Sự liên kết giữa hyperuricemia và các chỉ số béo phì không truyền thống

Clinical Rheumatology - Tập 38 - Trang 1055-1062 - 2018
Xing Zhen Liu1, Hui Hua Li2, Shan Huang2, Dong Bao Zhao3
1Army Convalescence Area, Hangzhou Sanatorium of People’s Liberation Army, Hangzhou, China
2Department of Endocrinology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
3Department of Rheumatology, Changhai Hospital, Naval Military Medical University (The Second Military Medical University), Shanghai, China

Tóm tắt

Sự liên kết giữa một số chỉ số béo phì mới và hyperuricemia chưa rõ ràng. Do đó, chúng tôi nhằm điều tra sự liên kết này để cung cấp hỗ trợ lý thuyết cho việc quản lý hyperuricemia ở những người thừa cân/béo phì. Một nghiên cứu cắt ngang được thực hiện trên 174.698 người lớn. Các giá trị chỉ số béo phì cơ thể (BAI), chỉ số hình dáng (CI), chỉ số hình dạng cơ thể (ABSI), chỉ số tròn của cơ thể (BRI), chỉ số béo phì nội tạng (VAI), chỉ số tích lũy lipid (LAP) và chỉ số tim mạch chuyển hóa (CMI) đã được chia thành bốn tứ phân vị, và phân tích logistic đa biến được sử dụng để phân tích sự liên kết giữa chúng và hyperuricemia. Đường cong nhận diện đặc trưng và diện tích bên dưới đường cong (AUC) được sử dụng để đánh giá khả năng dự đoán cho hyperuricemia. Sau khi điều chỉnh cho các biến gây nhiễu, LAP và CMI cho thấy sự liên kết mạnh hơn với hyperuricemia so với các chỉ số khác. Tỷ lệ odds (OR) cho hyperuricemia trong tứ phân vị cao nhất của LAP và CMI lần lượt là 2.049 (CI 95% = 1.824–2.302) và 4.332 (CI 95% = 3.938–4.765). Giá trị AUC của LAP là 0.632 (95% CI = 0.626–0.637), p < 0.001; và giá trị AUC của CMI là 0.687 (95% CI = 0.682–0.692), p < 0.001. Giá trị cắt nhọn tối ưu của LAP và CMI lần lượt là 26.21 và 0.485. LAP và CMI, kết hợp giữa vòng eo và các thông số lipid và các chỉ số béo phì nội tạng đáng tin cậy, có mối liên kết chặt chẽ với hyperuricemia hơn các chỉ số khác. Vì vậy, chúng có thể là những chỉ số theo dõi tiềm năng cho việc quản lý hyperuricemia ở những người thừa cân/béo phì.

Từ khóa

#hyperuricemia #chỉ số béo phì #thừa cân #nghiên cứu cắt ngang #sức khỏe tim mạch

Tài liệu tham khảo

Kawada T (2018) Hyperuricaemia and type 2 diabetes mellitus. Clin Exp Pharmacol Physiol 45(8):870 von Lueder TG, Girerd N, Atar D, Agewall S, Lamiral Z, Kanbay M et al (2015) High-risk myocardial infarction database initiative investigators. Serum uric acid is associated with mortality and heart failure hospitalizations in patients with complicated myocardial infarction: findings from the high-risk myocardial infarction database initiative. Eur J Heart Fail 17(11):1144–1151 Peng TC, Wang CC, Kao TW, Chan JY, Yang YH, Chang YW et al (2015) Relationship between hyperuricemia and lipid profiles in US adults. Biomed Res Int 2015:127596 Qaseem A, Harris RP, Forciea MA, Clinical Guidelines Committee of the American College of Physicians (2017) Management of acute and recurrent gout: a clinical practice guideline from the American College of Physicians. Ann Intern Med 166(1):58–68 Hamburger M, Baraf HS, Adamson TC, Basile J, Bass L, Cole B et al (2011) 2011 recommendations for the diagnosis and management of gout and hyperuricemia. Phys Sportsmed 39(4):98–123 Nevill AM, Stewart AD, Olds T, Holder R (2006) Relationship between adiposity and body size reveals limitations of BMI. Am J Phys Anthropol 129(1):151–156 Bray GA, Smith SR, de Jonge L, Xie H, Rood J, Martin CK et al (2012) Effect of dietary protein content on weight gain, energy expenditure, and body composition during overeating: a randomized controlled trial. JAMA 307(1):47–55 Gu Z, Li D, He H, Wang J, Hu X, Zhang P et al (2018) Body mass index, waist circumference, and waist-to-height ratio for prediction of multiple metabolic risk factors in Chinese elderly population. Sci Rep 8(1):385 Yamada A, Sato KK, Kinuhata S, Uehara S, Endo G, Hikita Y et al (2016) Association of visceral fat and liver fat with hyperuricemia. Arthritis Care Res (Hoboken) 68(4):553–561 Wang H, Sun Y, Wang S, Qian H, Jia P, Chen Y et al (2018 May 16) Body adiposity index, lipid accumulation product, and cardiometabolic index reveal the contribution of adiposity phenotypes in the risk of hyperuricemia among Chinese rural population. Clin Rheumatol. https://doi.org/10.1007/s10067-018-4143-x. Gu D, Ding Y, Zhao Y, Miao S, Qu Q (2018) Positively increased visceral adiposity index in hyperuricemia free of metabolic syndrome. Lipids Health Dis 17(1):101 Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF, Feldman HI et al (2009) A new equation to estimate glomerular filtration rate. Ann Intern Med 150(9):604–612 Ting K, Gill TK, Keen H, Tucker GR, Hill CL (2016) Prevalence and associations of gout and hyperuricaemia: results from an Australian population-based study. Intern Med J 46(5):566–573 Zhu Y, Pandya BJ, Choi HK (2011) Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008. Arthritis Rheum 63(10):3136–3141 Kumar AU, Browne LD, Li X, Adeeb F, Perez-Ruiz F, Fraser AD et al (2018) Temporal trends in hyperuricaemia in the Irish health system from 2006-2014: a cohort study. PLoS One 13(5):e0198197 Lai SW, Tan CK, Ng KC (2000) Epidemiology of hyperglycemia in elderly persons. J Gerontol A Biol Sci Med Sci 55(5):M257–M259 Liu H, Zhang XM, Wang YL, Liu BC (2014) Prevalence of hyperuricemia among Chinese adults: a national cross-sectional survey using multistage, stratified sampling. J Nephrol 27(6):653–658 Yang X, Xiao Y, Liu K, Jiao X, Lin X, Wang Y et al (2018) Prevalence of hyperuricemia among the Chinese population of the southeast coastal region and association with single nucleotide polymorphisms in urate-anion exchanger genes: SLC22A12, ABCG2 and SLC2A9. Mol Med Rep 18(3):3050–3058 Chen JH, Pan WH, Hsu CC, Yeh WT, Chuang SY, Chen PY et al (2013) Impact of obesity and hypertriglyceridemia on gout development with or without hyperuricemia: a prospective study. Arthritis Care Res (Hoboken). 65(1):133–140 You L, Liu A, Wuyun G, Wu H, Wang P (2014) Prevalence of hyperuricemia and the relationship between serum uric acid and metabolic syndrome in the Asian Mongolian area. J Atheroscler Thromb 21(4):355–365 Bergman RN, Stefanovski D, Buchanan TA, Sumner AE, Reynolds JC, Sebring NG et al (2011) A better index of body adiposity. Obesity (Silver Spring) 19(5):1083–1089 Marcadenti A, Fuchs FD, Moreira LB, Gus M, Fuchs SC (2017) Adiposity phenotypes are associated with type-2 diabetes: LAP index, body adiposity index, and neck circumference. Atherosclerosis 266:145–150 Rost S, Freuer D, Peters A, Thorand B, Holle R, Linseisen J et al (2018) New indexes of body fat distribution and sex-specific risk of total and cause-specific mortality: a prospective cohort study. BMC Public Health 18(1):427 Bowman K, Atkins JL, Delgado J, Kos K, Kuchel GA, Ble A et al (2017) Central adiposity and the overweight risk paradox in aging: follow-up of 130,473 UK Biobank participants. Am J Clin Nutr 106(1):130–135 Zhang J, Fang L, Qiu L, Huang L, Zhu W, Yu Y (2017) Comparison of the ability to identify arterial stiffness between two new anthropometric indices and classical obesity indices in Chinese adults. Atherosclerosis 263:263–271 Chen X, Liu Y, Sun X, Yin Z, Li H, Deng K et al (2018) Comparison of body mass index, waist circumference, conicity index, and waist-to-height ratio for predicting incidence of hypertension: the rural Chinese cohort study. J Hum Hypertens 32(3):228–235 Kim TH, Lee SS, Yoo JH, Kim SR, Yoo SJ, Song HC et al (2012) The relationship between the regional abdominal adipose tissue distribution and the serum uric acid levels in people with type 2 diabetes mellitus. Diabetol Metab Syndr 4(1):3 Britton KA, Fox CS (2011) Ectopic fat depots and cardiovascular disease. Circulation 124(24):e837–e841 Takahashi S, Yamamoto T, Tsutsumi Z, Moriwaki Y, Yamakita J, Higashino K (1997) Close correlation between visceral fat accumulation and uric acid metabolism in healthy men. Metabolism 46(10):1162–1165 Hikita M, Ohno I, Mori Y, Ichida K, Yokose T, Hosoya T (2007) Relationship between hyperuricemia and body fat distribution. Intern Med 46(17):1353–1358 Janghorbani M, Aminorroaya A, Amini M (2017) Comparison of different obesity indices for predicting incident hypertension. High Blood Press Cardiovasc Prev 24(2):157–166 Wakabayashi I, Daimon T (2015) The “cardiometabolic index” as a new marker determined by adiposity and blood lipids for discrimination of diabetes mellitus. Clin Chim Acta 438:274–278 Krajcoviechova A, Tremblay J, Wohlfahrt P, Bruthans J, Tahir MR, Hamet P et al (2016) The impact of blood pressure and visceral adiposity on the association of serum uric acid with albuminuria in adults without full metabolic syndrome. Am J Hypertens 29(12):1335–1342 Dong H, Xu Y, Zhang X, Tian S (2017) Visceral adiposity index is strongly associated with hyperuricemia independently of metabolic health and obesity phenotypes. Sci Rep 7(1):8822 Facchini F, Chen YD, Hollenbeck CB, Reaven GM (1991) Relationship between resistance to insulin-mediated glucose uptake, urinary uric acid clearance, and plasma uric acid concentration. JAMA 266(21):3008–3011 Seyed-Sadjadi N, Berg J, Bilgin AA, Grant R (2017) Visceral fat mass: is it the link between uric acid and diabetes risk? Lipids Health Dis 16(1):142 Dessein PH, Shipton EA, Stanwix AE, Joffe BI, Ramokgadi J (2000) Beneficial effects of weight loss associated with moderate calorie/carbohydrate restriction, and increased proportional intake of protein and unsaturated fat on serum urate and lipoprotein levels in gout: a pilot study. Ann Rheum Dis 59(7):539–543 Fan J, Xu JH, Wang J, Wang GZ, Zhang YQ, Liu XZ (2014) Effects of laparoscopic adjustable gastric banding on weight loss, metabolism, and obesity-related comorbidities: 5-year results in China. Obes Surg 24(6):891–896 Richette P, Doherty M, Pascual E, Barskova V, Becce F et al (2017) Castañeda-Sanabria J, 2016 updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis 76(1):29–42 Dalbeth N, Bardin T, Doherty M, Lioté F, Richette P, Saag KG et al (2017) Discordant American College of Physicians and international rheumatology guidelines for gout management: consensus statement of the Gout, Hyperuricemia and Crystal-Associated Disease Network (G-CAN). Nat Rev Rheumatol 13(9):561–568 Nielsen SM, Bartels EM, Henriksen M, Wæhrens EE, Gudbergsen H, Bliddal H et al (2017) Weight loss for overweight and obese individuals with gout: a systematic review of longitudinal studies. Ann Rheum Dis 76(11):1870–1882 Deurenberg P, Deurenberg-Yap M, Guricci S (2002) Asians are different from Caucasians and from each other in their body mass index/body fat per cent relationship. Obes Rev 3(3):141–146