累积尿酸暴露值与急性胰腺炎发病风险的相关性

doi:10.3969/j.issn.1006-5725.2024.14.018

Abstract

Abstract:

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.

Key words: uric acid, cumulative exposure, acute pancreatitis, cohort studies

CLC Number:

R576

A′fang SU,Guangjian LI,Yunshui ZHANG,Xiujuan ZHAO,Shouling WU,Xiaozhong. JIANG. A study on the association between exposure of uric acid accumulation and risks of acute pancreatitis[J]. The Journal of Practical Medicine, 2024, 40(14): 2009-2014.

Figures/Tables 4

Tab.1

Fig. 1

Tab.2

Tab.3

References 30

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组别	例数	性别（例）		年龄（岁）	BMI （kg/m²）	SBP （mmHg）	DBP （mmHg）	TG （mmol/L）	TC （mmol/L）	HDL-C （mmol/L）
组别	例数	男	女	年龄（岁）	BMI （kg/m²）	SBP （mmHg）	DBP （mmHg）	TG （mmol/L）	TC （mmol/L）	HDL-C （mmol/L）
Q1组	13 947	8 396	5 551	49.79 ± 10.42	24.37 ± 3.29	126.6 ± 18.11	82.44 ± 10.44	1.46 ± 1.19	4.83 ± 0.89	1.57 ± 0.45
Q2组	13 951	10 185	3 766	52.76 ± 11.47	24.81 ± 3.33	130.1 ± 18.79	83.85 ± 10.61	1.56 ± 1.38	4.90 ± 0.96	1.56 ± 0.48
Q3组	13 949	11 452	2 497	54.80 ± 11.96	25.32 ± 3.33	132.4 ± 19.63	84.85 ± 10.92	1.69 ± 1.44	5.04 ± 1.01	1.55 ± 0.51
Q4组	13 950	12 543	1 407	56.37 ± 12.91	25.98 ± 3.34	135.2 ± 20.17	86.32 ± 11.18	2.02 ± 1.78	5.22 ± 1.12	1.53 ± 0.51
F/χ²值		3 772.88		819.45	606.76	495.77	320.12	392.76	407.68	17.44
P值		< 0.001		< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001

自变量	β值	SE	χ2值	P值	风险比	95%CI
模型1
第1分位组
第2分位组	0.51	0.25	4.02	0.05	1.66	1.01 ~ 2.74
第3分位组	0.24	0.27	0.78	0.38	1.27	0.75 ~ 2.15
第4分位组	0.85	0.24	12.4	0.00	2.33	1.46 ~ 3.74
1SD	0.25	0.07	12.48	0.00	1.29	1.12 ~ 1.48
模型2
第1分位组
第2分位组	0.43	0.26	2.86	0.09	1.54	0.93 ~ 2.54
第3分位组	0.11	0.27	0.17	0.68	1.12	0.65 ~ 1.91
第4分位组	0.68	0.25	7.41	0.01	1.98	1.21 ~ 3.23
1SD	0.20	0.08	7.20	0.01	1.23	1.06 ~ 1.42
模型3
第1分位组
第2分位组	0.42	0.26	2.69	0.10	1.52	0.92 ~ 2.52
第3分位组	0.08	0.28	0.09	0.77	1.09	0.63 ~ 1.86
第4分位组	0.57	0.26	4.92	0.03	1.77	1.07 ~ 2.92
1SD	0.17	0.08	4.51	0.03	1.18	1.01 ~ 1.38
年龄	-0.003	0.009	0.12	0.73	1.00	0.98 ~ 1.02
男性	0.39	0.25	2.42	0.12	1.48	0.90 ~ 2.41
吸烟	-0.33	0.19	3.12	0.08	0.72	0.50 ~ 1.04
饮酒	0.66	0.27	6.03	0.01	1.93	1.14 ~ 3.27
教育	-0.40	0.22	3.25	0.07	0.67	0.44 ~ 1.04
体育锻炼	0.36	0.20	3.16	0.08	1.43	0.96 ~ 2.11
高血压病史	0.20	0.20	1.03	0.31	1.22	0.83 ~ 1.79
糖尿病史	0.25	0.21	1.52	0.22	1.29	0.86 ~ 1.93
胆石症病史	0.76	0.29	6.71	0.01	2.14	1.20 ~ 3.80
TC	-0.16	0.08	3.55	0.06	0.86	0.73 ~ 1.01
TG	0.18	0.03	32.39	< 0.001	1.19	1.12 ~ 1.27
EGFR	-0.00	0.00	0.08	0.77	1.00	0.99 ~ 1.01

自变量	β值	SE	wald χ2值	P值	HR值	95%CI
Q1				1.00
Q2	0.42	0.26	2.61	0.11	1.53	0.91 ~ 2.55
Q3	0.08	0.29	0.08	0.79	1.08	0.62 ~ 1.90
Q4	0.56	0.26	4.48	0.03	1.75	1.04 ~ 2.95

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A study on the association between exposure of uric acid accumulation and risks of acute pancreatitis

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