Arthritis Care Res:体重指数(BMI)越高 痛风发病率越高
2013-01-09 Arthritis Care Res dxy
BMI指数越高的组,其痛风发作相对风险也越高 美国一般人群中的痛风发病率逐渐增高,且与肥胖的发生率相关。而通过体重指数(BMI)分组以明确体重与痛风发作风险之间相关性的研究仍较少。针对这一问题,来自约翰霍普金斯大学公共卫生学院STEPHEN P博士等人进行了一项研究,研究结果发表于2013年1月的《关节炎治疗与研究》(Arthritis Care&
BMI指数越高的组,其痛风发作相对风险也越高
美国一般人群中的痛风发病率逐渐增高,且与肥胖的发生率相关。而通过体重指数(BMI)分组以明确体重与痛风发作风险之间相关性的研究仍较少。针对这一问题,来自约翰霍普金斯大学公共卫生学院STEPHEN P博士等人进行了一项研究,研究结果发表于2013年1月的《关节炎治疗与研究》(Arthritis Care & Res)杂志上。研究认为BMI指数越高的组,其痛风发作相对风险也越高。故卫生保健从业者应对超重及肥胖成年人增加的痛风发病率引起重视。
研究中的参与者(年龄均≥20岁)来自于1988-1994和2007-2010年间的全国健康营养调查,痛风由对医师诊断的个人报告进行确定。体重指数(BMI)分为以下几组:<18.5kg/m2,18.5-24.9kg/m2,25-29.9kg/m2,30-34.9kg/m2,≥35kg/m2,并作为连续变量纳入评估。BMI各组与痛风之间横断面相关性经人口统计学和肥胖相关疾病进行调整。
研究发现,美国人群中,痛风的粗发病率在正常BMI(18.5-24.9kg/m2)的参与者中为1-2%,在超重的参与者中为3%,在Ⅰ度肥胖的参与者中为4-5%,在Ⅱ度或Ⅲ度的肥胖参与者中为5-7%。在1988-1944年间的全国健康营养调查中,最高BMI组调整后的痛风发病率是正常BMI组的2.46倍(95%可信区间[95%CI] 1.44-4.21),而在2007-2010年间的调查中,这一数值为2.21(95%CI 1.50-3.26)。值得注意的是,随BMI分组的不断升高,其痛风发病率的相关性也逐渐增高。在两个研究的观察期中发现,美国成年人的平均升高为1.76米(5英尺9英寸),每增加1个单位的BMI,即3.1kg(6.8磅),即使经过血清尿酸值的调整,其痛风的发病率仍增加5%(p <0.001)。
通过对非西班牙裔白种人,非西班牙裔黑种人及墨西哥裔美国人的调查发现,BMI指数越高,其痛风发作相对风险也越高,故卫生保健从业者应当对来源于超重及肥胖的美国成年人的逐渐升高的痛风负担提起重视。
Body mass index, obesity, and prevalent gout in the United States in 1988-1994 and 2007-2010.
Objective
To determine the association and prevalence of gout among overweight, obese, and morbidly obese segments of the US population.
Methods
Among participants (age ≥20 years) of the National Health and Nutrition Examination Surveys in 1988–1994 and 2007–2010, gout status was ascertained by self-report of a physician diagnosis. Body mass index (BMI) was examined in categories of <18.5 kg/m2, 18.5–24.9 kg/m2, 25–29.9 kg/m2, 30–34.9 kg/m2, and ≥35 kg/m2and as a continuous variable. The cross-sectional association of BMI category with gout status was adjusted for demographic and obesity-related medical disorders.
Results
In the US, the crude prevalence of gout was 1–2% among participants with a normal BMI (18.5–24.9 kg/m2), 3% among overweight participants, 4–5% with class I obesity, and 5–7% with class II or class III obesity. The adjusted prevalence ratio comparing the highest to a normal BMI category was 2.46 (95% confidence interval [95% CI] 1.44–4.21) in 1988–1994 and 2.21 (95% CI 1.50–3.26) in 2007–2010. Notably, there was a progressively greater prevalence ratio of gout associated with successively higher categories of BMI. In both survey periods, for an average American adult standing 1.76 meters (5 feet 9 inches), a 1-unit higher BMI, corresponding to 3.1 kg (∼6.8 pounds) greater weight, was associated with a 5% greater prevalence of gout, even after adjusting for serum uric acid (P < 0.001).
Conclusion
Health care providers should be aware of the elevated burden of gout among both overweight and obese adults, applicable to both women and men, and observed among non-Hispanic whites, non-Hispanic African Americans, and Mexican Americans in the US.
作者:Arthritis Care Res
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