Study On The Interaction Of Influencing Factors On The Prevalence Of Hyperuricemia In Overweight And Obese People

Objective:The prevalence of hyperuricemia(HUA)is increasing year by year,and is closely related to overweight and obesity.Explore the relevant influencing factors of HUA in overweight and obese people and the impact of their interaction on the prevalence,so as to provide reference for the prevention and treatment of HUA in overweight and obese people.Methods:(1)Taking4384 overweight and obese people who underwent physical examination in the physical examination department of the Affiliated Hospital of Guilin Medical College from March 1 to June 31,2017 as the research objects,the epidemiological statistics of HUA were carried out and the epidemic trend was analyzed.(2)Collect the basic information of the study population,including gender,age,height,weight,systolic blood pressure(SBP),diastolic blood pressure(DBP),uric acid(UA),creatinine(Cr),blood urea nitrogen(BUN),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-c),high density lipoprotein cholesterol(HDL-c),fasting plasma glucose(FPG),and calculate body mass index(BMI),Glomerular filtration rate(GFR),triglyceride glucose index(Ty G).(3)The classification tree model and logistic single factor and multi factor regression model were established to screen the independent influencing factors and interactive related factors of HUA in overweight and obese people.At the same time,ROC curve is used to evaluate the classification tree and logistic regression model.(4)The influencing factors of possible interaction of the factors that affect the interaction of HUA screened by the classification tree model were replaced by Logistic regression product items for quantitative analysis of single factor and multi factor multiplicative interaction.The independent influential factors of Logistic regression were included in the multivariate analysis as confounding factors.Finally,R software was used to invoke ggthemes package to conduct quantitative and visual analysis of single factor and multi factor additive interaction.(5)A total of 1030 patients with complete clinical data examined by the physical examination department of Affiliated Hospital of Guilin Medical College from November 1 to November 30,2017 were included in the study to verify the relevant influencing factors of multiplicative interaction and additive interaction.result:(1)After the PSM propensity score matching of gender and age,The clinical data of the two groups were analyzed.The results showed that the levels of SBP,DBP,ALT,AST,Cr,BUN,TG,TC,LDL-c,Ty G in the case group were higher than those in the control group,and the difference was statistically significant(P<0.01),while the levels of FPG,GFR and HDL-c in the case group were lower than those in the control group,The difference was statistically significant(P<0.01).(3)The classification tree model shows that the influencing factors of overweight and obesity HUA include men,TG,GFR,Cr and age,suggesting that the interaction of men with high TG,men with low GFR,high TG with high Cr and men with high Cr has an impact on the prevalence of HUA in overweight and obese people.The independent influencing factors of HUA in overweight and obese people screened by Logistic regression were men,TG,GFR,Cr,age and HDL-c.The area under the curve(AUC)of ROC curve of Logistic regression model and classification tree model were 0.784 and 0.783.There was no significant difference in AUC between the two models(P>0.05).(4)Multiplicative interaction analysis:the relevant influencing factors suggested by the Classification tree were substituted into the Logistic regression product term equation one by one.No matter univariate analysis or multivariate analysis,men combined with high TG,men combined with low GFR,high TG combined with high Cr and men combined with high Cr had positive multiplication interaction on HUA in overweight and obese people(univariate and multivariate:OR>1,B≠0,P<0.05).(5)Additive interaction analysis:the additive interaction of men with high TG,men with low GFR,high TG with high Cr and men with high Cr was analyzed.Univariate and multivariate quantitative analysis showed that the combined effect of men and high TG was significantly greater than that of men and high TG alone.The combined effect of men and low GFR was significantly greater than that of men and low GFR alone.The analysis of interaction evaluation index shows that men with high TG and men with low GFR have significant additive interaction significance(the confidence interval of RERI and AP does not include 0,and the confidence interval of SI does not include 1).(6)The validation group showed that men combined with high TG and men combined with low GFR had both positive multiplication interaction and additive interaction.Conclusion:(1)The prevalence of HUA in some overweight and obese people in Guilin city is higher,and the prevalence of HUA in overweight and obese men is higher than that in women.(2)The prevalence of HUA in overweight and obese people is accompanied by obvious lipid metabolism disorder,elevated blood pressure and insulin resistance.(3)Men with high TG and men with low GFR have obvious positive multiplicative interaction and additive interaction on the prevalence of HUA in overweight and obese people.The population with high TG or low GFR in men should be listed as the key population for the prevention and treatment of HUA in overweight and obese people.