Study On The Relationship Between Body Mass Index,blood Lipid Metabolism Index And Hyperuricemia In Physical Examination Population

Objective:To explore the relationship between body mass index（BMI）,lipid metabolism index and the incidence of hyperuricemia（HUA）in the physical examination cohort,analyze the impact of the interaction between BMI and lipid on the incidence of HUA in the physical examination population of different sexes,and explore the dose-response relationship between gender-specific BMI,traditional lipid metabolism index and combined lipid metabolism index and HUA,so as to provide early screening Early diagnosis provides clinical prediction basis.Methods:According to the method of nested case-control study,5855people were selected as the baseline of this study.265 new patients with HUA during the follow-up period were selected as the case group.Among the patients who did not have HUA during the follow-up at the same time,the control group was matched with the same sex and age（±2 years）in a ratio of1:1 using the propensity score matching method.Finally,a total of 530subjects were included.Cox regression model was used to fit conditional logistic regression to analyze the relationship between BMI,traditional lipid metabolism index and combined lipid metabolism index and HUA.The additive and multiplicative models were used to analyze the influence of the interaction between BMI and blood lipids on the pathogenesis of HUA.The dose-response relationship was fitted with a restricted cubic spline model to reveal the effects of BMI and lipid metabolism indicators on the pathogenesis of HUA.Results:1.The detection rate of HUA in the physical examination population is 4.63%.The incidence rate of men is higher than that of women,but the incidence rate of women aged 51-65 years（6.29%）is higher than that of men（5.50%）.2.With the increase of BMI level,the incidence risk of HUA in both male and female physical examination population increased,P_trend<0.05.Among the traditional indicators of lipid metabolism,the high level group（Q4）of male total cholesterol（TC）（Q3）,triglyceride（TG）and low density lipoprotein cholesterol（LDL-C）（Q4）has the highest risk of UA,4.013 times higher than the low level group（Q1）（95%CI:1.894-8.504）3.149 times（95%CI:1.549-6.403）and 5.706 times（95%CI:2.652-12.277）,the level of high density lipoprotein cholesterol（HDL-C）in men is inversely proportional to the incidence risk of HUA,and the incidence risk of HUA in men with hyperlipidemia is increased by 1.706 times（95%CI:1.094-2.661）compared with those with normal blood lipid level,P_trend<0.05;The Q4 group of women with TC,TG and LDL-C had the highest risk of developing UA,7.518 times（95%CI:2.077-27.219）,6.811 times（95%CI:1.972-23.528）and 5.913 times（95%CI:1.618-21.612）,respectively,compared with Q1 group.The level of HDL-C in women was inversely proportional to the risk of developing UA.The risk of developing UA in the group of women with hyperlipidemia was1.586 times（95%CI:1.044-6.407）higher than that in the group with normal blood lipid level,P_trend<0.05.Among the combined lipid metabolism indicators,the risk of UA in Q3 group of male TC/HDL-C is the highest,while that in Q4 group of TG/HDL-C,LDL-C/HDL-C,and non-HDL-C is the highest,while that in Q4 group of female TC/HDL-C,TG/HDL-C,LDL-C/HDL-C,and non-HDL-C is the highest,and that in male is 2.492 times（95%CI:1.169-5.312）,2.569 times（95%CI:1.363-4.842）,3.096 times（95%CI:1.490-6.433）,respectively 5.321 times（95%CI:2.436-11.623）,P_trend<0.05;Women were 10.185 times（95%CI:2.433-42.635）,8.878 times（95%CI:1.920-41.057）,12.110 times（95%CI:2.402-61.054）,9.444 times（95%CI:2.540-35.115）,respectively,compared with Q1 group,P_trend<0.05.3.There are additive interactions between BMI and hyperlipidemia in men and women on the occurrence of HUA,and they are synergistic effects.There is no multiplicative interaction between the two factors.Men and women who are overweight,obese and have hyperlipidemia have 3.382 times the risk of developing HUA（95%CI:1.580-7.240）and 3.095 times the risk of normal people（95%CI:0.809-11.842）.The risk of developing HUA under the combined interaction is greater than the risk when the two factors exist alone.4.The results of restrictive cubic spline model showed that the associations of BMI,TG,TC/HDL-C and TG/HDL-C with HUA risk showed a nonlinear-dose response relationship in the male health examination population.The risk of HUA increased significantly when BMI>25.07 kg/m²,TG>1.51 mmol/L,and TC/HDL-C>4.13.HDL-C,LDL-C,LDL-C/HDL-C,and non-HDL-C were associated with HUA risk in a linear dose-response relationship.The risk of HUA decreased significantly when HDL-C>1.15mmol/L,and increased significantly when LDL-C>2.59 mmol/L and LDL-C/HDL-C>2.24.There was no dose-response relationship between TC and HUA.In the female health examination population,the associations of BMI,TG,TG/HDL-C and HUA risk present nonlinear dose-response relationship.The risk of HUA increased significantly when BMI>22.57 kg/m² and TG>1.33 mmol/L.TC,HDL-C,LDL-C,TC/HDL-C,LDL-C/HDL-C,and non-HDL-C showed a linear dose-response relationship with the risk of HUA.When HDL-C>1.40 mmol/L,the risk of HUA decreased significantly.When TC/HDL-C>3.50 and LDL-C/HDL-C>1.87,the risk of HUA increased significantly.Conclusion:The incidence rate of male HUA is higher than that of female,and the incidence is younger.BMI and blood lipids in the physical examination population are correlated with the onset of HUA.In different sex groups,the additive interaction between BMI and hyperlipidemia and HUA will increase the risk of HUA,but no additive interaction has been found.There is an obvious dose-response relationship between the traditional lipid metabolism index and combined lipid metabolism index except TC in men and BMI on the onset of HUA The correlation between blood lipid metabolism index and the risk of HUA is dose-response relationship.Finding the effective cut-off point of the index will help to better predict the occurrence of disease in clinical practice.