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| 总能量与三大营养素摄入及变化对血尿酸水平的影响分析 |
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王云锋;田飞飞;文静;郭秀花;杨兴华;1,2
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1.首都医科大学公共卫生学院;2.临床流行病学北京市重点实验室
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| 摘要: |
| 目的基于纵向数据分析总能量、碳水化合物、脂肪、蛋白质摄入及变化情况对血尿酸水平和高尿酸血症(Hyperuricemia,HUA)患病影响,为HUA防治的膳食指导提供参考。方法利用全国营养与健康调查2006年至2009年数据,按纳入排除标准收集有膳食调查记录和血尿酸水平检测的对象,膳食调查采用24h膳食回顾询问法,每轮连续3d,分析采用单因素分析及多水平logistic回归分析。结果 (1)本研究共纳入对象4111例,其中男1871例,HUA患者361例,患病率为19.29%;女2240例,HUA患者194例,患病率为8.66%。(2)男性HUA患病率随年龄增长而下降;饮酒是男性HUA危险因素,且饮酒频率越高,风险越大[(OR=1.26,95%CI(1.08,1.48),P=0.004)];男性HUA患病率受膳食营养素影响相对较小,研究仅发现脂肪摄入大幅度增加是其危险因素[(OR=1.54,95%CI(1.05,2.27),P=0.017)],总能量及碳水化合物、蛋白质摄入及变化未发现有统计学意义。(3)女性HUA患病率随年龄增长而上升,受膳食影响相对较大,总能量摄入处于中等偏上水平(Q3)[(OR=0.57,95%CI(0.36,0.92),P=0.03)]、碳水化合物摄入较高(Q4)[(OR=0.45,95%CI(0.26,0.77),P=0.004)]、蛋白质摄入处于中等偏下水平(Q2)[(OR=0.54,95%CI(0.35,0.82),P=0.004)]患病风险最低;脂肪摄入增加幅度较大[(OR=1.70,95%CI(1.02,2.85),P=0.043)]和蛋白质摄入增加幅度较大[(OR=1.65,95%CI(1.00,2.73),P=0.050)]均是女性HUA的危险因素。结论在男性人群中,控制体重、减少饮酒频率,控制脂肪摄入增加幅度有利于降低HUA患病率;在女性人群中,控制体重,保持适量的蛋白质和较高比例的碳水化合物摄入,控制脂肪、蛋白质摄入增加的幅度有利于降低HUA患病率。 |
| 关键词: 血尿酸 高尿酸血症 膳食 能量 碳水化合物 脂肪 蛋白质 患病率 |
| DOI： |
| 分类号:R151.4； R917.74； R343 |
| 基金项目:北京市自然科学基金资助项目(编号:Z160002);北京市教委面上项(编号:KM201310025010);数据来源支持基金:NIH(R01-HD30880,DK056350,R24 HD050924和R01-HD38700) |
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| Effect of Total Energy and Three Major Nutrients Intake and Their Changes on Serum Uric Acid Level |
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Wang Yunfeng;Tian Feifei;Wen Jing1,2
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1.School of Public Health,Capital Medical University;2.Beijing Key Laboratory of Clinical Epidemiology
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| Abstract: |
| Objective Based on longitudinal data,the effects of total energy,carbohydrate,fat and protein intake as well as their changes on serum uric acid level and morbidity of hyperuricemia( HUA) were analyzed,to provide references for dietary guidance in the prevention and treatment of HUA. Methods Using the data of national nutrition and health survey from 2006 to2009,respondents with dietary survey records and serum uric acid determination were collected according to inclusion and exclusion criteria.24 h dietary review inquiry was adopted to undergo dietary survey,3 consecutive days for each turn,and single factor analysis as well as multilevel logistic regression analysis were adopted. Results A total of 4111 cases were included in this study,of which 1871 were male,361 with HUA,bringing a morbidity of 19. 29% and 2240 were females,194 with HUA,bringing a morbidity of 8. 66%.The HUA morbidity of males decreased with aging.Drinking was a risk factor of HUA for males,and the higher the frequency of drinking,the greater the risk[( OR = 1. 26,95%CI( 1. 08,1. 48),P = 0. 004) ].HUA morbidity of males was less likely to be influenced by dietary nutrients,and the only discovery was that greatly increasing fat intake was a risk factor[( OR = 1. 54,95%CI( 1. 05,2. 27),P = 0. 017) ],while there was no statistically significant findings in intake amount and changes of total energy,carbohydrates and protein.The HUA morbidity of females increased with aging,and are prone to be influenced by diet.Intermediate as well as slightly above level of total energy intake( Q3) [( OR = 0. 57,95% CI( 0. 36,0. 92),P = 0. 03) ],high level of carbohydrates intake( Q4) [( OR = 0. 45,95%CI( 0. 26,0. 77),P = 0. 004) ]and intermediate as well as slightly below level of protein intake( Q2) [( OR = 0. 54,95%CI( 0. 35,0. 82),P = 0. 004) ]resulted in low risk of disease.Great increase of fat[( OR = 1. 70,95%CI( 1. 02,2. 85),P = 0. 043) ]and protein[( OR = 1. 65,95% CI( 1. 00,2. 73),P = 0. 050) ]intake were both risk factors of HUA for females.Conclusion In the male population,controlling weight,decreasing frequency of drinking and controlling the increase of fat intake are beneficial to decrease the morbidity of HUA.In the female population,controlling weight,maintaining a moderate amount of protein and a high proportion of carbohydrate intake and controlling the increase of fat and protein intake will reduce the morbidity of HUA |
| Key words: blooduricacid hyperuricemia diet energy carbohydrates fat protein morbidity |
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