【摘要】 【目的】探讨高尿酸血症合并超重/肥胖人群相关危险/保护因素及高危体质。【方法】在回顾性横断面研究基础上，对2017～2018年两年间在广州中医药大学第二附属医院进行体检的2 661例健康人或患者进行筛选纳入。根据血尿酸（SUA）是否偏高及体质量指数（BMI）是否符合超重/肥胖标准，将受检人群分为H-O组613例、H-N组368例、N-O组457例和N-N组1 223例（H代表高尿酸血症、O代表超重/肥胖、N代表正常SUA或BMI）；并对221例受检者进行中医体质辨识，其中H-O组65例、H-N组51例、N-O组27例和N-N组78例。运用二元Logistic回归探讨H-O组人群的相关危险/保护因素及高危体质。【结果】（1）单因素分析结果显示：性别、年龄、BMI、身高、体质量、舒张压（DBP）、收缩压（SBP）、腰围、腰高比（WHtR）、合并症（胆囊息肉、脂肪肝、胆囊结石、肾结石）、血肌酐（SCr）、血清白蛋白（ALB）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、谷丙转氨酶（ALT）、谷草转氨酶（AST）、空腹血糖（FBG）等指标在H-O组与N-N组之间比较，差异均有统计学意义（P<0.05或P<0.001）。（2）二元Logistic回归分析显示：H-O组中HDL-C是保护因素，男性、肾结石、脂肪肝、DBP、TG、SCr可能是其独立危险因素。（3）中医体质分布方面，H-O组的高危偏颇体质主要是痰湿质、湿热质、气虚质3种体质或兼杂有之，其中最常见的是痰湿质，与平和质相比具有显著性差异（P<0.001）,OR值为43.750。【结论】高尿酸血症与超重/肥胖常相互影响病情及预后，重视高血压、血脂紊乱、肾功能不全等带来的风险应该贯穿于病前及疾病全程，肾结石、脂肪肝同样不容忽视；以纠正痰湿质等高危体质作为立足点的“未病先防”措施对高尿酸血症合并超重/肥胖的发生或许是有效的。更多还原

【Abstract】 Objective To explore the risk/protective factors and high-risk traditional Chinese medicine(TCM)constitution type in a population of hyperuricemia combined with overweight/obesity. Methods A retrospective cross-sectional study was carried out in 2 661 healthy individuals or patients who underwent physical examination at the Second Affiliated Hospital of Guangzhou University of Chinese Medicine from 2017 to 2018. With reference to the blood uric acid(SUA)level and the body mass index(BMI),the subjects were divided into the HO group(613 cases),H-N group(368 cases),N-O group(457 cases)and N-N group(1 223 cases). Here,“H”referred to hyperuricemia,“O”referred to overweight/obesity, and“N”referred to normal SUA or BMI.Furthermore,Chinese medicine(TCM)body constitution identification was conducted in a total of 221 subjects,65 cases from the H-O group,51 cases from the H-N group,27 cases from the N-O group and 78 cases from the N-N group. Binary logistic regression was used to explore the risk/protective factors and high-risk constitution type of the H-O group. Results (1)The results of the univariate analysis showed that statistically significant differences were shown in the gender,age,BMI,body height,body mass,diastolic blood pressure(DBP),systolic blood pressure(SBP),waist circumference,waist-to-height ratio(WHtR),comorbidities(gallbladder polyps,fatty liver, gallbladder stones, kidney stones), serum creatinine(SCr), serum albumin(ALB), total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),alanine transferase(ALT),aspartate transferase(AST)and fasting blood glucose(FBG)between the H-O group and N-N group(P<0.05 or P<0.001).(2)Binary logistic regression analysis showed that HDL-C was a protective factor for the H-O group,and male,kidney stones,fatty liver,DBP,TG and SCr might be the independent risk factors for the H-O group.(3)The high-risk biased constitution types in the H-O group were phlegm-damp constitution,damp-heat constitution and qi deficiency constitution or a combination of them,and the most common constitution type was phlegm-damp constitution,which differed from the balanced constitution(P<0.001), with the OR being 43.750. Conclusion Hyperuricemia and overweight/obesity often interact with each other in terms of illness and prognosis. The risks associated with hypertension, dyslipidaemia and renal insufficiency should be taken into account before illness and throughout the course of the disease,so do the risks of renal calculi and fatty liver. Preventive-treatment measures based on the correction of high-risk body constitution types such as phlegm-damp constitution may be effective on preventing the development of hyperuricaemia combined with overweight/obesity.更多还原