中国骨质疏松杂志

男性体检人群血尿酸水平对前臂骨密度的影响及其与体质量指数的交互作用

Effects of serum uric acid level on forearm bone mineral density and its interaction with body mass index in males under physical examination

DOI：10.3969/j.issn.1006-7108.2023.01.006

中文关键词: 血清尿酸前臂骨密度骨质疏松交互作用

英文关键词:serum uric acid forearm bone mineral density osteoporosis interaction

基金项目:河北省医学科学研究重点课题计划(20211202)

作者	单位
刘焕欣1 李忠2 聂倩1 陈菲菲1 张令霞1 马慧娟3，4*	1.河北省人民医院体检中心，河北石家庄 050051 2.石家庄市人民医院普外一科，河北石家庄 050011 3.河北省人民医院代谢病重点实验室，河北石家庄 050051 4.河北省人民医院内分泌科，河北石家庄 050051

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中文摘要:

目的探讨男性体检人群血清尿酸（serum uric acid，SUA）水平对前臂骨密度（bone mineral density，BMD）的影响及SUA与体质量指数（body mass index，BMI）对BMD影响的交互作用。方法选取2020年1～12月于河北省人民医院体检中心进行年度体检的50岁及以上的2270名男性。采用双能X线骨密度仪测定非优势侧前臂桡骨远端1/3处BMD值，计算T值，根据T值分为骨量正常组、骨量减少组和骨质疏松组。SUA水平在正常范围者按四分位分为Q1～Q4组，高于正常范围者为Q5组。探讨各组SUA变化及与BMD的关系，分析骨量异常的影响因素，建立相乘和相加效应模型分析影响因素间的交互作用。结果骨质疏松组SUA水平低于骨量正常组和骨量减少组，Q1～Q5组BMD值、T值、骨量减少患病率、骨质疏松症患病率比较差异均有统计学意义(P＜0.05)。双变量相关性分析显示，BMD值、T值均与SUA呈正相关性(P＜0.05)。有序多分类Logistic回归分析显示，年龄、收缩压(SBP)、患有高血压与骨量异常的风险呈正相关性，BMI、SUA与骨量异常的风险呈负相关性(P＜0.05)。SUA与BMI对骨量影响存在相乘交互作用，不存在相加交互作用，RERI、AP和S的估计值(95%CI)分别为-0.114(-0.622，0.394)、-0.177(-0.980，0.627)和1.475(0.189，11.485)。结论在50岁以上的男性体检人群中，年龄、SBP、患有高血压是骨量异常的危险因素，BMI、SUA是骨量异常的保护因素。BMI与SUA之间存在相乘交互作用，不存在相加交互作用。

英文摘要:

Objective To explore the effect of serum uric acid (SUA) level on forearm bone mineral density (BMD) and the interaction between SUA and body mass index (BMI) on BMD in males under physical examination. Methods A total of 2,270 male annual health examinees over 50 years old were selected from the Health Examination Center of our hospital from January to December 2020. Dual-energy X-ray absorptiometry was used to measure the BMD value at the distal 1/3 of the radius of the non-dominant forearm. The research subjects were divided into normal bone mass group, osteopenia group, and osteoporosis group according to the T value of forearm bone mass. Those whose SUA level within the normal range were divided into Q1-Q4 groups according to quartiles, and those whose SUA level above the normal range were divided into Q5 group. The changes of SUA and its correlation with BMD were explored in each group. The influencing factors of abnormal bone mass were analyzed. The multiplicative and additive effect models were performed to explore the interaction among the influencing factors. Results The level of SUA in the forearm osteoporosis group was lower than that in the normal bone mass group and the osteopenia group. There was significant difference in BMD value, T value, prevalence of osteopenia, and osteoporosis between Q1-Q5 groups (P<0.05). Bivariate correlation analysis indicated that BMD value and T value were positively associated with SUA level (P<0.05). Ordinal multiclass logistic regression analysis showed that age, systolic blood pressure (SBP), and hypertension were positively correlated with the risk of abnormal bone mass. However, BMI and SUA were negatively correlated with the risk of abnormal bone mass (P<0.05). There was a multiplicative interaction but no additive interaction between BMI and SUA on bone mass. The estimated values (95% CI) of RERI, AP and S were -0.114 (-0.622, 0.394), -0.177 (-0.980, 0.627), and 1.475 (0.189, 11.485), respectively. Conclusion In the male physical examination population over 50 years old, age, SBP, and hypertension are risk factors of abnormal bone mass, and BMI and SUA are protective factors of abnormal bone mass. There is a multiplicative but not an additive interaction between BMI and SUA.

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