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Article(id=1321169587626954890, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321169578152014376, articleNumber=null, orderNo=null, doi=10.11847/zgggws1146826, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1735574400000, receivedDateStr=2024-12-31, revisedDate=1752249600000, revisedDateStr=2025-07-12, acceptedDate=1754064000000, acceptedDateStr=2025-08-02, onlineDate=1792920975834, onlineDateStr=2026-10-25, pubDate=1760025600000, pubDateStr=2025-10-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792920975834, onlineIssueDateStr=2026-10-25, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792920975834, creator=13701087609, updateTime=1792920975834, updator=13701087609, issue=Issue{id=1321169578152014376, tenantId=1146029695717560320, journalId=1319373219989389464, year='2025', volume='41', issue='10', pageStart='1153', pageEnd='1280', issueExtLink='null', onlineDate='null', pubDate='1760025600000', pubDateStr='2025-10-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792920973575, creator='13701087609', updateTime=1792920973575, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1168, endPage=1175, ext={EN=ArticleExt(id=1321169587845058699, articleId=1321169587626954890, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Associations between triglyceride glucose-obesity composite indices and risk of hyperuricemia among adults in Qingdao, China: a prospective cohort study, columnId=1320427696342020970, journalTitle=Chinese Journal of Public Health, columnName=Epidemiological Research, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the associations between triglyceride glucose (TyG)-obesity composite indices and the risk of hyperuricemia (HUA) in Qingdao, China, providing a basis for the prevention and management of HUA.

Methods

A prospective cohort study was conducted, encompassing a total of 3 294 adults recruited in the baseline survey from 2006 to 2009 and participating the follow-up survey from 2012 to 2015 and 2019 to 2023. Cox proportional hazards regression was adopted to analyze the associations of baseline TyG-body mass index (TyG-BMI) and TyG-waist circumference (TyG-WC) with the risk of HUA. The restricted cubic spline method was used to analyze the dose-response relationships of baseline TyG-BMI and TyG-WC with the risk of HUA. Subgroup analyses were performed based on covariates such as gender and age, and their interactions with the TyG-obesity composite indices were analyzed.

Results

A total of 430 (13.1%) adults were identified with HUA. Multivariate Cox regression analysis showed that the highest quartiles of baseline TyG-BMI and TyG-WC increased the risk of HUA by 48% (HR = 1.48, 95%CI: 1.10–1.99) and 46% (HR = 1.46, 95%CI: 1.08–1.99) compared with the lowest quartiles. Restricted cubic splines indicated linear dose-response relationships of baseline TyG-BMI (Poverall < 0.001, Pnon-linear = 0.639) and TyG-WC (Poverall < 0.001, Pnon-linear = 0.776) with the risk of HUA. Subgroup analyses showed that the highest quartiles of baseline TyG-obesity composite indices in females, rural adults, and hypertension adults were higher than those in males, urban adults, and non-hypertension adults (all P < 0.05). No significant interactions were observed with TyG-obesity composite indices (all P > 0.05).

Conclusion

Elevated baseline levels of TyG-BMI and TyG-WC are associated with an increased risk of HUA, particularly among females, rural adults, and hypertension adults.

, authors=Haojia WU1, Jian SUN2, Meiyi YE3, Zhi WANG4, Baozhu GUO1, Jing CUI4, Jianping SUN4, authorsList=Haojia WU, Jian SUN, Meiyi YE, Zhi WANG, Baozhu GUO, Jing CUI, Jianping SUN, authorCompany=null, correspAuthors=Jianping SUN, authorNote=null, correspAuthorsNote=
SUN Jianping, E-mail:
, copyrightStatement=Copyright © 2025 Chinese Journal of Public Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1321169591095644311, articleId=1321169587626954890, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=青岛市成年人TyG–肥胖联合指数与高尿酸血症发病关系的前瞻性队列研究, columnId=1320427696509793132, journalTitle=中国公共卫生, columnName=流行病学研究, runingTitle=null, highlight=null, articleAbstract=
目的

探讨青岛市甘油三酯葡萄糖指数（TyG）–肥胖联合指数与高尿酸血症（HUA）发病风险的关联，以期为预防与管理HUA提供科学依据。

方法

采用前瞻性队列研究，选取2006—2009年参与青岛市糖尿病预防项目并于2012—2015年、2019—2023年完成随访的3 294名成年人作为研究对象。采用Cox比例风险回归分析基线TyG–体质量指数（TyG-BMI）、TyG–腰围指数（TyG-WC）不同水平组与HUA发病风险的关联，采用限制性立方样条图分析基线TyG-BMI、TyG-WC指数与HUA发病风险的剂量–反应关系，根据性别、年龄等协变量进行亚组分析，并分析其与TyG–肥胖联合指数的交互作用。

结果

HUA发病430例，新发HAU累计发病率13.1%。多因素Cox回归分析显示，基线TyG-BMI、TyG-WC指数的Q4水平组较Q1组HUA的发病风险分别增加48%（HR=1.48，95%CI=1.10～1.99）和46%（HR=1.46，95%CI=1.08～1.99）。限制性立方样条图显示，基线TyG-BMI（P整体<0.001，P非线性=0.639）、TyG-WC（P整体<0.001，P非线性=0.776）指数与HUA发病风险均呈线性剂量关系。女性、农村、高血压病人群Q4组基线TyG–肥胖联合指数的HUA发病风险关联分别高于男性、城市、非高血压（均P<0.05），各亚组均不存在交互作用（均P>0.05）。

结论

基线TyG-BMI和TyG-WC指数升高均与HUA发病风险增加相关，且在女性、农村及高血压人群中更为显著。

, authors=吴浩佳1, 孙健2, 叶美怡3, 王治4, 郭宝柱1, 崔静4, 孙健平4, *, *, authorsList=吴浩佳, 孙健, 叶美怡, 王治, 郭宝柱, 崔静, 孙健平, authorCompany=null, correspAuthors=孙健平, authorNote=

吴浩佳（1999—），硕士在读，研究方向：公共卫生（营养与食品卫生学）

, correspAuthorsNote=
孙健平，E-mail：
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Frontiers in Endocrinology, 2022, 13: 1035114., articleTitle=null, refAbstract=null), Reference(id=1321169602147635452, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=29, rfOrder=28, authorNames=null, journalName=null, refType=null, unstructuredReference=Ponticelli C, Podestà M A, Moroni G. Hyperuricemia as a trigger of immune response in hypertension and chronic kidney disease[J]. Kidney International, 2020, 98(5): 1149-1159., articleTitle=null, refAbstract=null), Reference(id=1321169602235715837, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=30, rfOrder=29, authorNames=null, journalName=null, refType=null, unstructuredReference=李蓉蓉, 王盛书, 杨姗姗, 等. 北京城乡老年人血尿酸水平与全因死亡风险的关联研究[J]. 中国慢性病预防与控制, 2024, 32(1): 15-21., articleTitle=null, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1321169591326331032, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, xref=1, ext=[AuthorCompanyExt(id=1321169591334719641, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, companyId=1321169591326331032, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1School of Public Health, Shandong Second Medical University, Weifang 261053, China), AuthorCompanyExt(id=1321169591347302554, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, companyId=1321169591326331032, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1山东第二医科大学公共卫生学院，山东 潍坊 261053)]), AuthorCompany(id=1321169591447965851, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, xref=2, ext=[AuthorCompanyExt(id=1321169591460548764, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, companyId=1321169591447965851, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2Department of Urology, Qingdao Women and Children’s Hospital, Qingdao 266000, China), AuthorCompanyExt(id=1321169591468937373, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, companyId=1321169591447965851, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2青岛市妇女儿童医院泌尿外科，山东 青岛 266000)]), AuthorCompany(id=1321169591573794974, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, xref=3, ext=[AuthorCompanyExt(id=1321169591582183583, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, companyId=1321169591573794974, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3College of Humanities and Social Sciences, Dalian Medical University, Dalian 116000, China), AuthorCompanyExt(id=1321169591586377888, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, companyId=1321169591573794974, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3大连医科大学人文与社会科学学院，辽宁 大连 116000)]), AuthorCompany(id=1321169591666069665, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, xref=4, ext=[AuthorCompanyExt(id=1321169591682846882, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, companyId=1321169591666069665, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=4Qingdao Center for Disease Control and Prevention/Qingdao Institute of Preventive Medicine, Qingdao 266000, China), AuthorCompanyExt(id=1321169591695429795, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, companyId=1321169591666069665, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=4青岛市疾病预防控制中心/青岛市预防医学研究院，山东 青岛 266000)])], figs=[ArticleFig(id=1321169596749566165, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, language=EN, label=Fig.1, caption=Dose-response curves of baseline TyG-obesity composite indices with the risk of HUA, figureFileSmall=GQvhsct1+hTObkK0Dm4iag==, figureFileBig=vM2X+Dus40fh4GML2fC2vw==, tableContent=null), ArticleFig(id=1321169596829257942, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, language=CN, label=图1, caption=基线TyG–肥胖联合指数与HUA发病风险的剂量–效应曲线

注：限制性立方样条模型均调整了年龄、性别、城乡分布、SBP、DBP、TC、LDL-C、ALT和GGT。

, figureFileSmall=GQvhsct1+hTObkK0Dm4iag==, figureFileBig=vM2X+Dus40fh4GML2fC2vw==, tableContent=null), ArticleFig(id=1321169597148025047, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, language=EN, label=Tab.1, caption=

General demographic data of participants

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总数（n=3 294）非HUA组（n=2 864）HUA组（n=430）χ2/t值P值
年龄/岁51.18±10.1950.86±10.1853.33±10.054.710<0.001
性别/人数（构成比/%）0.0970.755
　男1 125（34.2）981（34.3）144（33.5）
　女2 169（65.8）1 883（65.7）286（66.5）
受教育程度/人数（构成比/%）3.2990.192
　小学及以下1 360（41.3）1 166（40.7）194（45.1）
　初中1 172（35.6）1 033（36.1）139（32.3）
　高中及以上762（23.1）665（20.2）97（22.6）
婚姻状况/人数（构成比/%）1.1170.290
　未婚430（13.1）145（5.1）27（6.3）
　已婚2 864（86.9）2 719（94.9）403（93.7）
城乡分布/人数（构成比/%）7.9000.005
　城市809（24.6）680（23.7）129（30.0）
　农村2 485（75.4）2 184（76.3）301（70.0）
饮酒/人数（构成比/%）0.1950.659
　否2 789（84.7）2 428（84.8）361（84.0）
　是505（15.3）436（15.2）69（16.0）
吸烟/人数（构成比/%）0.4360.509
　否2 591（78.7）2 258（78.8）333（77.4）
　是703（21.3）606（21.2）97（22.6）
BMI/（kg/m2）25.17±4.4525.07±3.4225.84±3.564.295<0.001
WC/cm83.27±10.0482.94±9.9985.50±10.044.947<0.001
SBP/mmHg133.24±21.22132.35±20.84139.13±22.755.823<0.001
DBP/mmHg82.76±11.6682.44±11.4784.83±12.703.678<0.001
FPG/mmol/L5.59±0.985.57±0.955.73±1.123.203<0.001
TC/mmol/L5.23±1.015.20±0.995.45±1.084.618<0.001
TG/mmol/L1.28±0.831.24±0.781.51±1.074.855<0.001
LDL-C/mmol/L3.01±0.882.98±0.873.16±0.923.907<0.001
HDL-C/mmol/L1.64±0.391.65±0.391.61±0.38–2.0110.044
UA/μmol/L281.21±61.64277.77±60.89304.10±61.788.346<0.001
GGT/u/L21.58±23.8021.24±24.3223.85±19.812.1250.034
ALT/u/L16.06±11.6416.04±11.7516.22±10.910.2990.765
TyG-BMI174.14±31.05172.79±30.56183.09±32.766.133<0.001
TyG-WC576.04±95.67571.57±94.38605.82±98.956.972<0.001
), ArticleFig(id=1321169597336768728, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, language=CN, label=表1, caption=

研究对象的一般人口学情况比较

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总数（n=3 294）非HUA组（n=2 864）HUA组（n=430）χ2/t值P值
年龄/岁51.18±10.1950.86±10.1853.33±10.054.710<0.001
性别/人数（构成比/%）0.0970.755
　男1 125（34.2）981（34.3）144（33.5）
　女2 169（65.8）1 883（65.7）286（66.5）
受教育程度/人数（构成比/%）3.2990.192
　小学及以下1 360（41.3）1 166（40.7）194（45.1）
　初中1 172（35.6）1 033（36.1）139（32.3）
　高中及以上762（23.1）665（20.2）97（22.6）
婚姻状况/人数（构成比/%）1.1170.290
　未婚430（13.1）145（5.1）27（6.3）
　已婚2 864（86.9）2 719（94.9）403（93.7）
城乡分布/人数（构成比/%）7.9000.005
　城市809（24.6）680（23.7）129（30.0）
　农村2 485（75.4）2 184（76.3）301（70.0）
饮酒/人数（构成比/%）0.1950.659
　否2 789（84.7）2 428（84.8）361（84.0）
　是505（15.3）436（15.2）69（16.0）
吸烟/人数（构成比/%）0.4360.509
　否2 591（78.7）2 258（78.8）333（77.4）
　是703（21.3）606（21.2）97（22.6）
BMI/（kg/m2）25.17±4.4525.07±3.4225.84±3.564.295<0.001
WC/cm83.27±10.0482.94±9.9985.50±10.044.947<0.001
SBP/mmHg133.24±21.22132.35±20.84139.13±22.755.823<0.001
DBP/mmHg82.76±11.6682.44±11.4784.83±12.703.678<0.001
FPG/mmol/L5.59±0.985.57±0.955.73±1.123.203<0.001
TC/mmol/L5.23±1.015.20±0.995.45±1.084.618<0.001
TG/mmol/L1.28±0.831.24±0.781.51±1.074.855<0.001
LDL-C/mmol/L3.01±0.882.98±0.873.16±0.923.907<0.001
HDL-C/mmol/L1.64±0.391.65±0.391.61±0.38–2.0110.044
UA/μmol/L281.21±61.64277.77±60.89304.10±61.788.346<0.001
GGT/u/L21.58±23.8021.24±24.3223.85±19.812.1250.034
ALT/u/L16.06±11.6416.04±11.7516.22±10.910.2990.765
TyG-BMI174.14±31.05172.79±30.56183.09±32.766.133<0.001
TyG-WC576.04±95.67571.57±94.38605.82±98.956.972<0.001
), ArticleFig(id=1321169597437432025, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, language=EN, label=Tab.2, caption=

Comparison of different baseline TyG-obesity composite indices and incidence of HUA

, figureFileSmall=null, figureFileBig=null, tableContent=
联合指数水平TyG-BMITyG-WC
例数发病数/例累计发病率/%发病密度/（例/千人年）例数发病数/例累计发病率/%发病密度/（例/千人年）
Q1824749.020.2823718.619.1
Q28239811.921.38249511.525.1
Q382411113.527.582410412.624.1
Q482314717.933.882316019.436.6
χ2值29.88417.10545.61620.440
P值<0.001<0.001<0.001<0.001
), ArticleFig(id=1321169597521318106, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, language=CN, label=表2, caption=

基线人群不同TyG–肥胖联合指数水平与HUA发病情况的比较

, figureFileSmall=null, figureFileBig=null, tableContent=
联合指数水平TyG-BMITyG-WC
例数发病数/例累计发病率/%发病密度/（例/千人年）例数发病数/例累计发病率/%发病密度/（例/千人年）
Q1824749.020.2823718.619.1
Q28239811.921.38249511.525.1
Q382411113.527.582410412.624.1
Q482314717.933.882316019.436.6
χ2值29.88417.10545.61620.440
P值<0.001<0.001<0.001<0.001
), ArticleFig(id=1321169597613592795, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, language=EN, label=Tab.3, caption=

Cox regression between baseline TyG-obesity composite indices and the risk of HUA

, figureFileSmall=null, figureFileBig=null, tableContent=
分组模型1模型2模型3
β $ S_{\overline{x}} $HR（95%CI）P值β $ S_{\overline{x}} $HR（95%CI）P值β $ S_{\overline{x}} $HR（95%CI）P值
TyG-BMI0.0010.0050.001
　Q11.001.001.00
　Q20.290.1541.35（0.99～1.82）0.0530.2970.1541.35（0.99～1.82）0.0540.2340.1561.26（0.93～1.71）0.133
　Q30.3300.1501.39（1.04～1.87）0.0280.3280.1501.39（1.03～1.86）0.0290.2130.1551.24（0.91～1.68）0.168
　Q40.5690.1431.71（1.34～2.34）<0.0010.5660.1431.76（1.33～2.33）<0.0010.3900.1531.48（1.10～1.99）0.011
TyG-WC0.0010.001<0.001
　Q11.001.001.00
　Q20.2770.1571.32（0.97～1.80）0.1650.2820.1571.33（0.97～1.81）0.0730.2210.1591.25（0.91～1.70）0.165
　Q30.1460.1551.16（0.86～1.57）0.3440.1490.1561.16（0.86～1.58）0.3400.0360.1611.04（0.76～1.42）0.824
　Q40.5600.1431.75（1.32～2.32）<0.0010.5710.1451.77（1.33～2.35）<0.0010.3810.1571.46（1.08～1.99）0.015
), ArticleFig(id=1321169597697478876, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, language=CN, label=表3, caption=

基线TyG–肥胖联合指数与HUA发病风险的Cox回归

, figureFileSmall=null, figureFileBig=null, tableContent=
分组模型1模型2模型3
β $ S_{\overline{x}} $HR（95%CI）P值β $ S_{\overline{x}} $HR（95%CI）P值β $ S_{\overline{x}} $HR（95%CI）P值
TyG-BMI0.0010.0050.001
　Q11.001.001.00
　Q20.290.1541.35（0.99～1.82）0.0530.2970.1541.35（0.99～1.82）0.0540.2340.1561.26（0.93～1.71）0.133
　Q30.3300.1501.39（1.04～1.87）0.0280.3280.1501.39（1.03～1.86）0.0290.2130.1551.24（0.91～1.68）0.168
　Q40.5690.1431.71（1.34～2.34）<0.0010.5660.1431.76（1.33～2.33）<0.0010.3900.1531.48（1.10～1.99）0.011
TyG-WC0.0010.001<0.001
　Q11.001.001.00
　Q20.2770.1571.32（0.97～1.80）0.1650.2820.1571.33（0.97～1.81）0.0730.2210.1591.25（0.91～1.70）0.165
　Q30.1460.1551.16（0.86～1.57）0.3440.1490.1561.16（0.86～1.58）0.3400.0360.1611.04（0.76～1.42）0.824
　Q40.5600.1431.75（1.32～2.32）<0.0010.5710.1451.77（1.33～2.35）<0.0010.3810.1571.46（1.08～1.99）0.015
), ArticleFig(id=1321169597772976349, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, language=EN, label=Tab.4, caption=

Subgroup analysis between baseline TyG-obesity composite indices and the risk of HUA

, figureFileSmall=null, figureFileBig=null, tableContent=
分组人数HR（95%CI）P交互检验
Q1Q2Q3Q4
TyG-BMI
　性别0.813
　　男1 1251.001.40（0.84～2.34）1.37（0.80～2.33）1.50（0.89～2.55）
　　女2 1691.001.18（0.81～1.73）1.17（0.81～1.70）1.49（1.04～2.15）
　年龄/岁0.738
　　<601 1251.001.18（0.82～1.70）1.08（0.75～1.56）1.40（0.98～2.01）
　　≥602 1691.001.30（0.79～2.46）1.53（0.88～2.68）1.60（0.92～2.77）
　城乡分布0.225
　　城市8091.000.80（0.44～1.44）1.23（0.71～2.14）1.24（0.71～2.17）
　　农村2 4851.001.48（1.03～2.11）1.27（0.87～1.83）1.71（1.19～2.44）
　高血压0.469
　　否1 8111.001.27（0.86～1.81）1.09（0.73～1.64）1.17（0.76～1.80）
　　是1 4831.001.52（0.88～2.62）1.70（1.02～2.86）2.19（1.34～3.60）
TyG-WC
　性别0.087
　　男1 1251.001.70（0.96～2.98）0.96（0.51～1.80）1.61（0.91～2.88）
　　女2 1691.001.02（0.70～1.50）1.04（0.72～1.51）1.46（1.04～2.12）
　年龄/岁0.301
　　<601 1251.001.20（0.84～1.71）0.98（0.68～1.42）1.49（1.04～2.12）
　　≥602 1691.001.31（0.68～2.51）1.08（0.57～2.04）1.36（0.74～2.53）
　城乡分布0.051
　　城市8091.000.63（0.33～1.20）0.88（0.49～1.58）1.49（0.84～2.65）
　　农村2 4851.001.61（1.12～2.32）1.19（0.81～1.74）1.57（1.08～2.28）
　高血压0.594
　　否1 8111.001.08（0.74～1.58）0.94（0.63～1.42）1.11（0.73～1.70）
　　是1 4831.001.96（1.05～3.64）1.65（0.91～3.00）2.59（1.44～4.65）
), ArticleFig(id=1321169597852668126, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169587626954890, language=CN, label=表4, caption=

基线TyG–肥胖联合指数与HUA风险之间的亚组分析

, figureFileSmall=null, figureFileBig=null, tableContent=
分组人数HR（95%CI）P交互检验
Q1Q2Q3Q4
TyG-BMI
　性别0.813
　　男1 1251.001.40（0.84～2.34）1.37（0.80～2.33）1.50（0.89～2.55）
　　女2 1691.001.18（0.81～1.73）1.17（0.81～1.70）1.49（1.04～2.15）
　年龄/岁0.738
　　<601 1251.001.18（0.82～1.70）1.08（0.75～1.56）1.40（0.98～2.01）
　　≥602 1691.001.30（0.79～2.46）1.53（0.88～2.68）1.60（0.92～2.77）
　城乡分布0.225
　　城市8091.000.80（0.44～1.44）1.23（0.71～2.14）1.24（0.71～2.17）
　　农村2 4851.001.48（1.03～2.11）1.27（0.87～1.83）1.71（1.19～2.44）
　高血压0.469
　　否1 8111.001.27（0.86～1.81）1.09（0.73～1.64）1.17（0.76～1.80）
　　是1 4831.001.52（0.88～2.62）1.70（1.02～2.86）2.19（1.34～3.60）
TyG-WC
　性别0.087
　　男1 1251.001.70（0.96～2.98）0.96（0.51～1.80）1.61（0.91～2.88）
　　女2 1691.001.02（0.70～1.50）1.04（0.72～1.51）1.46（1.04～2.12）
　年龄/岁0.301
　　<601 1251.001.20（0.84～1.71）0.98（0.68～1.42）1.49（1.04～2.12）
　　≥602 1691.001.31（0.68～2.51）1.08（0.57～2.04）1.36（0.74～2.53）
　城乡分布0.051
　　城市8091.000.63（0.33～1.20）0.88（0.49～1.58）1.49（0.84～2.65）
　　农村2 4851.001.61（1.12～2.32）1.19（0.81～1.74）1.57（1.08～2.28）
　高血压0.594
　　否1 8111.001.08（0.74～1.58）0.94（0.63～1.42）1.11（0.73～1.70）
　　是1 4831.001.96（1.05～3.64）1.65（0.91～3.00）2.59（1.44～4.65）
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青岛市成年人TyG–肥胖联合指数与高尿酸血症发病关系的前瞻性队列研究
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吴浩佳 1 , 孙健 2 , 叶美怡 3 , 王治 4 , 郭宝柱 1 , 崔静 4 , 孙健平 4, *, *
中国公共卫生 | 流行病学研究 2025,41(10): 1168-1175
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中国公共卫生 |流行病学研究 2025 , 41 (10) : 1168 -1175
青岛市成年人TyG–肥胖联合指数与高尿酸血症发病关系的前瞻性队列研究
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吴浩佳1, 孙健2, 叶美怡3, 王治4, 郭宝柱1, 崔静4, 孙健平4, *, *
作者信息
  • 1山东第二医科大学公共卫生学院，山东 潍坊 261053
  • 2青岛市妇女儿童医院泌尿外科，山东 青岛 266000
  • 3大连医科大学人文与社会科学学院，辽宁 大连 116000
  • 4青岛市疾病预防控制中心/青岛市预防医学研究院，山东 青岛 266000
通讯作者:
孙健平，E-mail：
作者简介:

吴浩佳（1999—），硕士在读，研究方向：公共卫生（营养与食品卫生学）

Associations between triglyceride glucose-obesity composite indices and risk of hyperuricemia among adults in Qingdao, China: a prospective cohort study
Haojia WU1, Jian SUN2, Meiyi YE3, Zhi WANG4, Baozhu GUO1, Jing CUI4, Jianping SUN4
Affiliations
  • 1School of Public Health, Shandong Second Medical University, Weifang 261053, China
  • 2Department of Urology, Qingdao Women and Children’s Hospital, Qingdao 266000, China
  • 3College of Humanities and Social Sciences, Dalian Medical University, Dalian 116000, China
  • 4Qingdao Center for Disease Control and Prevention/Qingdao Institute of Preventive Medicine, Qingdao 266000, China
    • Corresponding Author:
    SUN Jianping, E-mail:
出版时间: 2025-10-10 doi: 10.11847/zgggws1146826
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摘要
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目的

探讨青岛市甘油三酯葡萄糖指数（TyG）–肥胖联合指数与高尿酸血症（HUA）发病风险的关联，以期为预防与管理HUA提供科学依据。

方法

采用前瞻性队列研究，选取2006—2009年参与青岛市糖尿病预防项目并于2012—2015年、2019—2023年完成随访的3 294名成年人作为研究对象。采用Cox比例风险回归分析基线TyG–体质量指数（TyG-BMI）、TyG–腰围指数（TyG-WC）不同水平组与HUA发病风险的关联，采用限制性立方样条图分析基线TyG-BMI、TyG-WC指数与HUA发病风险的剂量–反应关系，根据性别、年龄等协变量进行亚组分析，并分析其与TyG–肥胖联合指数的交互作用。

结果

HUA发病430例，新发HAU累计发病率13.1%。多因素Cox回归分析显示，基线TyG-BMI、TyG-WC指数的Q4水平组较Q1组HUA的发病风险分别增加48%（HR=1.48，95%CI=1.10～1.99）和46%（HR=1.46，95%CI=1.08～1.99）。限制性立方样条图显示，基线TyG-BMI（P整体<0.001，P非线性=0.639）、TyG-WC（P整体<0.001，P非线性=0.776）指数与HUA发病风险均呈线性剂量关系。女性、农村、高血压病人群Q4组基线TyG–肥胖联合指数的HUA发病风险关联分别高于男性、城市、非高血压（均P<0.05），各亚组均不存在交互作用（均P>0.05）。

结论

基线TyG-BMI和TyG-WC指数升高均与HUA发病风险增加相关，且在女性、农村及高血压人群中更为显著。

高尿酸血症（HUA）  /  TyG指数（TyG）  /  肥胖  /  代谢综合征  /  前瞻队列研究  /  成年人  /  青岛市
Objective

To explore the associations between triglyceride glucose (TyG)-obesity composite indices and the risk of hyperuricemia (HUA) in Qingdao, China, providing a basis for the prevention and management of HUA.

Methods

A prospective cohort study was conducted, encompassing a total of 3 294 adults recruited in the baseline survey from 2006 to 2009 and participating the follow-up survey from 2012 to 2015 and 2019 to 2023. Cox proportional hazards regression was adopted to analyze the associations of baseline TyG-body mass index (TyG-BMI) and TyG-waist circumference (TyG-WC) with the risk of HUA. The restricted cubic spline method was used to analyze the dose-response relationships of baseline TyG-BMI and TyG-WC with the risk of HUA. Subgroup analyses were performed based on covariates such as gender and age, and their interactions with the TyG-obesity composite indices were analyzed.

Results

A total of 430 (13.1%) adults were identified with HUA. Multivariate Cox regression analysis showed that the highest quartiles of baseline TyG-BMI and TyG-WC increased the risk of HUA by 48% (HR = 1.48, 95%CI: 1.10–1.99) and 46% (HR = 1.46, 95%CI: 1.08–1.99) compared with the lowest quartiles. Restricted cubic splines indicated linear dose-response relationships of baseline TyG-BMI (Poverall < 0.001, Pnon-linear = 0.639) and TyG-WC (Poverall < 0.001, Pnon-linear = 0.776) with the risk of HUA. Subgroup analyses showed that the highest quartiles of baseline TyG-obesity composite indices in females, rural adults, and hypertension adults were higher than those in males, urban adults, and non-hypertension adults (all P < 0.05). No significant interactions were observed with TyG-obesity composite indices (all P > 0.05).

Conclusion

Elevated baseline levels of TyG-BMI and TyG-WC are associated with an increased risk of HUA, particularly among females, rural adults, and hypertension adults.

hyperuricemia (HUA)  /  triglyceride glucose (TyG) index  /  obesity  /  metabolic syndrome  /  prospective cohort study  /  adult  /  Qingdao city
吴浩佳, 孙健, 叶美怡, 王治, 郭宝柱, 崔静, 孙健平. 青岛市成年人TyG–肥胖联合指数与高尿酸血症发病关系的前瞻性队列研究. 中国公共卫生, 2025 , 41 (10) : 1168 -1175 . DOI: 10.11847/zgggws1146826
Haojia WU, Jian SUN, Meiyi YE, Zhi WANG, Baozhu GUO, Jing CUI, Jianping SUN. Associations between triglyceride glucose-obesity composite indices and risk of hyperuricemia among adults in Qingdao, China: a prospective cohort study[J]. Chinese Journal of Public Health, 2025 , 41 (10) : 1168 -1175 . DOI: 10.11847/zgggws1146826
正文
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高尿酸血症（hyperuricemia, HUA）是一种由嘌呤代谢紊乱而引起的代谢综合征，不仅会引起痛风及肾脏疾病，而且还与糖尿病等代谢性疾病密切相关[1]。随着人们生活方式和饮食习惯的改变，全球HUA的患病率居高不下[2]。美国健康与营养调查结果显示，2015—2016年，美国20岁以上成年人HUA患病率高达20.1%（95%CI=17.8%～22.4%）[3]。2015—2016年、2018—2019年，我国对31个省（自治区、直辖市）的18岁以上成年人的调查结果显示，HUA患病率已由2015—2016年的11.1%（95%CI=10.3%～11.8%）上升到2018—2019年的14.0%（95%CI=13.1%～14.8%）[4]。HUA在全球的流行及其危害已使其成为备受关注的公共卫生问题。近年来，甘油三酯葡萄糖指数–体质量指数（triglyceride-glucose-body mass index, TyG-BMI）、TyG–腰围指数（waist circumference, WC）等TyG–肥胖联合指数被提出，这些指标的特点是不依赖于血清胰岛素抵抗（insulin resistance, IR）水平，且有研究证实，其与HUA发病风险密切关联，但目前的研究多集中在横断面研究[5–8]，队列研究有限。截至目前，国内有研究者开展的一项前瞻性队列研究较为典型，其研究对象为831例基线尿酸（uric acid, UA）水平正常的高血压患者[9]，这为相关研究提供了重要依据。考虑到我国东部沿海地区HUA的患病率较中西部地区高[10]，且目前关于普通社区居民TyG–肥胖联合指数与HUA关联性的前瞻性研究相对较少。因此，本研究基于青岛地区35～74岁成年人群的前瞻性队列研究，进行基线TyG-BMI、TyG-WC与HUA发病风险的关联研究，以期为预防与管理HUA提供科学依据。
1　对象与方法
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1.1　研究对象
研究对象来源于青岛市糖尿病预防项目。项目的四阶段随机抽样综合考虑地域分布的均衡性以及经济水平。2006—2009年，在青岛市12个区（市）随机抽取3个城区（市南区、原市北区、原四方区）、3个农村（原胶南市、原黄岛区、即墨区），在每个区（市）各随机抽取5个街道（乡镇），每个街道（乡镇）各抽取1个居委会（行政村），在每个居委会（行政村）随机抽取35～74岁的男女常住居民各100人、共12 100人进行调查，最终建立9 040人自然人群队列。本项目分别于2012—2015年（随访终止时间：2015年9月15日）和2019—2023年（随访终止时间：2023年12月21日）进行了随访。
1.1.1　随访对象
本研究随访起点是研究对象首次参加青岛市糖尿病预防项目时间，研究对象发生新发HUA时终止随访，未发生HUA者以2015年9月15日或2023年12月21日作为随访终点。2012—2023年12月完成随访的研究对象共7 405人，随访率81.91%。
1.1.2　纳入标准
（1）基线调查时研究对象年龄35～74岁；（2）基线调查时研究对象在辖区居住≥5年；（3）研究对象自愿参加且签署知情同意书；（4）研究对象至少完成一次随访调查。
1.1.3　排除标准
（1）排除基线确诊HUA者1 416例；（2）排除基线空腹血糖值（fasting plasma glucose, FPG）信息缺失者647人、基线甘油三酯油（triacylglycerol, TG）信息缺失者836人、基线BMI信息缺失者378人、基线HWC信息缺失者362人、基线HUA信息缺失者371人，随访UA信息缺失者101人；（3）排除由于迁户、拒绝随访甚至死亡等原因而失访的1 635人。
根据上述纳入与排除标准，最终纳入本研究的调查对象共3 294人。本研究经世界糖尿病基金会伦理委员会审核通过，并经青岛市疾病预防控制中心伦理委员会批准，且在医学研究登记备案信息系统备案（备案号：MR-37-23-038916），所有研究对象在参与调查前均签署知情同意书。
1.2　估计样本含量
经统计分析，本研究HUA发病率为13.05%。共纳入19个自变量，参考10-EPV（10 events per variable）原则[11]，发生事件组人数不低于：19×10=190人，总样本量不低于190/0.130 5≈1 455人，最终纳入的研究对象3 294人，符合统计学要求。
1.3　研究方法
1.3.1　问卷调查
基线与随访调查均采用青岛市糖尿病项目统一设计的调查问卷，由经统一培训并考核合格的医护人员作为调查员面对面访谈采集信息。问卷内容包括个人信息（姓名、民族、出生日期、家庭住址等），社会人口学信息（性别、年龄等），行为危险因素（吸烟、饮酒等）等相关信息。
1.3.2　体格检查
研究对象的身高、体重采用身高体重计测量，并计算BMI。腰围（WC）的测量采用标准软尺，测量时软尺置于受试者右侧腋中线髂嵴上缘与十二肋下缘连线的中点，绕腹一周，读数精确至0.1 cm。血压测量采用标准的水银血压计，测量时受试者需坐位并静息5 min，手臂与心脏保持同一水平，结果以毫米汞柱（mmHg）为单位记录。
1.3.3　实验室检查
受试者需在空腹状态下，禁食8～12 h后采集静脉血液5 mL。在血样采集前，研究人员须核实受试者的基本资料无误后方可收集样本。测定受试者FPG、TG、总胆固醇（total cholesterol, TC）、低密度脂蛋白胆固醇（low density lipoprotein cholesterin, LDL-C）、高密度脂蛋白胆固醇（high-density lipoprotein cholesterol, HDL-C）、HUA、丙氨酸氨基转氨酶（alanine aminotransferase, ALT）、γ–谷氨酰胺转移酶（gamma Glutamyl Transferase, GGT）等。其中，采用葡萄糖氧化酶法测定FPG、酶法测定TG、TC和HUA；直接法测定HDL-C；匀相法测定LDL-C；赖氏法检测ALT；国际临床化学联盟法测定GGT。
1.4　诊断标准及相关变量定义
（1）依据中国HUA相关疾病诊疗多学科专家共识[12]：非同日2次空腹HUA水平男性≥420 μmol/L、女性≥360 μmol/L即为HUA。（2）依据中国高血压防治指南（2018年修订版）[13]：在未使用降压药物的情况下，非同日3次测量血压，平均收缩压（systolic blood pressure, SBP）≥140 mmHg和/或舒张压（diastolic blood pressure, DBP）≥90 mmHg（1 mmHg=0.133 kPa）；或者患者有高血压既往史，目前正在使用降压药物即为高血压。（3）根据世界卫生组织2017年标准，吸烟：每日至少吸1支烟、持续满1年，或累积吸烟量达到18包/年以上即为吸烟；烟包括香烟和/或烟叶等。饮酒：平均每周饮酒次数达到≥1次且持续时间超过1年即为饮酒，包括啤酒、白酒、葡萄酒、黄酒、米酒以及其他各类酒精饮料。（4）体质量指数（body mass index, BMI）=体重（kg）/身高（m）2；（5）TyG指数=Ln[TG（mg/dL）×FPG（mg/dL）/2][14]；（6）TyG-BMI指数=TyG指数×BMI[15]；（7）TyG-WC指数=TyG指数×WC[16]。
1.5　质量控制
现场调查前开展预调查，以优化问卷设计与调查流程。调查员经严格培训后上岗，培训涵盖问卷调查、体格检查、血样采集与处理、应急处理等内容。调查过程中，现场设置信息登记、血样采集、体格测量、问卷调查等区域，保障调查有序进行。实验室检测前，检查校准仪器设备，确保检测准确性。为保证问卷合格率，每日随机抽取5%问卷进行评估。数据采用双录入法，并由专业人员全程监督审核，严控数据质量。
1.6　统计方法
采用SPSS 26.0、R4.3.1、Graphpad Prism 9.5软件完成统计学分析及统计图的绘制。以均数和标准差（$ \overline{x}\pm s $）表示计量资料，两组间的比较采用独立样本t检验；采用人数（%）描述计数资料，组间比较采用χ2检验。根据研究对象基线TyG-BMI指数、基线TyG-WC指数从小到大排序，采用四分位法分别将其分为4个组（Q1～Q4）。本次队列以是否新发HUA为因变量，以随访时间（月）为时间变量，采用Cox比例风险回归分析基线TyG-BMI、TyG-WC不同水平组与HUA发病风险的关联：模型1未调整混杂因素；模型2调整年龄、性别；模型3在模型2的基础上调整城乡分布、SBP、DBP、TC、LDL-C、ALT、GGT。采用限制性立方样条图分析基线TyG–肥胖联合指数与HUA发病风险的剂量–反应关系。根据性别、年龄（<60、≥60岁）、城乡分布和是否患有高血压进行亚组分析，并分析性别、年龄、城乡分布、高血压与TyG–肥胖联合指数对HUA发病风险的交互作用。所有检验均为双侧检验，检验水准α=0.05。
2　结　果
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2.1　基线人群特征（表1）
本研究共纳入研究对象3 294人，其中男性1 125人（34.2%）、女性2 169人（65.8%）。HUA发病人数为430例。HUA组的年龄、城市人口居住比例、BMI、WC、SBP、DBP、FPG、TC、TG、LDL-C、UA、GGT、TyG-BMI、TyG-WC均高于非HUA组，而HDL-C却低于非HUA组（均P<0.05）。HUA组与非HUA组的性别、受教育程度、婚姻状况、饮酒、吸烟、ALT差异均无统计学意义（均P>0.05）。
2.2　基线人群不同TyG–肥胖联合指数水平与HUA发病情况比较（表2）
本研究平均随访时间为（4.91±3.35）人年，共随访16 180.58人年，新发HUA累计发病率13.1%，总发病密度26.57例/千人年。随着基线人群TyG-BMI水平的升高，HUA的累计发病率（χ2=29.884）及发病密度（χ2=17.105）均呈上升趋势，且差异有统计学意义（P<0.001）。随着基线人群TyG-WC水平的升高，HUA的累计发病率呈上升趋势，差异有统计学意义（χ2=45.616，P<0.001）。不同TyG-WC水平HUA的发病密度差异有统计学意义（χ2=20.440，P<0.001）。
2.3　基线人群TyG–肥胖联合指数与HUA的发病风险的Cox回归（表3）
多因素Cox回归分析，在调整性别、年龄、城乡分布、SBP、DBP、TC、LDL-C、ALT、GGT后（模型3），与基线人群TyG-BMI指数的Q1水平组相比，Q4组的HUA发病风险增加48%（HR=1.48，95%CI=1.10～1.99）；与基线人群TyG-WC指数的Q1水平组相比，Q4组的HUA发病风险增加46%（HR=1.46，95%CI=1.08～1.99）。
2.4　基线人群TyG–肥胖联合指数与HUA发病的线性关联分析（图1）
限制性立方样条模型分析显示，在校正性别、年龄、城乡分布、SBP、DBP、TC、LDL-C、ALT、GGT后，基线人群TyG-BMI指数与HUA发病风险呈线性关联，随着基线TyG-BMI因子得分增加，HUA发病风险呈现上升趋势（P整体<0.001，P非线性=0.639）。基线TyG-WC指数与HUA发病风险呈线性关联，随着因子得分增加，HUA发病风险呈现上升趋势（P整体<0.001，P非线性=0.776）。
2.5　基线TyG–肥胖联合指数与HUA发病风险的亚组分析（表4）
根据基线特征分层进行亚组分析。结果显示，女性TyG-BMI（HR=1.49，95%CI=1.04～2.15）、TyG-WC（HR=1.46，95%CI=1.04～2.12），Q4组与HUA发病风险的关联均高于男性；农村人群TyG-BMI（HR=1.71，95%CI=1.19～2.44）、TyG-WC（HR=1.57，95%CI=1.08～2.28），Q4组与HUA发病风险的关联均高于城市人群；高血压人群TyG-BMI（HR=2.19，95%CI=1.34～3.60）、TyG-WC（HR=2.59，95%CI=1.44～4.65），Q4组与HUA发病风险的关联均高于非高血压人群。性别、年龄、城乡分布及高血压与基线TyG–肥胖联合指数对HUA发病风险的交互作用差异均无统计学意义（P交互>0.05）。
3　讨　论
收起
本研究通过大规模前瞻性队列研究探讨青岛地区35～74岁基线人群TyG–肥胖联合指数与HUA发病的关联，研究结果表明，基线人群TyG-BMI指数、TyG-WC指数的Q4水平能增加HUA的发病风险，基线TyG-BMI指数、TyG-WC指数与HUA发病风险均呈线性关联，且这2个指标与HUA发病风险的关联在女性、农村以及高血压人群中更为明显。
TyG–肥胖联合指数与HUA发病风险的关联可能与IR密切相关。目前关于IR与HUA发生机制较少，但已有证据表明，IR是HUA、2型糖尿病、肥胖及动脉粥样硬化等一系列慢性非传染性疾病发生发展的病理基础[17]。在IR状态下，细胞对胰岛素的敏感性下降，使得葡萄糖摄取和利用出现障碍，过多的葡萄糖会在体内堆积，进而刺激肝脏脂肪酸合成增加，导致TG水平升高[18]，这也体现在本研究中的TyG-BMI和TyG-WC指数的变化上。同时本研究发现，基线人群TyG-BMI和TyG-WC指数与HUA发病风险呈线性关联，这与既往报道相似[6–7]。进一步研究发现，IR能够引发全身性炎症反应和氧化应激[19]，炎症因子和氧化应激能够影响机体脂质代谢[20]，在脂质代谢紊乱的情况下，会进一步影响肾脏的血液循环和代谢环境，并引起尿酸盐排泄功能障碍，从而在HUA的形成及发展过程中发挥致病性作用[21]。值得注意的是，高胰岛素–正葡萄糖钳夹技术被认为是临床评估IR的金标准方法，但由于操作复杂且具有侵入性，并不适用于临床实践中[22]。目前TyG-BMI、TyG-WC等TyG–肥胖联合指数被认为是IR的可靠替代指标[23–24]。既往研究探讨了TyG-BMI、TyG-WC与HUA的关系，一项基于美国健康与营养调查和中国健康与老龄化纵向研究的数据的横断面研究发现，TyG-BMI指数和TyG-WC指数与HUA患病风险增加相关[8]；另一项在对我国深圳市2 011例45岁及以上的中老年人2型糖尿病患者的横断面研究发现，与TyG-BMI指数和TyG-WC指数的Q1相比，Q4水平均与HUA患病风险呈正相关[25]。此外，一项基于2011—2018年的美国健康与营养调查对7 743名18岁以上成年人的横断面研究发现，TyG-BMI指数与HUA之间存在正相关性[26]。本研究与上述研究均证实了TyG–肥胖联合指数与HUA存在关联，但本研究作为前瞻性队列研究，能在因果关联时间顺序上更好地阐释TyG–肥胖联合指数对HUA发病的影响。在有限的前瞻性研究中，仅Zhang Q等[9]对我国831例HUA水平正常且患有高血压者开展了为期5年的连续健康检查。结果显示，TyG-WC指数是高血压人群中HUA发病的危险因素，但该研究是基于高血压患者，而本研究队列来自社区的普通人群，且样本量较大。本研究发现，与基线TyG-BMI和TyG-WC指数的Q1相比，TyG-BMI和TyG-WC指数的Q4水平均与HUA患病风险呈正相关，这与既往研究结果一致[8–9, 25–26]。综上所述，TyG–肥胖联合指数与HUA的关联可以通过IR解释，IR会影响肾小管上皮细胞的功能，使肾小管对UA的重吸收能力增加，进而降低UA的排泄量，诱发HUA[27]。
本研究还通过亚组分析进一步探讨不同因素与TyG–肥胖联合指数对HUA发病风险的影响。结果显示，性别、年龄、城乡分布、是否患高血压与TyG–肥胖联合指数对HUA发病风险无交互效应。但在女性、高血压人群中发现，TyG–肥胖联合指数能使HUA发病风险显著升高，这可能是本次研究中女性的平均年龄为50岁，而这一年龄组女性大多处于绝经期，绝经期女性雌激素水平下降，对肾脏尿酸盐排泄的抑制作用降低[28]。此外，研究结果显示，高血压能激活肾素–血管紧张素系统，进而减少肾脏血流量、降低肾脏灌注压，从而影响UA的正常排泄[29]。本次研究结果还显示，农村人群中TyG–肥胖联合指数也能增加HUA的发病风险，可能与农村居民对HUA的认知程度以及医疗保健水平低有关[30]。
本项研究的优势在于采用前瞻性队列研究，通过分析基线TyG-BMI指数、TyG-WC指数与HUA发病风险的关联，从因果关联的时间顺序方面更好地解释TyG–肥胖联合指数对HUA发病的影响。此外，本研究通过在随访过程中使用统一的问卷调查、体格检查和实验室检测手段，确保所收集数据的精确性和可信度。但本研究也存在一定局限性：（1）本研究的资料未收集到一些变量，例如饮食习惯、体育锻炼等信息；（2）此次研究未收集影响HUA水平的药物使用信息。这些信息可能对BMI和WC与确诊HUA之间的关联产生影响。因此，今后研究应完善饮食情况及药物使用等相关信息，进一步深入探讨TyG–肥胖联合指数与HUA发病的关系。
综上所述，基线人群TyG-BMI指数、TyG-WC指数升高与HUA的发病风险呈正相关，且在女性、农村及高血压人群中更为明显。应关注上述人群TyG–肥胖联合指数，以降低HUA发病风险。

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2025年第41卷第10期
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doi: 10.11847/zgggws1146826
  • 接收时间：2024-12-31
  • 首发时间：2026-10-25
  • 出版时间：2025-10-10
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  • 收稿日期：2024-12-31
  • 修回日期：2025-07-12
  • 录用日期：2025-08-02
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    1山东第二医科大学公共卫生学院，山东 潍坊 261053
    2青岛市妇女儿童医院泌尿外科，山东 青岛 266000
    3大连医科大学人文与社会科学学院，辽宁 大连 116000
    4青岛市疾病预防控制中心/青岛市预防医学研究院，山东 青岛 266000

通讯作者:

孙健平，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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