基于倾向性评分匹配法的体质量指数与高尿酸血症的关联性

doi:10.6040/j.issn.1671-7554.0.2025.1055

摘要/Abstract

摘要： 目的探讨体检人群体质量指数(body mass index, BMI)与高尿酸血症(hyperuricemia, HUA)的关联。方法回顾性选取2023年1月至12月于甘肃省某三甲医院体检中心进行体检且重要变量完整的1 305名体检者作为研究对象,收集其人口学资料及相关生化指标,分为正常BMI组(BMI<24 kg/m²)(n=569)和高BMI组(BMI≥24 kg/m²)(n=736)。采用倾向性评分匹配法(propensity score matching, PSM)对两组进行1∶1匹配,均衡潜在混杂因素,通过单因素和多因素logistic回归分析BMI与HUA的关联,采用限制性立方样条(restricted cubic spline, RCS)分析两者之间的剂量-反应关系,进一步对BMI各亚组进行分层分析。结果经PSM控制组间协变量后,成功匹配343对,两组协变量均衡性良好(SMD均<0.1)。匹配前后高BMI组与正常BMI组HUA的患病率差异有统计学意义(30.3% vs. 10.7%, χ2=72.245, P<0.001; 20.1% vs. 14.3%, χ2=4.094, P=0.043)。PSM后的多因素logistic回归显示,高BMI组患HUA的风险是正常BMI组的1.781倍(95%CI:1.078~2.736,P=0.023)。RCS分析表明,BMI与HUA患病风险呈正相关,BMI越高,HUA患病风险越高,两者之间无非线性关联(P_非线性=0.725)。分层分析结果显示,BMI≥26 kg/m²显著增加HUA风险,尤其在男性、≤50岁及无慢性病人群中风险显著升高(P<0.05)。结论高BMI是HUA的独立危险因素,且关联性在特定人群中更为显著。PSM有效控制了混杂偏倚,在体检人群中关注BMI水平对于预防和控制HUA具有重要意义,建议通过体质量管理降低HUA患病风险,以此降低代谢性疾病负担,改善群体健康水平。

关键词: 体质量指数, 高尿酸血症, 倾向性评分匹配, 限制性立方样条

Abstract: Objective To explore the association between body mass index(BMI)of the physical examination population and hyperuricemia(HUA). Methods A retrospective selection was made of 1,305 physical examinees who underwent physical examinations at the physical examination center of a tertiary hospital in Gansu Province from January to December 2023 with complete important variables as the research subjects. Their demographic data and related biochemical indicators were collected. They were divided into the normal BMI group(BMI < 24)(n=569)and the high BMI group(BMI≥24)(n=736). The propensity score matching(PSM)method was used to conduct a 1∶1 match between the two groups to balance the potential confounding factors. The association between BMI and HUA was analyzed through univariate and multivariate logistic regression. The dose-response relationship between the two was analyzed using restricted cubic splines(RCS), and further stratified analysis was conducted for each subgroup of BMI. Results After controlling the covariates between groups by PSM, 343 pairs were successfully matched, and the balance of covariates in both groups was good(SMD <0.1). The differences in the prevalence of HUA between the high BMI group and the normal BMI group before and after matching were statistically significant(30.3% vs. 10.7%, χ2=72.245, P<0.001; 20.1% vs. 14.3%, χ2=4.094, P=0.043). Multivariate logistic regression after PSM showed that the risk of HUA in the high BMI group was 1.781 times larger than that of the normal BMI group(95%CI: 1.078-2.736, P=0.023). RCS analysis indicated that BMI was positively correlated with the risk of HUA. The higher the BMI, the higher the risk of HUA. There was no significant nonlinear association between the two indicators(nonlinear P=0.725). The results of stratified analysis showed that BMI≥26 significantly increased the risk of HUA, especially among men, those aged ≤50 years, and those without chronic diseases(P<0.05). Conclusion High BMI is an independent risk factor for HUA, and the association is more significant in specific populations. PSM effectively controls confounding bias. Paying attention to BMI levels in the physical examination population is of great significance for the prevention and control of HUA. It is recommended to reduce the risk of HUA through body mass management, thereby reducing the burden of metabolic diseases and improving the health level of the population.

Key words: Body mass index, Hyperuricemia, Propensity score matching, Restricted cubic spline

中图分类号:

R589.7

张椿卉,王超艺,杨靖涵,张文霞,孔雨佳,石福艳,王素珍. 基于倾向性评分匹配法的体质量指数与高尿酸血症的关联性[J]. 山东大学学报 (医学版), 2026, 64(4): 100-108.

ZHANG Chunhui, WANG Chaoyi, YANG Jinghan, ZHANG Wenxia, KONG Yujia, SHI Fuyan, WANG Suzhen. Association between body mass index and hyperuricemia based on propensity score matching method[J]. Journal of Shandong University (Health Sciences), 2026, 64(4): 100-108.

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