87(0.75~1.00)	0.043
高血压History of hypertension
无病史且本次检测血压正常Not being diagnosed as hypertension and the blood pressure was normal	1.00	1.00	1.00
无病史但本次检测收缩压≥140 mmHg和(或)舒张压≥90 mmHg Not being diagnosed as hypertension but systolic blood pressure ≥140 mmHg and (or) diastolic blood pressure ≥90 mmHg	0.18	7.74	1.20(1.06~1.37)	0.005
有高血压病史且正在治疗Being diagnosed as hypertension and currently with medication	0.38	20.09	1.46(1.23~1.72)	< 0.001
有高血压病史但目前未治疗Being diagnosed as hypertension but currently without medication	0.39	7.99	1.48(1.12~1.93)	0.005
冠心病Coronary heart disease
无No	1.00	1.00	1.00
有Yes	0.70	10.09	2.02(1.30~3.11)	0.001
慢性肾脏病Chronic kidney disease
否No	1.00	1.00	1.00
是Yes	0.86	78.13	2.37(1.96~2.87)	< 0.001
肝功能Liver function
正常Normal	1.00	1.00	1.00
异常Abnormal	0.36	15.90	1.44(1.20~1.71)	< 0.001
血脂Dyslipidemia
正常Normal	1.00	1.00	1.00
异常Abnormal	0.60	106.52	1.81(1.62~2.03)	< 0.001
BMI
正常Normal weight	1.00	1.00	1.00
偏瘦Lose weight	-0.30	3.93	0.74(0.54~0.99)	0.047
超重Overweight	0.65	109.16	1.92(1.70~2.17)	< 0.001
肥胖Obesity	1.14	168.58	3.13(2.64~3.72)	< 0.001
膳食模式Dietary pattern
杂粮面食模式Multigrain pasta dietary pattern	1.00	1.00	1.00
畜肉蔬果模式Meat and vegetables and fruits dietary pattern	0.03	0.12	1.03(0.87~1.21)	0.732
水产禽蛋模式Aquatic and poultry and eggs dietary pattern	-0.20	6.33	0.82(0.70~0.96)	0.012
杂食模式Omnivorous dietary pattern	-0.04	0.33	0.96(0.82~1.11)	0.566
注：HUA，高尿酸血症。 Note: HUA, hyperuricemia.

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参考文献(25)

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