目的 探讨开滦研究队列人群尿酸累积暴露量与急性胰腺炎（AP）发病风险的关联。 方法 采用前瞻性队列的研究方法，以参加开滦集团2006-2010年度健康体检、无AP病史和UA资料完整的队列人群为观察队列，以研究对象完成2010年度健康体检时点为随访起点，以新发AP事件、死亡或至随访结束（2021年12月31日）为随访终点。根据每连续2次体检所测尿酸的均值及每连续2次体检的间隔时间计算尿酸累积暴露量（cumUA），将cumUA按四分位进行分组，观察各组人群基线资料和新发AP发病率。经Kaplan-Meier法计算累积发病率，以LogRank法进行检验，采用Cox回归模型分析不同cumUA分组对新发AP事件的影响。 结果 研究共纳入55 799人，按基线cumUA四分位数水平分4组，4组间性别、年龄、BMI、收缩压（SBP）、舒张压（DBP）、FPG、TC、TG、LDL-C、HDL-C、吸烟、饮酒、受教育程度≥ 9年、体育锻炼、高血压病史、胆石症病史差异有统计学意义（P < 0.05），4组间糖尿病病史没有差异（P = 0.30），本研究平均随访（10.52 ± 1.75）年，共发生AP事件153例，4组的发病密度分别为1.65例/万人年、2.76例/万人年、2.13例/万人年、3.96例/万人年，Log-Rank检验4组间发病率差异有统计学意义（χ² = 67.64，P < 0.001）。以Q1组为对照，进一步校正了性别、年龄、TC、TG、eGFR、吸烟、饮酒、受教育程度、体育锻炼、高血压病史、糖尿病病史、胆石症病史后，Q4组发生AP的HR = 1.77（95%CI：1.07 ~ 2.92）。排除随访期间死亡人群后重新进行多因素Cox回归分析，结果发现Q4组发生AP的HR = 1.75（95%CI：1.04 ~ 2.95）。 结论 随着cumUA的暴露增加，AP的发病率和发病风险均呈上升趋势。

Objective To investigate the correlation between exposure of uric acid accumulation and the risks of acute pancreatitis （AP） in the population in Kailuan Group. Methods A prospective study was performed based on thesubjects receiving annual physical examination during 2006 to 2010 in Kailuan Group. All of them had no AP history but had complete data on UA. The starting point of follow-up was when the subjects completed the health examination in 2010， and the end point was new AP events， deaths or the end of follow-up （2021-12-31）. Exposure of uric acid accumulation （cumUA） was calculated according to the average values of uric acid measured in each two consecutive physical examinations and the intervalbetween these two consecutive physical examinations. The cumulative incidences of AP indifferent subgroups （determined by the quartile of cumUA） were described using Kaplan-Meier product limit-method and compared by log-rank test. Multivariate Cox proportional hazards regression model was used to analyze the impacts of different cumUA subgroups on new occurrence of AP events. Results A total of 55，799 subjects were included in this study. The subjects were divided into four groups according to the quartile of cumUA. Sex ratio， average age， BMI， systolic blood pressure （SBP）， diastolic blood pressure （DBP）， FPG， TC， TG， LDL-C， HDL-C， smoking， alcohol consumption， education ≥ 9 years， physical exercise， history of hypertension， and history of cholelithiasis differed significantly among the groups （P < 0.05）， there was no difference in diabetes history among the 4 groups （P = 0.30）. 153 patients developed AP during an average follow-up of （10.52 ± 1.75） years， the incidence rates were 1.65， 2.76， 2.13 and 3.96 per 10 000 person-year in the Q1， Q2， Q3and Q4， respectively （P < 0.01）. After adjusting sex， age， TC， TG， eGFR， smoking， alcohol consumption， education， physical activity， and history of hypertension， diabetes， or cholelithiasis， Multivariate analysis showed a significantly increased risk in Q4 （HR = 1.77， 95%CI： 1.07 ~ 2.92） as comparing with Q1. After excluding deaths during the follow-up period， Multivariate Cox regression analysis was performed again in Q4 HR = 1.75 （95%CI： 1.04 ~ 2.95）. Conclusions With the increase of cumUA exposure， both morbidity and risk of AP occurrence have the tendency of rising.