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绝经前后血尿酸水平变化的队列研究

代巧云 吴寿岭 杨雪莹 陈朔华 曹宗富 张亚亚 马旭

代巧云, 吴寿岭, 杨雪莹, 陈朔华, 曹宗富, 张亚亚, 马旭. 绝经前后血尿酸水平变化的队列研究[J]. 中华疾病控制杂志, 2024, 28(1): 8-13. doi: 10.16462/j.cnki.zhjbkz.2024.01.002
引用本文: 代巧云, 吴寿岭, 杨雪莹, 陈朔华, 曹宗富, 张亚亚, 马旭. 绝经前后血尿酸水平变化的队列研究[J]. 中华疾病控制杂志, 2024, 28(1): 8-13. doi: 10.16462/j.cnki.zhjbkz.2024.01.002
DAI Qiaoyun, WU Shouling, YANG Xueying, CHEN Shuohua, CAO Zongfu, ZHANG Yaya, MA Xu. A cohort study on the changes of serum uric acid in the pre- and post-menopause[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(1): 8-13. doi: 10.16462/j.cnki.zhjbkz.2024.01.002
Citation: DAI Qiaoyun, WU Shouling, YANG Xueying, CHEN Shuohua, CAO Zongfu, ZHANG Yaya, MA Xu. A cohort study on the changes of serum uric acid in the pre- and post-menopause[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(1): 8-13. doi: 10.16462/j.cnki.zhjbkz.2024.01.002

绝经前后血尿酸水平变化的队列研究

doi: 10.16462/j.cnki.zhjbkz.2024.01.002
基金项目: 

国家科技资源共享服务平台项目 2005DKA21300

详细信息
    通讯作者:

    马旭,E-mail:maxubioinfo@163.com

  • 中图分类号: R173

A cohort study on the changes of serum uric acid in the pre- and post-menopause

Funds: 

National Science and Technology Resources Sharing Service Platform Project 2005DKA21300

More Information
  • 摘要:   目的  探讨绝经前后血尿酸(serum uric acid, SUA)水平变化。  方法  基于开滦体检队列,用线性和分段线性混合效应模型分析绝经前后SUA变化,并分析基线年龄和基线BMI分别与绝经前后时间分段的相乘交互作用。  结果  2006—2020年的7次体检共3 747例女性,共21 223人次体检记录被纳入分析。首次体检平均年龄为(46.19±4.11)岁,中位绝经年龄为51.00(50.00, 53.00)岁。与绝经前相比,绝经后SUA水平升高10.15 μmol/L。SUA从绝经前11年开始缓慢增加,平均年增长量为1.99 μmol/L;绝经前5~前2年每年平均增加3.30 μmol/L;SUA在绝经前后2年的平均年增长量为4.60 μmol/L;随后平均年增长量下降,在绝经5年后,平均年增长量降至1.77 μmol/L。基线年龄 < 40岁与绝经后2~ < 5年(Pinteraction=0.009)和绝经≥5年(Pinteraction < 0.001)的时间分段存在交互作用,基线年龄40~ < 45岁与绝经前后2年时间有交互作用(Pinteraction=0.033);除基线年龄 < 40岁对绝经2年后SUA变化有影响,其他基线年龄组SUA在绝经前后的变化一致。基线BMI与绝经前后各时间分段均无交互作用(均Pinteraction>0.05)。  结论  绝经对SUA有不良影响,中年女性在绝经前后应关注SUA水平,采取积极防控策略。
  • 图  1  不同基线年龄组(A)和不同基线BMI组(B)女性绝经前后SUA的分段线性混合效应模型拟合图

    SUA:血尿酸。

    Figure  1.  Fitting graph of piece-wise linear mixed effect model for SUA before and after menopause in women according to different baseline age groups (A) and baseline BMI groups (B)

    SUA: serum uric acid.

    表  1  研究队列信息

    Table  1.   The information of study cohort

    队列信息The information of cohort 第1次体检The first examination 第2次体检The second examination 第3次体检The third examination 第4次体检The fourth examination 第5次体检The fifth examination 第6次体检The sixth examination 第7次体检The seventh examination
    参加当次体检人数Number of participants in the current examination 3 746 3 160 3 340 3 229 2 948 2 901 3 080
    缺失当次体检人数Missing of participants in the current examination 0 586 406 517 798 845 666
    因SUA缺失而剔除的记录数Number of records excluded due to missing SUA 304 77 60 82 87 156 415
    纳入分析的记录数Number of records included in the analysis 3 442 3 083 3 280 3 147 2 861 2 745 2 665
    注:SUA, 血尿酸。
    Note: SUA, serum uric acid.
    下载: 导出CSV

    表  2  研究对象各次体检特征

    Table  2.   Characteristics of participants at each examination

    变量Variable 第1次体检The first examination 第2次体检The second examination 第3次体检The third examination 第4次体检The fourth examination 第5次体检The fifth examination 第6次体检The sixth examination 第7次体检The seventh examination
    记录数Records 3 442 3 083 3 280 3 147 2 861 2 745 2 665
    年龄/岁Age/years, x±s 46.19±4.11 47.73±4.59 49.45±4.68 51.71±4.68 53.82±4.76 56.42±4.56 57.89±4.49
    教育程度Education level
      高中以下 Below senior high school 2 392(69.53) 2 055(66.66) 2 202(67.13) 2 105(66.89) 1 926(67.58) 1 918(69.9) 1 769(66.43)
      高中及以上 Senior high school or above 1 048(30.47) 1 028(33.34) 1 078(32.87) 1 042(33.11) 924(32.42) 826(30.10) 894(33.57)
      缺失人数Missing 2 0 0 0 1 1 2
    基线吸烟状态 Baseline smoking status
      不吸烟No smoking 3 388(98.43) 3 033(98.38) 3 233(98.57) 3 099(98.47) 2 828(98.85) 2 707(98.62) 2 634(98.84)
      既往吸烟Previous smoking 9(0.26) 9(0.29) 8(0.24) 8(0.25) 6(0.21) 6(0.22) 6(0.23)
      当前吸烟Current smoking 45(1.31) 41(1.33) 39(1.19) 40(1.27) 27(0.94) 32(1.17) 25(0.94)
    饮酒状态Drinking status
      不饮酒 No drinking 3 203(93.06) 2 824(91.63) 3 100(94.51) 2 975(94.68) 2 700(94.41) 2 598(94.82) 2 511(94.47)
      偶尔饮酒 Occasional drinking 227(6.60) 246(7.98) 172(5.24) 152(4.84) 148(5.17) 128(4.67) 138(5.19)
      经常饮酒 Often drinking 12(0.35) 12(0.39) 8(0.24) 15(0.48) 12(0.42) 14(0.51) 9(0.34)
      缺失人数Missing 0 1 0 5 1 5 7
    体育锻炼Physical activity
      无 No 194(5.65) 550(17.90) 1 014(30.98) 1 003(31.96) 909(31.82) 806(29.50) 855(32.22)
      偶尔 Occasional 2 901(84.53) 1 941(63.18) 1 833(56.00) 1 786(56.92) 1 649(57.72) 1 619(59.26) 1 521(57.31)
      经常 Often 337(9.82) 581(18.91) 426(13.02) 349(11.12) 299(10.47) 307(11.24) 278(10.47)
      缺失人数Missing 10 11 7 9 4 13 11
    高血压Hypertension
      无 No 2 595(75.48) 2 281(74.03) 2 309(70.40) 2 099(66.72) 1 783(62.83) 1 635(59.67) 1 548(58.33)
      有 Yes 843(24.52) 800(25.97) 971(29.60) 1 047(33.28) 1 055(37.17) 1 105(40.33) 1 106(41.67)
      缺失人数Missing 4 2 0 1 23 5 11
    糖尿病Diabetes
      无 No 3 256(94.73) 2 854(92.66) 3 010(91.80) 2 801(89.20) 2 492(87.81) 2 347(85.84) 2 235(84.69)
      有 Yes 181(5.27) 226(7.34) 269(8.20) 339(10.80) 346(12.19) 387(14.16) 404(15.31)
      缺失人数Missing 5 3 1 7 23 11 26
    血脂异常Dyslipidemia
      无 No 2 554(74.20) 1 921(62.31) 1 985(60.54) 1 690(53.72) 1 446(50.65) 1 324(48.29) 1 144(42.93)
      有 Yes 888(25.80) 1 162(37.69) 1 294(39.46) 1 456(46.28) 1 409(49.35) 1 418(51.71) 1 521(57.07)
      缺失人数Missing 0 0 1 1 6 3 0
    BMI/(kg·m-2), x±s 24.61±3.39 24.51±3.32 24.78±3.34 24.82±3.29 24.81±3.21 24.86±3.35 24.84±3.37
    肌酐/(μmol·L-1) Creatinine /(μmol·L-1), x±s 78.35±23.19 71.99±20.38 67.36±18.22 64.97±18.68 61.05±28.87 59.36±17.22 59.32±14.63
    SUA/(μmol·L-1), x±s 229.89±63.49 239.38±65.97 244.32±64.68 258.78±69.77 271.14±69.75 280.67±71.32 285.03±70.84
    注:SUA, 血尿酸。
    ①以人数(占比%)表示。
    Note: SUA, serum uric acid.
    ① Number of people(proportion%).
    下载: 导出CSV

    表  3  与绝经相关的各时间分段内SUA的估计年度变化:分段线性混合效应模型的结果

    Table  3.   Estimated annual changes in SUA within each time segment in relation to final menstrual period: results of piece-wise linear mixed effect models

    变量Variable 粗模型Crude model 多变量调整模型 Multivariable adjustment model
    β值value (sx) P值value β值value (sx) P值value
    绝经相关时间分段Menopausal related time segments
      A. < -5年years 3.146(0.427) < 0.001 1.992(0.501) < 0.001
      B. -5~ < -2年years 4.362(0.554) < 0.001 3.304(0.617) < 0.001
      C. -2~ < 2年years 5.541(0.406) < 0.001 4.597(0.489) < 0.001
      D. 2~ < 5年years 4.408(0.523) < 0.001 3.652(0.598) < 0.001
      E. ≥5年years 2.564(0.364) < 0.001 1.771(0.448) < 0.001
    相邻时间分段比较Comparison of adjacent time segments
      A与B (A∶B) 0.155 0.134
      B与C (B∶C) 0.162 0.137
      C与D (C∶D) 0.168 0.268
      D与E (D∶E) 0.018 0.020
    注:①绝经相关时间分段,负值表示绝经前时间,正值表示绝经后时间; ②调整的变量包括基线文化程度、吸烟状态、时变的年龄、BMI、饮酒状态、体育锻炼、肌酐、高血压、糖尿病、血脂异常。
    Note: ① Menopausal related time segments, negative values represent premenopausal time, and positive values represent postmenopausal time; ②The adjusted variables included baseline of education level, smoking status, and time-varying age, BMI, drinking status, physical activity, creatinine, hypertension, diabetes, dyslipidemia.
    下载: 导出CSV
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  • 收稿日期:  2023-05-17
  • 修回日期:  2023-08-29
  • 网络出版日期:  2024-02-05
  • 刊出日期:  2024-01-10

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