本文選題：HUA + 少數(shù)民族　； 參考：《貴陽醫(yī)學院》2015年碩士論文

【摘要】：目的:近年來隨著人們生活水平的日益提高、生活行為方式的不斷改變,高尿酸血癥(Hyperuricemia,HUA)的檢出率呈現(xiàn)逐年上升的趨勢。血尿酸水平升高不僅與痛風有關,還可能與血壓紊亂、血糖血脂代謝異常、腎功能異常等病癥有關。本課題通過探討少數(shù)民族成人HUA與代謝性疾病、飲食行為因素之間的關系,為少數(shù)民族地區(qū)HUA人群提供飲食指導、有效預防痛風及其并發(fā)癥的發(fā)生。通過研究血清炎癥因子白介素-1(IL-1)與HUA及其他代謝性疾病之間關系,為慢性病的預防控制提供科學指導。方法:采用隨機整群抽樣的方法收集貴州省黔南州都勻市兩所醫(yī)院2014年1月到2014年12月的體檢人群資料,獲得符合條件的體檢資料12808份,同期采用病例對照研究方法抽取符合HUA診斷標準的布依、苗族、漢族各100例作為病例組,在3個民族中分別抽取血尿酸水平正常者各100例作為對照組。對被調查對象進行問卷調查,收集基本信息、生活方式、飲食習慣、身體測量和生化指標等資料。采用酶聯(lián)免疫吸附試驗檢測病例對照研究對象血清中IL-1的含量。結果:(1)本次研究中共收集體檢人群資料12808份,HUA的有3081例,檢出率為24.06%。其中男性7837人,HUA有2701例,檢出率為34.47%;女性4971人,HUA的有380例,檢出率7.64%。男性HUA檢出率明顯高于女性,差異有統(tǒng)計學意義(χ2=1136.1,P=0.000)。(2)本次研究中男性與女性不同年齡段血尿酸水平表現(xiàn)為:女性血尿酸水平和HUA的檢出率隨年齡的增長而升高,而男性血尿酸水平未見隨年齡增長而升高的趨勢。(3)體檢人群中尿酸與各生化指標之間相關性分析顯示:舒張壓、甘油三酯、肌酐、體質指數(shù)、低密度脂蛋白與尿酸水平呈正相關關系,高密度脂蛋白、空腹血糖與血尿酸水平呈負相關關系。(4)體檢人群中HUA組SBP、DBP、BMI、BUN、CREA、TG、HDL、LDL、FPG水平與正常組之間差異有統(tǒng)計學意義(P0.05)。且HUA組高血壓、高血糖、超重或肥胖、高甘油三脂血癥的檢出率均高于正常組。(5)病例對照研究中HUA組與對照組相比:在布依族、苗族SUA、SBP、DBP、CHOL、TG、CREA、腹圍、BMI差異有統(tǒng)計學意義(P0.05);漢族SUA、DBP、CREA、CHOL、TG、BMI差異有統(tǒng)計學意義(P0.05)。(6)病例對照研究中人群血尿酸水平與各生化指標之間的相關分析顯示:肌酐、低密度脂蛋白、腹圍與尿酸水平呈正相關,空腹血糖、高密度脂蛋白與血尿酸水平呈負相關。(7)病例對照研究人群中既往病史比較顯示:布依族人群中與HUA相關的是高血壓、脂肪肝;苗族人群中為脂肪肝和痛風;漢族人群中為高脂血癥、脂肪肝、痛風。(8)病例組與對照組飲食生活比較顯示:高度酒的飲用量、啤酒飲用量(瓶)、在家用餐的頻率差異有統(tǒng)計學意義。(9)探究食物對血尿酸水平的影響,采用二分類Logistic回歸分析顯示,粗糧、動物內臟、河魚、奶類、紅酸湯、菌菇類、白酒與血尿酸水平之間存在相關性(P0.05)。(10)分民族對血尿酸水平和食物進行Logistic回歸分析顯示,布依族食用饅頭、紅酸湯、禽肉類、茶葉、白酒與血尿酸水平有關;苗族食用粗糧、蔬菜酸湯、動物內臟、奶類與血尿酸水平有關;漢族食用豆腐、紅酸湯、茶葉、紅酒、米酒、甜飲料與血尿酸水平有關(P0.05)。(11)食物按每月食用量進行比較分析可知:在布依族人群中,病例組與對照組之間食用饅頭、粗糧、動物內臟、海產品、紅酸湯、白酒差異有統(tǒng)計學意義;在苗族人群中,病例組人群在食用動物內臟、海產品、奶類、白酒、啤酒、米酒與對照組差異有統(tǒng)計學意義;在漢族人群中,病例組與對照組在食用粗糧、動物內臟、菌菇類、蔬菜酸湯、白酒、啤酒上差異有統(tǒng)計學意義(12)各民族HUA組與對照組IL-1水平差異有統(tǒng)計學意義。白介素-1(IL-1)與各生化指標相關性分析可知:IL-1水平與肌酐、尿酸、BMI呈正相關關系。結論:貴州省黔南州少數(shù)民族地區(qū)體檢人群的HUA檢出率較高,且男性明顯高于女性;HUA與高血壓、高甘油三脂等多項代謝異常均有相關性;在膳食因素中食用饅頭、粗糧、紅酸湯是HUA的保護因素。而食用禽肉類、動物內臟、白酒是HUA的危險因素。在引起血尿酸增高的食物中不同民族略有差異,布依族以動物內臟為主,苗族以飲用米酒為主,漢族以飲用白酒為主。HUA組的IL-1水平高于對照組,相關分析提示血尿酸水平對IL-1的影響力較強。
[Abstract]:Objective: in recent years, the detection rate of Hyperuricemia (HUA) is increasing year by year with the increasing living standard and the changing of life behavior. The increase of serum uric acid level is not only related to gout, but also may be related to the disorder of blood pressure, abnormal blood lipid metabolism and abnormal renal function. The relationship between HUA and metabolic diseases and dietary behavioural factors is explored to provide dietary guidance for the HUA population in ethnic minority areas to effectively prevent gout and its complications. The relationship between serum inflammatory factor interleukins -1 (IL-1) and HUA and other metabolic diseases is studied for the prevention and control of chronic diseases. Methods: a random cluster sampling method was used to collect the data of the physical examination population from January 2014 to December 2014 in Tuyun City, Qiannan, Guizhou Province, and obtain 12808 eligible physical examination data. In the same period, a case control study was used to extract the HUA diagnostic criteria of Buyi, Miao and Han 100 cases as cases. In the group, 100 cases of normal blood uric acid in 3 nationalities were selected as the control group. The subjects were investigated by questionnaires to collect basic information, lifestyle, dietary habits, body measurement and biochemical indexes. The content of IL-1 in the serum of the subjects was detected by enzyme linked immunosorbent assay. Results: (1) There were 12808 data collected by the Chinese Communist Party, 3081 cases of HUA, of which 7837 were male and 2701 in HUA, 2701 in HUA, 4971 in women and 380 in HUA, and the detection rate of 7.64%. was significantly higher than that of women. The difference was statistically significant (2). (2) male and female were not in this study. The level of uric acid in the same age group showed that the level of uric acid and the detection rate of HUA increased with age, but the level of uric acid in men did not increase with age. (3) the correlation between uric acid and biochemical indexes in the population of physical examination showed diastolic pressure, triglyceride, creatinine, body mass index, low density lipoprotein. There was a positive correlation with uric acid level, high density lipoprotein, fasting blood glucose and blood uric acid level negative correlation. (4) HUA group SBP, DBP, BMI, BUN, CREA, TG, HDL, LDL, FPG level and normal groups were statistically significant (P0.05). And HUA group hypertension, hyperglycemia, overweight or obesity, the detection rate of hyperglycemia three lipemia are all Higher than the normal group. (5) compared with the control group, the HUA group was compared with the control group: the SUA, SBP, DBP, CHOL, TG, CREA, abdominal circumference and BMI of the Miao nationality were statistically significant (P0.05); (6) the correlation analysis between the serum uric acid level and the biochemical indexes in the case control study. Creatinine, low density lipoprotein, abdominal circumference were positively correlated with uric acid level, fasting blood glucose, high density lipoprotein and blood uric acid levels were negatively correlated. (7) a comparison of previous cases in a case control study showed that the HUA associated with the Buyi population was hypertension, fatty liver, and the Hmong population was fatty liver and gout; the Han population was higher. Lipidemia, fatty liver, gout. (8) the comparison between the case group and the control group showed that the drinking quantity of high alcohol, the amount of beer drinking (bottle), the difference in the frequency of eating at home were statistically significant. (9) to explore the effect of food on the level of uric acid, and the two classification Logistic regression analysis showed that coarse grain, animal viscera, river fish, milk, red acid soup, and bacteria There is a correlation between mushroom and blood uric acid (P0.05). (10) Logistic regression analysis of blood uric acid level and food shows that Buyi people eat steamed bread, red acid soup, poultry, tea, liquor and blood uric acid level; the Miao people eat coarse grain, vegetable sour soup, animal viscera, milk and blood uric acid level; Han food With tofu, red acid soup, tea, red wine, rice wine, sweet drink and blood uric acid level (P0.05). (11) a comparative analysis of food consumption according to monthly consumption shows that in Buyi people, there is a significant difference between the case group and the control group for eating steamed bread, coarse grain, animal viscera, seafood, red acid soup and liquor. There were significant differences between the groups in the edible animal viscera, seafood, milk, liquor, beer, rice wine and the control group. In the Han population, there was significant difference between the case group and the control group in the food coarse grain, animal viscera, mushroom, vegetable sour soup, liquor and beer (12) the difference of IL-1 level between the HUA group and the control group was statistically significant. The correlation analysis of interleukin -1 (IL-1) and various biochemical indexes showed that the level of IL-1 was positively correlated with creatinine, uric acid and BMI. Conclusion: the detection rate of HUA in the physical examination population in the minority areas of Qiannan Prefecture of Guizhou province was higher, and the male was obviously higher than that of the female; the correlation between HUA and hypertension, hyperglycerin three fat and other metabolic abnormalities were correlated; Eating steamed bread, coarse grain and red acid soup are the protection factors of HUA. While eating poultry meat, animal viscera and liquor is a risk factor for HUA. There are some differences in different ethnic groups in the food causing the increase of blood uric acid. The Buyi people mainly have animal viscera, the Miao people take drinking rice wine as the main body, and the IL-1 level of the Han group in the group of drinking liquor mainly in the.HUA group is higher than the control group. Analysis showed that serum uric acid level had a strong influence on IL-1.

【學位授予單位】：貴陽醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R589.7

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