2016年川西北气田体检钻井工人高尿酸血症及影响因素
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摘要
目的了解川西北气田钻井工人体检人群高尿酸血症现状并探讨其影响因素。方法于2016年1—12月,以工作现场位于川西北气田(平均海拔2552 m)参加健康体检且符合纳入标准的1051名男性气田钻井工人为研究对象,检测血尿酸、空腹血糖、血脂、血清肌酐及血红蛋白等指标,从中随机抽取一个作业队食堂,采用称重法和24 h回顾法进行膳食调查。比较不同血尿酸水平研究对象的生化指标水平及膳食摄入状况,用Logistic回归模型分析高尿酸血症的影响因素。结果 (1)2016年川西北气田体检钻井工人中检出高尿酸血症513人,检出率为48.8%。(2)高尿酸血症组研究对象血糖、血清总胆固醇、甘油三酯、肌酐和血红蛋白平均水平高于血尿酸正常组(P<0.05)。糖尿病、高胆固醇血症、高甘油三酯血症、血清肌酐及血红蛋白增高者发生高尿酸血症的危险度分别是血糖、血脂、血清肌酐和血红蛋白正常者的3.57(95%CI 2.45～4.67)、2.88(95%CI 1.99～4.16)、1.93(95%CI 1.30～2.86)、1.61(95%CI 1.01～2.51)和2.54(95%CI 2.11～3.36)倍(P<0.05)。(3)高尿酸血症组研究对象畜禽肉[(239.7±30.2)g]、油脂[(37.6±10.8)g]和食盐[(8.9±4.1)g]的摄入量高于血尿酸正常组[分别为(203.3±21.8)、(32.4±9.6)和(7.4±2.7)g],蔬菜[(167.7±126.8)g]、奶及奶制品[(73.6±32.9)g]、维生素B_2[(0.7±0.2)g]、维生素B_6[(0.4±0.1)g]、维生素B_(12)[(1.0±0.3)g]的摄入量低于血尿酸正常组[分别为(246.3±138.7)g、(91.4±38.1)g、(0.9±0.1)g、(0.6±0.1)g和(1.4±0.4)g](P<0.05)。蔬菜的摄入是高尿酸血症的保护因素[0.82(95%CI 0.65～0.93)],蛋白质[(1.47(95%CI 1.16～2.28)]、脂肪[2.34(95%CI 2.01～3.22)]的摄入是其危险因素。结论 2016年川西北气田钻井工人高尿酸血症患病率较高,与糖尿病、高胆固醇血症、高甘油三酯血症、血清肌酐及血红蛋白增高有关,也与脂肪摄入过多等膳食因素有关。
OBJECTIVE To investigate the prevalence and influencing factors of hyperuricemia among natural gas drilling workers in Northwest Sichuan gas field. METHODS A census of 1051 natural gas drilling workers in Northwest Sichuan gas field at an average altitude of 2552 meters was conducted in the survey, the serum uric acid, fasting blood glucose, blood lipid, creatinine and hemoglobin were detected. A staff canteen was randomly selected and the method of weighing and 24-hour dietary review were used for dietary survey. The blood biochemical level and dietary intake of subjects with different blood uric acid levels were compared, and the influencing factors of hyperuricemia were analyzed by Logistic regression model. RESULTS(1)There were 513 hyperuricemia patients in natural gas drilling workers, with a detection rate of 48.8%.(2)The levels of fasting blood glucose, total cholesterol, triglyceride, creatinine and hemoglobin in the hyperuricemia group were higher than those in the normouricemia group. The risk of hyperuricemia in patients with diabetes, hypercholesterolemia, hypertriglyceridemia, elevated serum creatinine and hemoglobin were 3.57(95%CI 2.45-4.67), 2.88(95%CI 1.99-4.16), 1.93(95%CI 1.30-2.86), 1.61(95%CI 1.01-2.51)and 2.54(95%CI 2.11-3.36)times of normal fasting blood glucose, blood lipid, serum creatinine and hemoglobin, respectively(P<0.05).(3)The intakes of meat, oil and salt in the hyperuricemia group were higher than those in the normouricemia group, while the intakes of vegetables, milk products and vitamin B were lower than those in the normouricemia group(P<0.05). Intake of vegetable is a protective factor for hyperuricemia(0.82(95%CI 0.65-0.93)), and intakes of protein(1.47(95%CI 1.16-2.28))and fat(2.34(95%CI 2.01-3.22)) are the risk factors. CONCLUSION Drilling workers in Northwest Sichuan gas field have a high prevalence of hyperuricemia and are related to diabetes, hypercholesterolemia, hypertriglyceridemia, elevated creatinine and hemoglobin, and too much protein, fat intake and too little vegetable intake.
OBJECTIVE To investigate the prevalence and influencing factors of hyperuricemia among natural gas drilling workers in Northwest Sichuan gas field. METHODS A census of 1051 natural gas drilling workers in Northwest Sichuan gas field at an average altitude of 2552 meters was conducted in the survey, the serum uric acid, fasting blood glucose, blood lipid, creatinine and hemoglobin were detected. A staff canteen was randomly selected and the method of weighing and 24-hour dietary review were used for dietary survey. The blood biochemical level and dietary intake of subjects with different blood uric acid levels were compared, and the influencing factors of hyperuricemia were analyzed by Logistic regression model. RESULTS(1)There were 513 hyperuricemia patients in natural gas drilling workers, with a detection rate of 48.8%.(2)The levels of fasting blood glucose, total cholesterol, triglyceride, creatinine and hemoglobin in the hyperuricemia group were higher than those in the normouricemia group. The risk of hyperuricemia in patients with diabetes, hypercholesterolemia, hypertriglyceridemia, elevated serum creatinine and hemoglobin were 3.57(95%CI 2.45-4.67), 2.88(95%CI 1.99-4.16), 1.93(95%CI 1.30-2.86), 1.61(95%CI 1.01-2.51)and 2.54(95%CI 2.11-3.36)times of normal fasting blood glucose, blood lipid, serum creatinine and hemoglobin, respectively(P<0.05).(3)The intakes of meat, oil and salt in the hyperuricemia group were higher than those in the normouricemia group, while the intakes of vegetables, milk products and vitamin B were lower than those in the normouricemia group(P<0.05). Intake of vegetable is a protective factor for hyperuricemia(0.82(95%CI 0.65-0.93)), and intakes of protein(1.47(95%CI 1.16-2.28))and fat(2.34(95%CI 2.01-3.22)) are the risk factors. CONCLUSION Drilling workers in Northwest Sichuan gas field have a high prevalence of hyperuricemia and are related to diabetes, hypercholesterolemia, hypertriglyceridemia, elevated creatinine and hemoglobin, and too much protein, fat intake and too little vegetable intake.
引文
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[15] HAMMARSTEN J, H?GSTEDT B. Clinical, hemodynamic, anthropometric, metabolic and insulin profile of men with high-stage and high-grade clinical prostate cancer[J]. Blood Press, 2004, 13(1):47-55.
[16] 西藏自治区人民医院.实用高原医学[M].拉萨:西藏人民出版社,1984.
[17] 袁智敏,张丽崧,杨丽芳.广州地区人群高尿酸血症的调查分析[J].营养学报,2004, 26(3):201-203.
[2] 王胜玉,娄晓敏,李明义,等.高海拔地区男性尿酸血症危险因素的分析[J].高原医学杂志,2014(4):32-34.
[3] 万学红,卢雪峰.诊断学 [M]. 8版.北京:人民卫生出版社,2013.
[4] 中国营养学会.中国居民膳食指南(2016)[M].北京:人民卫生出版社,2016.
[5] 中国营养学会.中国居民膳食营养素参考摄入量(2013版)[M].北京:科学出版社,2014.
[6] JOHNSON R J, TITTE S, CADE J R, et al. Uric acid, evolution and primitive cultures[J]. Semin Nephrol, 2005, 25(1): 3-8.
[7] LIU B, WANG T, ZHAO H N, et al. The prevalence of hyperuricemia in China: a meta-analysis[J]. BMC Public Health, 2011, 11(1):1-10.
[8] 韩涛,刘培培,荣胜忠,等.城市居民体检人群高尿酸血症的患病情况[J].卫生研究, 2013, 42(2):306-307.
[9] 王晓红.钻井作业现场健康危害因素及预防[J].中国石油和化工标准与质量, 2013(14):233-234.
[10] 孙小平,李兴杰,石红霞,等.临床医师职业紧张状况与其体检指标的相关性[J].兰州大学学报(医学版),2017,43(5):38-42.
[11] 张艳男,郭美宜,荣胜忠,等.哈尔滨市体检人群高尿酸血症与代谢综合征关系研究[J].卫生研究, 2015, 44(1):113-114.
[12] 朱佳妮,齐心月,谭杨,等.中老年人群高尿酸血症与糖脂代谢紊乱及膳食因素的关系研究[J].四川大学学报(医学版), 2016, 47(1):68-72.
[13] KIMI U S, ROSA G. Association of uricemia with biochemical and dietary factors in human adults with metabolic syndrome genotyped to C677T polymorphism in the methylenetetrahydrofolate reductase gene[J]. Nutr Hosp, 2011, 26(2):298-303.
[14] KARALIS D G. Intensive lowering of low-density lipoprotein cholesterol levels for primary prevention of coronary artery disease[J]. Mayo Clin Proc, 2009, 84(4):345-352.
[15] HAMMARSTEN J, H?GSTEDT B. Clinical, hemodynamic, anthropometric, metabolic and insulin profile of men with high-stage and high-grade clinical prostate cancer[J]. Blood Press, 2004, 13(1):47-55.
[16] 西藏自治区人民医院.实用高原医学[M].拉萨:西藏人民出版社,1984.
[17] 袁智敏,张丽崧,杨丽芳.广州地区人群高尿酸血症的调查分析[J].营养学报,2004, 26(3):201-203.