| 15 | 0 | 4 |
| 下载次数 | 被引频次 | 阅读次数 |
目的 分析肥胖儿童血尿酸水平及与维生素D水平的相关性。方法 选取2018年7月至2023年7月行健康体检的1 204例肥胖儿童纳入观察组，并选取同期性别年龄匹配的体检健康儿童1 204例纳入对照组，比较观察组和对照组儿童血尿酸水平及维生素D水平。再根据观察组儿童血尿酸水平分为高尿酸组178例与尿酸正常组1 026例，比较2组儿童一般资料。采用多因素logistic回归模型分析肥胖儿童发生高尿酸血症的影响因素，利用Pearson相关性分析肥胖儿童血尿酸与维生素D水平的关系。结果 观察组血尿酸水平显著高于对照组，25-羟维生素D[25(OH)D]水平显著低于对照组（P<0.01）。高尿酸组25(OH)D、高密度脂蛋白（HDL）水平显著低于尿酸正常组，三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白（LDL）水平显著高于尿酸正常组（P<0.01）。多因素logistic回归分析结果显示，血清25(OH)D、TG、TC、HDL、LDL水平是肥胖儿童发生高尿酸血症的影响因素（P<0.05,P<0.01）。肥胖儿童血尿酸与25(OH)D水平呈负相关性（r=-0.334,P<0.01）。结论 肥胖儿童血尿酸水平升高、维生素D水平下降，维生素D水平是肥胖儿童发生高尿酸血症的影响因素，且肥胖儿童血尿酸与维生素D水平呈负相关性。
Abstract：Objective To investigate the distribution of serum uric acid levels in obese children and its correlation with vitamin D levels. Methods A total of 1 204 obese children who underwent physical examination from July 2018 to July 2023 were selected as the observation group, and 1 204 gender and age matched healthy children who underwent physical examination during the same period were selected as the control group. The levels of serum uric acid and vitamin D were compared between the observation group and the control group. According to the level of serum uric acid, the children in the observation group were divided into a high uric acid group(n=178) and a normal uric acid group(n=1 026). The general data of the two groups were compared. Multivariate logistic regression model was used to analyze the influencing factors of hyperuricemia in obese children, and Pearson correlation analysis was used to analyze the relationship between serum uric acid level and vitamin D level in obese children. Results The level of serum uric acid in the observation group was significantly higher than that in the control group, while the level of 25-hydroxyvitamin D[25(OH) D] was significantly lower than that in the control group(P<0.01). The levels of 25(OH) D and high-density lipoprotein(HDL) in the high uric acid group were significantly lower than those in the control group, while the levels of triglyceride(TG),total cholesterol(TC), and low-density lipoprotein(LDL) were significantly higher than those in the control group(P<0.01).Multivariate logistic regression analysis showed that serum 25(OH) D, TG, TC, HDL, and LDL levels were the influencing factors for hyperuricemia in obese children(P<0.05 or P<0.01). There was a negative correlation between serum uric acid level and 25(OH) D level in obese children(r=-0.334, P<0.01). Conclusion The level of serum uric acid is increased and the level of vitamin D is decreased in obese children. The level of vitamin D is an influencing factor of hyperuricemia in obese children, and the level of serum uric acid is negatively correlated with the level of vitamin D in obese children.
[1]李自栋,贺亚楠,钱帅伟,等.肥胖青少年血尿酸水平特点及其与代谢指标的相关性研究[J].公共卫生与预防医学,2023,34(2):87-91.
[2]赵越.超重/肥胖与动脉粥样硬化发生的研究进展[J].公共卫生与预防医学,2024,35(1):129-132.
[3]MORADKHANI A, AZAMI M, ASSADI S, et al. Association of vitamin D receptor genetic polymorphisms with the risk of infertility:a systematic review and meta-analysis[J].BMC Pregnancy Childbirth, 2024,24(1):398.
[4]LAI C H, HUANG R J, WONG J K, et al. Confounded by obesity and modulated by urinary uric acid excretion, sleep-disordered breathing indirectly relates to hyperuricaemia in males:a structural equation model[J].J Sleep Res, 2021,30(3):e13108.
[5]LIN H, XU J, TENG C. Correlation between remnant cholesterol and hyperuricemia in patients with type 2 diabetes mellitus:a cross-sectional study[J].Lipids Health Dis, 2024,23(1):155.
[6]李辉,季成叶,宗心南,等.中国0~18岁儿童、青少年体块指数的生长曲线[J].中华儿科杂志,2009,47(7):493-498.
[7]符榕,张明英,边乐,等.肥胖儿童血尿酸水平与胰岛素抵抗相关性研究[J].中国实验诊断学,2021,25(7):971-974.
[8]LóPEZ-GIL J F, EZZATVAR Y, OJEDA-RODRíGUEZ A, et al.Is family meal frequency associated with obesity in children and adolescents? A cross-sectional study including 155 451 participants from 43 countries[J].Pediatr Obes, 2024,19(8):e13124.
[9]ZHANG P P, WANG Y X, GU J Y, et al. Cardiorespiratory fitness attenuates the association between fatness and cardiometabolic risk in Chinese children[J].Front Endocrinol(Lausanne), 2024,15:1361447.
[10]刘瑞萍,陈阳,武海滨,等.肥胖症儿童脂溶性维生素A、D、E水平及其影响因素[J].中国当代儿科杂志,2022,24(5):572-578.
[11]刘连琴,李磊,吕艳关.肥胖儿童维生素D缺乏与心血管及代谢紊乱危险因素的关系[J].实用临床医药杂志,2022,26(3):68-71,75.
[12]彭倩.维生素D补充结合童趣化膳食管理对肥胖患儿体质量及糖脂代谢的影响[J].保健医学研究与实践,2022,19(11):29-32.
[13]ZONG X, KELISHADI R, KIM H S, et al. Utility of waist-to-height ratio, waist circumference and body mass index in predicting clustered cardiometabolic risk factors and subclinical vascular phenotypes in children and adolescents:a pooled analysis of individual data from 14countries[J].Diabetes Metab Syndr, 2024,18(5):103042.
[14]RAO J, YE P, LU J, et al. Prevalence and related factors of hyperuricaemia in Chinese children and adolescents:a pooled analysis of 11 population-based studies[J].Ann Med, 2022,54(1):1608-1615.
[15]NOORI S, MIRZABABAEI A, AMINI M R, et al. Effect of orlistat on serum uric acid level in adults:a systematic review and meta-analysis of randomised controlled trials[J].Int J Clin Pract,2021,75(11):e14674.
[16]马佳,邓洁,杨莉,等.肥胖及糖尿病前期并发高尿酸血症患者血清内皮/炎性因子表达水平相关性[J].疑难病杂志,2022,21(4):394-398,409.
[17]王君,席新龙,赵棉.尿酸与冠心病、血压、血脂及体重指数的相关性研究[J].陕西医学杂志,2018,47(8):1032-1035.
[18]EBRAHIMPOUR-KOUJAN S, SANEEI P, LARIJANI B, et al.Consumption of sugar-sweetened beverages and serum uric acid concentrations:a systematic review and meta-analysis[J].J Hum Nutr Diet, 2021,34(2):305-313.
[19]唐露,胡丽平,李情姣,等.晨间限时进食法对超重/肥胖多囊卵巢综合征患者维生素D及糖脂代谢的影响[J].实用临床医药杂志,2023,27(18):127-132.
[20]付丽,王婷婷,丁蕾蕾,等.不同肥胖和代谢状态与高尿酸血症的相关性[J].中国医刊,2024,59(9):1022-1025.
[21]PARK C Y, HAN S N. Vitamin D and obesity[J].Adv Food Nutr Res, 2024,109:221-247.
[22]虎静,樊雨曦,杜婧.老年超重或肥胖男性体检人群正常血尿酸水平对腰椎骨密度的影响[J].中国骨质疏松杂志,2024,30(10):1438-1443.
[23]何英骁,刘振杰,熊莉华.维生素D缺乏腹型肥胖患者中医证型探讨及其生活习惯特点研究[J].新中医,2024,56(22):68-74.
[24]杨瑞香,黄丽娥,施雅丽,等.骨质疏松症合并高尿酸血症患者维生素D水平与骨代谢、血尿酸的关系[J].中国骨质疏松杂志,2021,27(2):244-247.
[25]BENNOUR I, HAROUN N, SICARD F, et al. Vitamin D and obesity/adiposity:a brief overview of recent studies[J].Nutrients,2022,14(10):2049.
[26]COPUR S, DEMIRAY A, KANBAY M. Uric acid in metabolic syndrome:does uric acid have a definitive role?[J].Eur J Intern Med, 2022,103:4-12.
[27]GU J, YUE H, WANG C, et al. Vitamin D pathway gene variation rs3740165 is associated with serological uric acid levels in healthy Chinese women[J].Front Endocrinol(Lausanne), 2022,13:1059964.
[28]ZHANG Z, HE J W, FU W Z, et al. An analysis of the association between the vitamin D pathway and serum 25-hydroxyvitamin D levels in a healthy Chinese population[J].J Bone Miner Res,2013,28(8):1784-1792.
[29]王颖捷,程昊然,周卫红.体脂成分及代谢指标与非肥胖人群代谢相关脂肪性肝病的相关性研究[J].中国全科医学,2023,26(6):672-680.
[30]TROGKANIS E, KARALEXI M A, SERGENTANIS T N, et al.Safety and efficacy of the consumption of the nutraceutical"red yeast rice extract"for the reduction of hypercholesterolemia in humans:a systematic review and meta-analysis[J].Nutrients,2024,16(10):1453.
[31]CAI L, HUANG Y, LI X, et al. Effects of dietary intervention on diabetic nephropathy:an umbrella review of systematic reviews and meta-analyses of randomized controlled trials[J].Front Endocrinol(Lausanne), 2024,15:1385872.
[32]LIU Y, WANG X, FANG Z. Evaluating the impact of exercise on intermediate disease markers in overweight and obese individuals through a network meta-analysis of randomized controlled trials[J].Sci Rep, 2024,14(1):12137.
[33]缪淑贤,卢英.血清尿酸水平升高对高甘油三酯血症的影响[J].南京医科大学学报（自然科学版）,2024,44(12):1702-1707.
[34]ALFAQIH M A, ABABNEH E, MHEDAT K, et al. Vitamin D reduces the activity of adenosine deaminase and oxidative stress in patients with type two diabetes mellitus[J].Mol Nutr Food Res,2024,68(12):e2300870.
[35]杨耀堂,孙绪敏,于德娟.维生素D3通过调控AMPK/mTOR信号通路对糖尿病肾病肾小管上皮细胞转分化的影响[J].中国中西医结合肾病杂志,2023,24(2):144-147.
[36]吴伊凡,张茜,肖新华.孕妇维生素D缺乏对子代肥胖影响的研究进展[J].中国研究型医院,2023,10(1):53-58.
[37]隋小芳,王娜,王凤玲,等.25羟维生素D与原发性高血压合并高尿酸血症的相关性研究[J].中国实验诊断学,2023,27(8):915-918.
[38]MA Z, XIONG T, LI Y, et al. The inverted u-shaped association between serum vitamin D and serum uric acid status in children and adolescents:a large cross-sectional and longitudinal analysis[J].Nutrients, 2024,16(10):1492.
基本信息:
DOI：
中图分类号:R723.14
引用信息:
[1]寇永妹,谷小娜,陈新春等.肥胖儿童血尿酸水平及与维生素D水平的相关性分析[J].临床误诊误治,2025,38(11):43-47.
基金信息:
河北省2017年度医学科学研究课题计划项目(20171280)