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Article(id=1241036336048697844, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241036327177744706, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202410303, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1729267200000, receivedDateStr=2024-10-19, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773815719854, onlineDateStr=2026-03-18, pubDate=1757433600000, pubDateStr=2025-09-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773815719854, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773815719854, creator=13701087609, updateTime=1773815719854, updator=13701087609, issue=Issue{id=1241036327177744706, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='17', pageStart='3073', pageEnd='3264', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773815717738, creator=13701087609, updateTime=1773840080282, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241138511152206262, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241036327177744706, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241138511152206263, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241036327177744706, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=3240, endPage=3246, ext={EN=ArticleExt(id=1241036336442962446, articleId=1241036336048697844, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Association between serum uric acid to high-density lipoprotein cholesterol ratio and liver function among Zhuang minority male residents aged 35-74 years in Guangxi, columnId=1228016569138213037, journalTitle=Modern Preventive Medicine, columnName=Clinical Medicine and Prevention, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the association between serum uric acid (SUA), the uric acid to high-density lipoprotein cholesterol ratio (UHR), and liver function among Zhuang minority male residents aged 35-74 years in Guangxi, and to provide scientific evidence for developing strategies to regulate SUA levels and preserve hepatic health.

Methods

A cross-sectional study was conducted based on the Guangxi Ethnic Minorities Cohort, using structured questionnaires, physical examinations, and blood and urine sample collection. Logistic regression analysis was used to identify factors associated with liver dysfunction, while restricted cubic spline was performed to evaluate dose-response relationships of SUA and UHR with liver dysfunction.

Results

This study included 4 977 Zhuang minority male adults, with a mean age of 54.8 years. Among them,38.4% of participants had middle school education, 53.9% were farmers, and 47.1% with household income over 30 000 Yuan in the past year, 30.9% with SUA levels >420 μmol/L, and 10.4% had liver dysfunction. After adjusting for confounders, compared to the normal SUA group, the adjusted OR(95% CI) for liver dysfunction in the 421-479 μmol/L and ≥480 μmol/L groups were 1.30 (1.01-1.67) and 1.69 (1.32-2.15), respectively. Compared with the lowest UHR quartile (≤22.25%), the adjusted OR (95% CI) for the 22.26-28.96%, 28.97-38.26%, and ≥38.27% quartiles were 1.23 (0.89-1.71), 1.76(1.24-2.50), and 2.08 (1.39-3.11), respectively. The risk of liver dysfunction increased non-linearly with the increase of SUA and UHR levels (Pnonlinearity <0.001).

Conclusions

SUA and UHR demonstrated significant associations with the risk of liver dysfunction among Zhuang minority male residents aged 35-74 years in Guangxi. Targeted health education efforts should be strengthened to control SUA levels and reduce UHR, thereby helping to preserve liver function in middle-aged and older individuals of the Zhuang minority.

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目的

探讨广西壮族自治区（简称广西）35～74岁壮族男性血清尿酸水平、尿酸/高密度脂蛋白胆固醇比值（UHR）与肝功能的关系，为血清尿酸控制、肝功能防护措施的制定提供科学依据。

方法

采用横断面调查的方法，基于广西少数民族自然人群队列对壮族男性进行问卷调查、体格检查，并采集血液和尿液进行检测，分别采用logistic回归和限制性立方样条分析肝功能异常的影响因素及其与血清尿酸、UHR的剂量-反应关系。

结果

共纳入4 977名壮族男性，年龄均数为54.8岁，初中文化程度者占38.4%，农业牧渔劳动者占53.9%，过去一年家庭总收入在3万元以上者占47.1%，SUA>420 μmol/L者占30.9%，肝功能异常检出率为10.4%。在控制其他因素影响后，与血清尿酸正常组相比，血清尿酸为421～479 μmol/L组和≥480 μmol/L组肝功能异常发生风险的调整OR值（95% CI）分别为1.30（1.01～1.67）、1.69（1.32～2.15）；与UHR≤22.25%组相比，UHR为22.26%～28.96%组、28.97%～38.26%组、≥38.27%组肝功能异常发生风险的调整OR值（95% CI）分别为1.23（0.89～1.71）、1.76（1.24～2.50）、2.08（1.39～3.11）。肝功能异常的发生风险随血清尿酸、UHR水平增加呈非线性增加（Pnonlinear<0.001）。

结论

广西35～74岁壮族男性血清尿酸、UHR水平与肝功能异常发生风险密切相关，应加强壮族中老年人健康教育，积极控制血清尿酸水平，降低UHR比值，保护肝脏健康。

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谢艺红，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=eu2cAA4RqF0Dktsl+4XuNQ==, magXml=y0GnrNMSbf+wPS/v3KU9Kg==, pdfUrl=null, pdf=/c9Bf9bZfUudNPuZfIqVPw==, pdfFileSize=733179, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=w0p2dVndhGrnOg97aXFohw==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=Vs6jPSIqprYtmwF/X4vkgg==, mapNumber=null, authorCompany=null, fund=null, authors=

戴学宾（2000—），男，硕士在读，研究方向：慢性病流行病学

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戴学宾（2000—），男，硕士在读，研究方向：慢性病流行病学

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戴学宾（2000—），男，硕士在读，研究方向：慢性病流行病学

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Eur J Prev Cardiol, 2022, 29(16): 2132-2134., articleTitle=The role of HDL cholesterol as a measure of 10-year cardiovascular risk should be re-evaluated, refAbstract=null)], funds=[Fund(id=1241139383269642373, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036336048697844, awardId=2017YFC0907103, language=CN, fundingSource=国家重点研发计划资助项目(2017YFC0907103), fundOrder=null, country=null), Fund(id=1241139383412248717, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036336048697844, awardId=2022GXNSFAA035623, language=CN, fundingSource=广西自然科学基金(2022GXNSFAA035623), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241139374860063451, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036336048697844, xref=null, ext=[AuthorCompanyExt(id=1241139374868452059, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036336048697844, companyId=1241139374860063451, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China), AuthorCompanyExt(id=1241139374876840671, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036336048697844, companyId=1241139374860063451, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=广西医科大学公共卫生学院，广西 南宁 530021)])], figs=[ArticleFig(id=1241139382023934008, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036336048697844, language=EN, label=Figure 1, caption=Dose-response relationship between SUA (μmol/L) and liver function Zhuang minority male residents aged 35-74 years in Guangxi, figureFileSmall=+U7hqrsUXSEzMbz+GXdORg==, figureFileBig=4vEHdXS5lx8EEIdg3p5MeA==, tableContent=null), ArticleFig(id=1241139382132985917, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036336048697844, language=CN, label=图1, caption=广西35～74岁壮族居民血清尿酸水平(μmol/L)与肝功能的剂量-反应关系

注：OR为比值比；CI为置信区间；SUA为血清尿酸。

, figureFileSmall=+U7hqrsUXSEzMbz+GXdORg==, figureFileBig=4vEHdXS5lx8EEIdg3p5MeA==, tableContent=null), ArticleFig(id=1241139382351089745, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036336048697844, language=EN, label=Figure 2, caption=Dose-response relationship between UHR (%) and liver function Zhuang minority male residents aged 35-74 years in Guangxi, figureFileSmall=uoCTPCuhgUPidaHfq5veoQ==, figureFileBig=eTxt7rSlIaL6nhwbqm37OA==, tableContent=null), ArticleFig(id=1241139382464335958, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036336048697844, language=CN, label=图2, caption=广西35～74岁壮族居民UHR与肝功能的剂量-反应关系

注：OR为比值比；CI为置信区间。

, figureFileSmall=uoCTPCuhgUPidaHfq5veoQ==, figureFileBig=eTxt7rSlIaL6nhwbqm37OA==, tableContent=null), ArticleFig(id=1241139382573387868, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036336048697844, language=EN, label=Table 1, caption=

Basic information, behavioral characteristics, and test results among Zhuang minority male residents aged 35-74 years in Guangxi［，n（%）， M（P25，P75）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量调查人数(n=4 977)肝功能正常组(n=4 460)肝功能异常组(n=517)χ2/t/Z值P值
年龄（岁）&54.8±10.455.2±10.450.9±10.28.864<0.001
年龄组（岁）75.931<0.001
35～44968 (19.4)807 (18.1)161 (31.1)
45～541 571 (31.6)1 385 (31.0)186 (36.0)
55～641 240 (24.9)1 145 (25.7)95 (18.4)
65～741 198 (24.1)1 123 (25.2)75 (14.5)
文化程度20.644<0.001
小学及以下1 895 (38.1)1 717 (38.5)178 (34.4)
初中1 911 (38.4)1 721 (38.6)190 (36.8)
高中909 (18.2)808 (18.1)101 (19.5)
大专及以上262 (18.3)214 (4.8)48 (9.3)
职业40.440<0.001
行政管理/专业技术人员/工人/销售服务人员/私营业主1 089 (21.9)920 (20.6)169 (32.7)
农业牧渔劳动者2 683 (53.9)2 434 (54.6)249 (48.2)
家务/待业/下岗/离休/退休/其他1 205 (24.2)1 106 (24.8)99 (19.1)
婚姻状况0.8090.667
已婚4 503 (90.5)4 039 (90.6)464 (89.7)
丧偶/分居/离婚340 (6.8)304 (6.8)36 (7.0)
未婚134 (2.7)117 (2.6)17 (3.3)
过去一年家庭总收入（万元）7.2070.027
<1887 (17.8)802 (18.0)85 (16.4)
1～31 747 (35.1)1 587 (35.6)160 (30.9)
≥32 343 (47.1)2 071 (46.4)272 (52.6)
慢性肝炎/肝硬化病史58.023<0.001
否4 901 (98.5)4 412 (98.9)489 (94.6)
是76 (1.5)48 (1.1)28 (5.4)
其他消化系统疾病病史（消化道溃疡/胆结石/胆囊炎等）0.7860.375
否4 611 (92.6)4 137 (92.8)474 (91.7)
是366 (7.4)323 (7.2)43 (8.3)
慢病史（包括高血压、糖尿病、冠心病、脑卒中史、慢性阻塞性肺疾病、哮喘、恶性肿瘤患病史）0.0080.928
否3 978 (79.9)3 564 (79.9)414 (80.1)
是999 (20.1)896 (20.1)103 (19.9)
过去半年用药史（降压、降血糖、降脂和心血管疾病用药等）0.1000.752
否4 078 (81.9)3 657 (82.0)421 (81.4)
是899 (18.1)803 (18.0)96 (18.6)
吸烟行为6.2810.043
不吸烟2 421 (48.6)2 148 (48.2)273 (52.8)
戒烟510 (10.2)452 (10.1)58 (11.2)
吸烟2 046 (41.1)1 860 (41.7)186 (36.0)
饮酒行为31.388<0.001
不饮酒1 811 (36.4)1 660 (37.2)151 (29.2)
偶尔饮酒1 893 (38.0)1 682 (37.7)211 (40.8)
适量饮酒405 (8.1)377 (8.5)28 (5.4)
过量饮酒868 (17.5)741 (16.6)127 (24.6)
体力活动水平4.7600.093
低1 690 (34.0)1 495 (33.5)195 (37.7)
中1 131 (22.7)1 029 (23.1)102 (19.7)
高2 156 (43.3)1 936 (43.4)220 (42.6)
血清尿酸分组(μmol/L)44.977<0.001
≤4203 440 (69.1)3 143 (70.5)297 (57.4)
421～479790 (15.9)694 (15.6)96 (18.6)
≥480747 (15.0)623 (13.9)124 (24.0)
UHR分组#（%）30.329<0.001
≤22.251 244 (25.0)1 144 (25.7)100 (19.3)
22.26～28.961 244 (25.0)1 140 (25.6)104 (20.1)
28.97～38.261 244 (25.0)1 104 (24.7)140 (27.3)
≥38.271 245 (25.0)1 072 (24.0)173 (33.3)
BMI (kg/m2)&23.5±3.423.4±3.424.6±3.8-7.363<0.001
甘油三脂 (mmol/L)*1.2 (0.9～1.9)1.2 (0.8～1.8)1.5 (1.0～2.4)-7.548<0.001
总胆固醇 (mmol/L)*5.0 (4.4～5.6)5.0 (4.4～5.6)4.9 (4.2～5.7)-0.0120.991
HDL-C (mmol/L)*1.3 (1.1～1.5)1.3 (1.1～1.5)1.2 (1.0～1.5)-2.4840.013
LDL-C (mmol/L)*2.9 (2.3～3.4)2.9 (2.4～3.5)2.7 (2.1～3.3)-4.647<0.001
肌酐 (μmol/L)*83.0 (75.0～93.0)83.0 (75.0～93.0)81.0 (73.0～90.7)-3.2840.001
血清尿酸 (μmol/L)*372.0 (318.0～439.0)370.0 (316.7～434.0)399.0 (335.1～475.0)-5.745<0.001
UHR (%)*29.0 (22.3～38.3)28.6 (22.0～37.9)32.6 (24.1～41.6)-5.343<0.001
), ArticleFig(id=1241139382745354340, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036336048697844, language=CN, label=表1, caption=

广西35～74岁不同肝功能壮族男性基本情况、行为特征及检测结果［），n（%），M（P25，P75）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量调查人数(n=4 977)肝功能正常组(n=4 460)肝功能异常组(n=517)χ2/t/Z值P值
年龄（岁）&54.8±10.455.2±10.450.9±10.28.864<0.001
年龄组（岁）75.931<0.001
35～44968 (19.4)807 (18.1)161 (31.1)
45～541 571 (31.6)1 385 (31.0)186 (36.0)
55～641 240 (24.9)1 145 (25.7)95 (18.4)
65～741 198 (24.1)1 123 (25.2)75 (14.5)
文化程度20.644<0.001
小学及以下1 895 (38.1)1 717 (38.5)178 (34.4)
初中1 911 (38.4)1 721 (38.6)190 (36.8)
高中909 (18.2)808 (18.1)101 (19.5)
大专及以上262 (18.3)214 (4.8)48 (9.3)
职业40.440<0.001
行政管理/专业技术人员/工人/销售服务人员/私营业主1 089 (21.9)920 (20.6)169 (32.7)
农业牧渔劳动者2 683 (53.9)2 434 (54.6)249 (48.2)
家务/待业/下岗/离休/退休/其他1 205 (24.2)1 106 (24.8)99 (19.1)
婚姻状况0.8090.667
已婚4 503 (90.5)4 039 (90.6)464 (89.7)
丧偶/分居/离婚340 (6.8)304 (6.8)36 (7.0)
未婚134 (2.7)117 (2.6)17 (3.3)
过去一年家庭总收入（万元）7.2070.027
<1887 (17.8)802 (18.0)85 (16.4)
1～31 747 (35.1)1 587 (35.6)160 (30.9)
≥32 343 (47.1)2 071 (46.4)272 (52.6)
慢性肝炎/肝硬化病史58.023<0.001
否4 901 (98.5)4 412 (98.9)489 (94.6)
是76 (1.5)48 (1.1)28 (5.4)
其他消化系统疾病病史（消化道溃疡/胆结石/胆囊炎等）0.7860.375
否4 611 (92.6)4 137 (92.8)474 (91.7)
是366 (7.4)323 (7.2)43 (8.3)
慢病史（包括高血压、糖尿病、冠心病、脑卒中史、慢性阻塞性肺疾病、哮喘、恶性肿瘤患病史）0.0080.928
否3 978 (79.9)3 564 (79.9)414 (80.1)
是999 (20.1)896 (20.1)103 (19.9)
过去半年用药史（降压、降血糖、降脂和心血管疾病用药等）0.1000.752
否4 078 (81.9)3 657 (82.0)421 (81.4)
是899 (18.1)803 (18.0)96 (18.6)
吸烟行为6.2810.043
不吸烟2 421 (48.6)2 148 (48.2)273 (52.8)
戒烟510 (10.2)452 (10.1)58 (11.2)
吸烟2 046 (41.1)1 860 (41.7)186 (36.0)
饮酒行为31.388<0.001
不饮酒1 811 (36.4)1 660 (37.2)151 (29.2)
偶尔饮酒1 893 (38.0)1 682 (37.7)211 (40.8)
适量饮酒405 (8.1)377 (8.5)28 (5.4)
过量饮酒868 (17.5)741 (16.6)127 (24.6)
体力活动水平4.7600.093
低1 690 (34.0)1 495 (33.5)195 (37.7)
中1 131 (22.7)1 029 (23.1)102 (19.7)
高2 156 (43.3)1 936 (43.4)220 (42.6)
血清尿酸分组(μmol/L)44.977<0.001
≤4203 440 (69.1)3 143 (70.5)297 (57.4)
421～479790 (15.9)694 (15.6)96 (18.6)
≥480747 (15.0)623 (13.9)124 (24.0)
UHR分组#（%）30.329<0.001
≤22.251 244 (25.0)1 144 (25.7)100 (19.3)
22.26～28.961 244 (25.0)1 140 (25.6)104 (20.1)
28.97～38.261 244 (25.0)1 104 (24.7)140 (27.3)
≥38.271 245 (25.0)1 072 (24.0)173 (33.3)
BMI (kg/m2)&23.5±3.423.4±3.424.6±3.8-7.363<0.001
甘油三脂 (mmol/L)*1.2 (0.9～1.9)1.2 (0.8～1.8)1.5 (1.0～2.4)-7.548<0.001
总胆固醇 (mmol/L)*5.0 (4.4～5.6)5.0 (4.4～5.6)4.9 (4.2～5.7)-0.0120.991
HDL-C (mmol/L)*1.3 (1.1～1.5)1.3 (1.1～1.5)1.2 (1.0～1.5)-2.4840.013
LDL-C (mmol/L)*2.9 (2.3～3.4)2.9 (2.4～3.5)2.7 (2.1～3.3)-4.647<0.001
肌酐 (μmol/L)*83.0 (75.0～93.0)83.0 (75.0～93.0)81.0 (73.0～90.7)-3.2840.001
血清尿酸 (μmol/L)*372.0 (318.0～439.0)370.0 (316.7～434.0)399.0 (335.1～475.0)-5.745<0.001
UHR (%)*29.0 (22.3～38.3)28.6 (22.0～37.9)32.6 (24.1～41.6)-5.343<0.001
), ArticleFig(id=1241139382866989168, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036336048697844, language=EN, label=Table 2, caption=

Multivariate logistic regression analysis of factors influencing abnormal liver function among Zhuang minority male residents aged 35-74 years in Guangxi

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型一模型二
调整OR (95% CI)P值调整OR (95% CI)P值
血清尿酸分组 (μmol/L)
≤4201.001.00
421～4791.47 (1.14～1.87)0.0021.30 (1.01～1.67)0.045
≥4802.02 (1.60～2.53)<0.0011.69 (1.32～2.15)<0.001
UHR分组（%）
≤22.251.001.00
22.26～28.960.99 (0.74-1.32)0.9201.23 (0.89-1.71)0.210
28.97～38.261.34 (1.02-1.76)0.0371.76 (1.24-2.50)0.002
≥38.271.70 (1.31-2.21)<0.0012.08 (1.39-3.11)<0.001
), ArticleFig(id=1241139383013789812, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036336048697844, language=CN, label=表2, caption=

广西35～74岁壮族男性肝功能异常影响因素的多因素logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型一模型二
调整OR (95% CI)P值调整OR (95% CI)P值
血清尿酸分组 (μmol/L)
≤4201.001.00
421～4791.47 (1.14～1.87)0.0021.30 (1.01～1.67)0.045
≥4802.02 (1.60～2.53)<0.0011.69 (1.32～2.15)<0.001
UHR分组（%）
≤22.251.001.00
22.26～28.960.99 (0.74-1.32)0.9201.23 (0.89-1.71)0.210
28.97～38.261.34 (1.02-1.76)0.0371.76 (1.24-2.50)0.002
≥38.271.70 (1.31-2.21)<0.0012.08 (1.39-3.11)<0.001
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广西35～74岁壮族男性尿酸/高密度脂蛋白胆固醇比值与肝功能的关联性研究
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戴学宾 , 仇小强 , 曾小云 , 苏莉 , 黄东萍 , 刘顺 , 韦玉霞 , 谢艺红
现代预防医学 | 临床与预防 2025,52(17): 3240-3246
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现代预防医学 | 临床与预防 2025, 52(17): 3240-3246
广西35～74岁壮族男性尿酸/高密度脂蛋白胆固醇比值与肝功能的关联性研究
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戴学宾, 仇小强, 曾小云, 苏莉, 黄东萍, 刘顺, 韦玉霞, 谢艺红
作者信息
  • 广西医科大学公共卫生学院，广西 南宁 530021

    • 戴学宾（2000—），男，硕士在读，研究方向：慢性病流行病学

通讯作者:

谢艺红，E-mail:
Association between serum uric acid to high-density lipoprotein cholesterol ratio and liver function among Zhuang minority male residents aged 35-74 years in Guangxi
Xue-bin DAI, Xiao-qiang QIU, Xiao-yun ZENG, Li SU, Dong-ping HUANG, Shun LIU, Yu-xia WEI, Yi-hong XIE
Affiliations
  • School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
出版时间: 2025-09-10 doi: 10.20043/j.cnki.MPM.202410303
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目的

探讨广西壮族自治区（简称广西）35～74岁壮族男性血清尿酸水平、尿酸/高密度脂蛋白胆固醇比值（UHR）与肝功能的关系，为血清尿酸控制、肝功能防护措施的制定提供科学依据。

方法

采用横断面调查的方法，基于广西少数民族自然人群队列对壮族男性进行问卷调查、体格检查，并采集血液和尿液进行检测，分别采用logistic回归和限制性立方样条分析肝功能异常的影响因素及其与血清尿酸、UHR的剂量-反应关系。

结果

共纳入4 977名壮族男性，年龄均数为54.8岁，初中文化程度者占38.4%，农业牧渔劳动者占53.9%，过去一年家庭总收入在3万元以上者占47.1%，SUA>420 μmol/L者占30.9%，肝功能异常检出率为10.4%。在控制其他因素影响后，与血清尿酸正常组相比，血清尿酸为421～479 μmol/L组和≥480 μmol/L组肝功能异常发生风险的调整OR值（95% CI）分别为1.30（1.01～1.67）、1.69（1.32～2.15）；与UHR≤22.25%组相比，UHR为22.26%～28.96%组、28.97%～38.26%组、≥38.27%组肝功能异常发生风险的调整OR值（95% CI）分别为1.23（0.89～1.71）、1.76（1.24～2.50）、2.08（1.39～3.11）。肝功能异常的发生风险随血清尿酸、UHR水平增加呈非线性增加（Pnonlinear<0.001）。

结论

广西35～74岁壮族男性血清尿酸、UHR水平与肝功能异常发生风险密切相关，应加强壮族中老年人健康教育，积极控制血清尿酸水平，降低UHR比值，保护肝脏健康。

壮族  /  男性  /  肝功能  /  尿酸水平  /  尿酸/高密度脂蛋白胆固醇
Objective

To explore the association between serum uric acid (SUA), the uric acid to high-density lipoprotein cholesterol ratio (UHR), and liver function among Zhuang minority male residents aged 35-74 years in Guangxi, and to provide scientific evidence for developing strategies to regulate SUA levels and preserve hepatic health.

Methods

A cross-sectional study was conducted based on the Guangxi Ethnic Minorities Cohort, using structured questionnaires, physical examinations, and blood and urine sample collection. Logistic regression analysis was used to identify factors associated with liver dysfunction, while restricted cubic spline was performed to evaluate dose-response relationships of SUA and UHR with liver dysfunction.

Results

This study included 4 977 Zhuang minority male adults, with a mean age of 54.8 years. Among them,38.4% of participants had middle school education, 53.9% were farmers, and 47.1% with household income over 30 000 Yuan in the past year, 30.9% with SUA levels >420 μmol/L, and 10.4% had liver dysfunction. After adjusting for confounders, compared to the normal SUA group, the adjusted OR(95% CI) for liver dysfunction in the 421-479 μmol/L and ≥480 μmol/L groups were 1.30 (1.01-1.67) and 1.69 (1.32-2.15), respectively. Compared with the lowest UHR quartile (≤22.25%), the adjusted OR (95% CI) for the 22.26-28.96%, 28.97-38.26%, and ≥38.27% quartiles were 1.23 (0.89-1.71), 1.76(1.24-2.50), and 2.08 (1.39-3.11), respectively. The risk of liver dysfunction increased non-linearly with the increase of SUA and UHR levels (Pnonlinearity <0.001).

Conclusions

SUA and UHR demonstrated significant associations with the risk of liver dysfunction among Zhuang minority male residents aged 35-74 years in Guangxi. Targeted health education efforts should be strengthened to control SUA levels and reduce UHR, thereby helping to preserve liver function in middle-aged and older individuals of the Zhuang minority.

Zhuang minorities  /  Male  /  Liver function  /  Uric acid levels  /  Uric acid to high-density lipoprotein cholesterol ratio
戴学宾, 仇小强, 曾小云, 苏莉, 黄东萍, 刘顺, 韦玉霞, 谢艺红. 广西35～74岁壮族男性尿酸/高密度脂蛋白胆固醇比值与肝功能的关联性研究. 现代预防医学, 2025 , 52 (17) : 3240 -3246 . DOI: 10.20043/j.cnki.MPM.202410303
Xue-bin DAI, Xiao-qiang QIU, Xiao-yun ZENG, Li SU, Dong-ping HUANG, Shun LIU, Yu-xia WEI, Yi-hong XIE. Association between serum uric acid to high-density lipoprotein cholesterol ratio and liver function among Zhuang minority male residents aged 35-74 years in Guangxi[J]. Modern Preventive Medicine, 2025 , 52 (17) : 3240 -3246 . DOI: 10.20043/j.cnki.MPM.202410303
正文
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血清尿酸（serum uric acid）是嘌呤代谢的终产物，其主要生成场所是肝脏[1]。研究发现，血清尿酸与非酒精性脂肪肝密切相关[2-3]，血清尿酸异常升高是转氨酶升高[3]和肝脂肪变性[4]的危险因素，可能与其通过炎症、氧化应激、损伤等引起肝脏脂肪堆积、缺氧和细胞损伤有关[5]。另外，血清尿酸与高血压、糖尿病、心脑血管疾病等多种疾病有关[6-7]，这些疾病也可导致肝功能损伤[8]。目前关于血清尿酸对肝功能影响的研究多基于体检人群，基于自然人群并控制其他疾病因素影响的研究较少。另外，近期研究发现，尿酸/高密度脂蛋白胆固醇比值（uric acid to high-density lipoprotein cholesterol ratio，UHR）作为一种新的炎症和代谢标志物[9-10]，是非酒精性脂肪肝的危险因素[11-12]，该指标具有更高的敏感性和特异性，但目前国内关于UHR与肝功能关系的研究少见报道。
广西壮族自治区（简称广西）壮族人口数占全国壮族人口数的87.8%，广西35～74岁壮族男性高尿酸血症（hyperuricemia，HUA）患病率高于全国平均水平[13]，且男性HUA患者丙氨酸氨基转移酶（alanine aminotransferase，ALT）和天门冬氨酸氨基转移酶（aspartate aminotransferase，AST）的异常率明显高于女性[14]。本研究旨在探讨35～74岁壮族男性血清尿酸水平、UHR与肝功能之间的关联性及其剂量-反应关系，为血清尿酸控制、肝功能防护措施的制定提供科学依据。
1　对象与方法
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1.1　研究对象
基于2018—2019年广西少数民族自然人群队列，选择壮族男性作为研究对象。纳入标准：（1）壮族男性；（2）年龄在35～74岁；（3）籍贯为广西，并在当地居住五年以上；（4）神志清楚，能够正常交流；（5）自愿参加，能配合问卷调查并签署知情同意书。排除标准：（1）患有严重精神疾病，不能正常交流者；（2）未完成问卷调查、体检或未提供血液标本者。本研究通过广西医科大学伦理委员会批准（伦理号：20170206-1）。
1.2　调查方法
采用横断面调查方法由经过统一培训的公共卫生人员开展面对面调查。调查内容：（1）结构化问卷调查，包括人口学基本特征（性别、年龄、职业等）、行为生活方式（吸烟、饮酒等，并采用国际体力活动问卷对过去一周体力活动情况进行评估）、疾病和用药史等；（2）体格检查：身高、体重、血压等；（3）实验室检查：采集清晨空腹静脉血10 ml，冷藏保存4 h内转运回实验室，当日离心分离送检，检测项目包括血清尿酸、甘油三脂（triglyceride）、总胆固醇（total cholesterol）、高密度脂蛋白胆固醇（high-density lipoprotein cholesterol，HDL-C）、低密度脂蛋白胆固醇（low-density lipoprotein cholesterol，LDL-C）、肌酐（creatinine）、ALT、AST等，检测仪器采用罗氏cobas c702型全自动生化分析仪（德国罗氏公司）进行。实验室检测委托广西品真医学检验实验室有限公司进行，每天随机抽取5%的样本送广西医科大学第一附属医院检验科进行检测比对，确保检测结果真实可靠。
1.3　相关概念定义及判定标准
（1）肝功能异常：ALT>40 U/L和（或）AST>40 U/L[15-16]；（2）HUA：在正常嘌呤饮食状态下，空腹血液标本血清尿酸>420 μmol/L(7 mg/dl)[1]；（3）吸烟情况：吸烟指每天≥1支或每周≥7支且持续时间超过六个月；不吸烟为从来不吸烟或吸烟的量和频率未达到吸烟定义的标准；戒烟为既往吸烟，但调查时已戒烟半年及以上[17]；（4）饮酒情况：分为不饮酒、偶尔饮酒、适量饮酒、过量饮酒，具体定义见本队列已发表文献[18]；（5）体力活动水平：根据不同强度体力活动对应的代谢当量赋值×每周频率（d/周）×每天时间（min/d）计算每周从事某种强度的体力活动水平，按照总体体力活动水平分级标准分高、中、低三个等级[19]。
1.4　统计学方法
使用R 4.3.3软件进行统计分析。连续变量采用（均数±标准差）或中位数（P25，P75）描述，分类变量采用频数和构成比描述。肝功能异常影响因素单因素分析采用t检验、Mann-Whitney U检验、χ2检验进行，将单因素分析P<0.1的变量纳入多因素logistic回归分析，采用限制性立方样条图探讨血清尿酸、UHR与肝功能异常发生风险的剂量-反应关系。双侧检验水准α=0.05。
2　结果
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2.1　基本情况
共纳入4 977名壮族男性，平均年龄为54.8岁，以45～54岁年龄组最多，占31.6%；初中文化程度占38.4%；小学及以下占38.1%；90.5%的研究对象已婚；53.9%的研究对象为农业牧渔劳动者；过去一年家庭总收入在3万元以上的占47.1%；有慢性肝炎/肝硬化病史占1.5%，有消化道溃疡/胆结石/胆囊炎等消化系统疾病病史占7.4%；血清尿酸在421～479 μmol/L之间占15.9%；血清尿酸≥480 μmol/L占15.0%；BMI均值为23.5 kg/m2，UHR中位数为29.0%。见表1。
2.2　肝功能异常影响因素分析
4 977名研究对象中，肝功能异常共517人，肝功能异常检出率为10.4%。单因素分析显示，不同年龄组、文化程度、职业、过去一年家庭总收入、慢性肝炎/肝硬化病史、吸烟行为、饮酒行为、血清尿酸分组及UHR分组的研究对象肝功能异常检出率不同（P<0.05），肝功能异常组的甘油三脂、血清尿酸、UHR高于肝功能正常组（P<0.05），而总胆固醇、HDL-C、LDL-C、肌酐低于肝功能正常组（P<0.05）。见表1。
以肝功能是否异常为因变量进行多因素logistic回归分析。当仅纳入有统计学意义的人口学特征变量进行校正时，与血清尿酸≤420 μmol/L组相比，血清尿酸为421～479 μmol/L组、≥480 μmol/L组的肝功能异常发生风险的调整OR值（95% CI）分别为1.47（1.14～1.87）、2.02（1.60～2.53）；与UHR≤22.25%组相比，UHR为28.97%～38.26%组、≥38.27%组肝功能异常发生风险的调整OR值（95% CI）分别为1.34（1.02～1.76）、1.70（1.31～2.21）。见表2。
将表1中所有P<0.1的变量纳入多因素分析，在校正统计学意义的变量后，与血清尿酸≤420 μmol/L组相比，血清尿酸为421～479 μmol/L组、≥480 μmol/L组肝功能异常发生风险的调整OR值（95% CI）分别为1.30（1.01～1.67）、1.69（1.32～2.15）；与UHR≤22.25%组相比，UHR为28.97%～38.26%组、≥38.27%组肝功能异常发生风险的调整OR值（95% CI）分别为1.76（1.24～2.50）、2.08（1.39～3.11）。见表2。
2.3　肝功能异常与血清尿酸水平的剂量-反应关系
将血清尿酸、UHR作为连续变量分析其与肝功能异常发生风险的剂量-反应关系。结果显示，在调整年龄、慢性肝炎/肝硬化病史、BMI、甘油三酯、HDL-C、LDL-C、饮酒行为的影响后，当血清尿酸≥384.92 μmol/L时，随着血清尿酸升高，肝功能异常发生的风险呈非线性增加（Pnonlinear<0.001），见图1；当UHR≥29.23%时，随着UHR升高，肝功能异常发生的风险呈非线性增加（Pnonlinear<0.001），见图2。
3　讨论
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随着经济的发展、膳食模式及生活方式发生改变，HUA患病率及肝功能异常率明显上升且呈年轻化趋势[13-14]。本研究显示，广西35～74岁壮族男性肝功能异常率为10.4%，低于海南省35～74岁居民的39.2%和西藏那曲市18岁及以上藏族居民的13.4%[20-21]，可能与肝功能异常评判标准和研究地区不同有关，海南省除采用ALT、AST进行判定外，同时将γ-谷酰胺转移酶作为肝功能异常判定标准[20]。西藏那曲市地处极高海拔地区，氧气含量较低，低氧环境易引发肝脏氧化应激而损害肝功能[22]。
本研究显示，在调整年龄、慢性肝炎/肝硬化病史、BMI、甘油三酯、HDL-C、LDL-C和饮酒行为等影响后，与血清尿酸正常组相比，血清尿酸为421～479 μmol/L组、≥480 μmol/L组肝功能异常的风险上升。与既往研究发现血清尿酸升高可引起肝脏损伤、ALT、AST水平增高一致[3,23]，可能由于血清尿酸升高可激活NLRP3炎性小体，导致肝细胞脂肪积累和胰岛素抵抗[24]；并可促进细胞氧化应激，损伤细胞膜、蛋白质和DNA，导致肝细胞凋亡或坏死[25]。另外，本研究发现，血清尿酸水平与肝功能异常发生风险存在剂量-反应关系，当血清尿酸≥384.92 μmol/L时（HUA判定标准为血清尿酸>420 μmol/L），肝功能异常发生的风险呈非线性增加，提示即使血清尿酸在正常水平，也可能对肝功能产生损害，与既往研究发现非酒精性脂肪肝发病率与血清尿酸存在剂量-反应关系的结果一致[26]，今后应加强血清尿酸水平的控制，减少对肝功能的影响。
近年来，UHR被认为是代谢和炎症性疾病的一种新颖且更敏感的生物标志物，对于代谢综合征的预测优于尿酸等其他公认的指标[27]，UHR与慢性肾病、2型糖尿病及其合并症等发生风险有关并可用于临床预测[9,28]。目前，国内外关于UHR与肝功能异常风险关系的研究较少，一项基于美国全国健康和营养调查（NHANES）的研究发现，UHR水平升高可增加非酒精性脂肪肝的风险及肝脂肪变性的严重程度[11]；Kosekli MA等人[12]基于医院非酒精性脂肪肝患者临床随访研究发现，UHR可用于肝脂肪变性的诊断。本研究发现，与UHR正常组相比，UHR为28.97%～38.26%组、≥38.27%组肝功能异常发生风险明显增加，且呈剂量-反应关系。可能与HDL-C具有抗炎、抗氧化、抗血栓形成以及缓解胰岛素抵抗等诸多特性[29]有关，其对血清尿酸升高引起的肝脏损伤具有一定拮抗作用，当血清尿酸相对较高而HDL-C相对较低时，UHR水平升高，肝功能异常风险升高。
综上，广西35～74岁壮族男性血清尿酸、UHR水平与肝功能异常发生风险密切相关，应加强壮族中老年人健康教育，积极控制血清尿酸水平，降低UHR比值，保护肝脏健康。
本研究的局限性在于采用横断面调查的方法进行，高血清尿酸、UHR水平与肝功能异常出现的先后顺序无法确定，今后需加强队列随访，采用纵向研究的方法进一步验证其因果关系；另外，由于目前肝功能异常判定尚无统一标准，本研究仅采用目前大多数研究通常采用的二个相对敏感的血清学指标（ALT、AST）进行判定，可能会低估肝功能异常检出率；同时，由于本研究主要关注35～74岁的壮族男性居民，研究结果的外推需要谨慎，建议今后进一步扩大研究对象的范围。
基金
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  • 国家重点研发计划资助项目(2017YFC0907103)
  • 广西自然科学基金(2022GXNSFAA035623)
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2025年第52卷第17期
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doi: 10.20043/j.cnki.MPM.202410303
  • 接收时间：2024-10-19
  • 首发时间：2026-03-18
  • 出版时间：2025-09-10
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  • 收稿日期：2024-10-19
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国家重点研发计划资助项目(2017YFC0907103)
广西自然科学基金(2022GXNSFAA035623)
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    广西医科大学公共卫生学院，广西 南宁 530021

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谢艺红，E-mail:
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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