1991-1994年金門縣30歲以上成人高尿酸血症盛行率與危險因子研究

The Prevalence and Risk Factors of Hyperuricemia in a Community-Based Study Among Kinmen Island Adults ≥30 Years Old in 1991-1994

10.6288/TJPH2005-24-01-07

陳水湖(Shui-Hu Chen)；莊紹源(Shao-Yuan Chuang)；周碧瑟(Pesus Chou)

高尿酸血症 ； 盛行率 ； 危險因子 ； 金門研究 ； hyperuricemia ； prevalence rate ； risk factor ； Kinmen study

台灣公共衛生雜誌

24卷1期（2005 / 02 / 01）

73 - 83

繁體中文

目標：探討金門縣社區性高尿酸血症盛行率及其相關危險因子。方法：於1991到1994年間，共11,922之30歲以上居民完成所有研究步驟。由熟練之訪員—陽明十字軍，進行結構式問卷調查，並由公共衛生護士採集禁食血液進行生化檢驗。以邏輯斯複迴歸模式分析高尿酸血症之相關危險因子。結果：篩檢率為59.3%(1l,922/20,112)。高尿酸血症盛行率平均為25.4%，其中男性（尿酸值≥7.0mg/dl）為31.0%，女性（尿酸值≥6.0mg/dl）為20.9%。男性尿酸平均值為6.3±l.4mg/dl, 女性為5.0±1.4mg/dl，男性高於女性。以性別和年齡分層探討相關危險因數，男女兩性30~39歲者之相關危險因子為高肌酸酐、高血脂、肥胖、高血壓，與女性停經。40歲以上者，除了上述相關危險因子之外，喝酒與使用利尿劑也是其極重要的危險因子。結論：高尿酸血症的相關危險因子會隨著性別與年齡而改變。利尿劑使用的重要性隨著年齡而上升。飲酒、停經與否、分別為男、女性的重要危險因子。

Objectives: The purpose of present study was to investigate the prevalence and risk factors of hyperuricemia in Kinmen Island. Methods: A total of 11,922 residents aged ≥30 years completed all examinations of the survey in Kinmen Island between 1991 and 1994. The response rate was 59.3% (11,922/20,112). The physical examination and structured questionnaire were carried out by the Yang-Ming Crusade, a group of well-trained medical students. Overnight fasting blood was collected by public health nurses. The risk factors of hyperuricemia were determined using multivariate logistic regression. Results: The crude prevalence of hyperuricemia, defined as serum uric acid ≥7.0mgIdl for men and ≥6.0mg/dl for women, was 25.4% (3 1.0% for men, 20.9% for women). The means and standard deviation of uric acid were 6.3±1.5mg/dl for men and 5.0±1.4mg/dl for women. Men had higher uric acid levels than women (p＜0.05). According to the age and sex spectrum, the risk factors of hyperuricemia were hyperlipidemia, high creatinine, obesity, and hypertension among young men and women, aged 30-39 years old and menopausal for women. Middle and old aged group (40-59 yrs and ≥60 yrs) had the same risk factors as young aged group except alcohol consumption of man and the use of diuretics in both sexes. Conclusions: The risk factors of hyperuricemia were changed by sex and age. Use of diuretics became more important for middle-aged and elderly subjects. Alcohol consumption for men and menopausal for women were the most important risk factors of hyperuricemia.

1. Abdurhman S(2001).Hyperuricemia in Saudi Arabia.Reumatol Int.
2. Bellowood P(1991).The Austronesian dispersal and the origin of languages.Sci Am.
3. Breckenridge A(1966).Hypertension and hyperuricemia.Lancet.
4. Chang HY,Pan WH,Tsai KS(2001).Hyperuricemia and gout in Taiwan: Results from the Nutritional and Health Survey in Taiwan (1993-96).J Reumatol.
5. Chang SJ,Ko YC,Wang TN,Chang FT,Cben CJ(1997).High prevalence of gout and related risk factora In Taiwan`s Aborigines.J Rheumatol.
6. Chen S,Du H,Wang Y,Xu L(1998).The epidemiology study of hyperuricemia and gout in a community population of Huangpu District in Shanghai.Chin Med J (Engl).
7. Chon P,Kuo HS,Chen CH,Lin CH(1997).Characteristics of non-participants and reasons for non-participants in a population survey in Kin-Hu, Kinmen.Eur J Epidemiol.
8. Chon P,Liao MJ,Kuo HS(1993).Program Description and Preliminary Health Survey Data in Kin-Hu, Kinmen.Zhonghua Yi Xue Za Zhi (Taipei).
9. Chou CT,Lai JS(1998).The epidemiology of hyperuricemia and gout in Taiwan aborigines.J Rheumatol.
10. Chou P,Soong LN,Lin HY(1993).Community-based epidemiologic study on hyperuricemia in Pu-Li, Taiwan.J Formos Med Assoc.
11. Darmawan J,Valkenburg H,Muirden K,Wigley R(1992).The epidemiology of gout and hyperuricemia in a rural population of Java.J Rheumtol.
12. Defronzo RA,Ferrannini E(1991).Insulin resistance. A multifaceted syndrome responsible for NIDDM, Obesity, Hypertension, dyslipidemia, and Atherosclerotic Cardiovascular disease.Diabetes Care.
13. Duff IF,Mikkelsen WM,Dodge HJ,Himes DS(1968).Comparison of uric acid levels in some Oriental and Caucasian groups unselected as to gout or hyperuricemia.Arthritis Rheum.
14. Eastmond CJ,Garton D,Robins S,Riddoch S(1995).The effect of alcoholic beverages on urate metabolism in gout sufferers.Br J Rhenmatol.
15. Faller J,Pox IH(1982).Ethanol-induced hyperuricemia: evidence for increased urate production by activation of adenine nucleotide turnover.N Eng J Med.
16. Gibson T,Grahame R(1974).Gout and hyperlipidemia.Ann Rheum Dis.
17. Gurwitz JH,Kalish SC,Bohn RL(1997).Thiazide diuretics and the initiation of anti-gout therapy.J Clin Epidemiol.
18. Hagerup LM(1974).Coronary heart disease risk factors in men and women.From the population study in Glostrup, Denmark. Acta Med Scand Suppl.
19. Hall AP,Barry PE,Dawber TR,McNamara PM(1967).Epidemiology of gout and hyperuricemia.A long-term population study. Am J Med.
20. Healey LA(1975).Epidemiology of hyperuricemia.Arth Rheum.
21. Herman JB,Mount FW,Medalie JH(1967).Diabetes prevalence and serum uric acid. Observations among 10,000 men in a survey of ischemic heart disease in Israel.Diabetes.
22. Kelly WN.,Kelly WN,Harris ED,Ruddy S(1981).Purine and deoxypurine metabolism.Textbook of Rheumatology.
23. Kelly WN,Palella TO,Kelly WN,Harris ED,Ruddy S(1991).Gout and other disorders of purine metabolism.Harrison`s of principles of internal medicine. 12th ed.
24. Klein R,Klein BE,Cornoni JC,Maready J,Cassel JC,Tyroler HA(1973).Serum uric acid. Its relationship to coronary heart disease risk factors and cardiovascular disease, Evan county, Georgia.Arch Intern Med.
25. Lai SW,Li TC,Ng KC(2002).Hyperuricemia and its related factors in Taiwanese middle-aged adults.Int J Nurs Pract.
26. Lai SW,Tan CK,Ng KC(2001).Epidemiology of hyperuricemia in the elderly.Yale J Biol Med.
27. Li Y,Stamler J,Xiao Z,Folsom A,Zhang H(1997).Serum uric acid and its correlates in Chinese adult population, urban and rural, of Beijing.Jot J Epidemiol.
28. Lin KC,Lin HY,Chou P(2000).Community-based epidemiologic study on hyperuricemia and Gout in Kin-Hu, kin-men, Taiwan.J Rheumatol.
29. Matthews KA,Meilahn E,Kuller LH,Kelsey SF,Caggiula AW,Wing RR(1989).Menopause and risk factors for coronary heart disease.N Engl J Med.
30. Mikkelsen WM(1965).The possible association of hyperuricemia and/or gout with diabetes mellitus.Arth Rheum.
31. Nishimura T,Shimizu T,Mineo I(1994).Influence of daily drinking habits on ethanol-induced hyperuricemia.Metabolism.
32. Tuomilehto J,Zimmet P,Wolf E,Ram P,Hunt D,King H(1988).Plasma uric acid level and its association with diabetes mellitus and some biologic parameters in a biracial population of Fiji.Am J of Epidemiol.
33. Vecchio PC,Emmerson BT(1992).Gout due to renal disease.Br J Rheumatol.
34. Woolliscroft JO,Colfer H,Pox IH(1982).Hyperuricemia in acute illness: a poor prognostic sign.Am J Med.
35. Yano K,Rhoads GG,Kagan A(1977).Epidemiology of serum uric acid among 8000 Japanese-American men in Hawaii.J Chron Dis.
36. 林孝義(1996)。痛風與高尿酸血症。
37. 林寬佳(1997)。金湖鎮社區性高尿酸血症及痛風之流行病學研究。
38. 莊紹源(1997)。金門縣金湖鎮男性高尿酸血症演變為痛風之追縱研究。
39. 陳再晉、游伯村(1995)。臺北市成年市民之血糖、血清膽固醇、尿酸及肌酸酐值調查報告。中華民國腎臟醫學會雜誌。
40. 黃政典(1995)。高尿酸血症在臺北市雙園與北投地區之流行病學之調查。中華衛誌。