慢性腹膜透析病人其血清尿酸值與體脂肪及血脂質相關

Serum Uric Acid Level is Correlated With Body Fat and Lipid Profiles in Chronic Peritoneal Dialysis Patients

在一般族群中，血清尿酸值與代謝症候群及心血管疾病有關，本研究的目的是想探討慢性腹膜透析病人中血清尿酸值是否與體脂肪及血脂質有相關性。材料與方法：病人來自成大醫院腹膜透析門診的病人共92位，36位男性及56位女性，分高尿酸組（血液尿酸值：男性>7.0mg/dl，女性>6.2mg/dl）及非高尿酸組。測量體位、主觀整體營養評估、分析生化值。結果：高尿酸組其三頭肌皮層厚度顯著高於非高尿酸組（21.2±9.7vs14.3±7.1mm,<0.0005）。高尿酸組的病人其血液尿素氮（59.8±15.6vs51.8±15.1mg/dl,<0.05）及血磷值（5.5±1.2vs4.7±1.3mg/dl,<0.005）都顯著高於非高尿酸組。在血脂質方面；三酸甘油酯（266.6±194.4vs150.5±93.7mg/dl,<0.05）及總膽固醇與高密度脂蛋白膽固醇的比值（6.1±2.3vs5.0±2.1mg/dl,<0.05）也以高尿酸組顯著高於非高尿酸組。血清尿酸值與身體質量指數、三頭肌皮層厚度、血液尿素氮、血磷等呈顯著的正相關。總結：本研究顯示在慢性腹膜透析病人中血清尿酸值較高組呈現如三頭肌皮層厚度增加、高的血液尿素氮、高血磷及高三酸甘油酯等現象。建議未來臨床照護上可藉由改善引起高尿酸血症的這些危險因子達治療與預防的效果。

The serum uric acid（UA）level is shown to be associated with metabolic syndrome （MS）and cardiovascular disease（CVDs）in the general population. In this study, we investigated association of the serum UA level with body fat, and lipid profiles in chronic peritoneal dialysis（PD; CPD）patients. Methods: This study enrolled 92 patients（36 males and 56 females）from the PD unit of National Cheng Kung University Hospital, Tainan. Patients were divided into a hyperuricemia group（serum UA > 7.0 mg/dl in men and > 6.2 mg/dl in women）and a non-hyperuricemia group. We measured anthropometric, subjective global assessment（SGA）, and biochemical parameters. Results: There was a significantly higher value of the triceps skinfold（TSF）thickness in the hyperuricemia group than the non-hyperuricemia group（21.2 ± 9.7 vs. 14.3 ± 7.1 mm, < 0.0005）. The hyperuricemia group had significantly higher serum blood urea nitrogen（BUN; 59.8 ± 15.6 vs. 51.8 ± 15.1 mg/dl, < 0.05）and serum phosphate levels（5.5 ± 1.2 vs. 4.7 ± 1.3 mg/dl, < 0.005） than the non-hyperuricemia group. As to the lipid profile, triglycerides（TG; 266.6 ± 194.4 vs. 150.5 ± 93.7 mg/dl, < 0.05）and Cholesterol/high-density lipoprotein cholesterol（6.1 ± 2.3 vs. 5.0 ± 2.1, < 0.05）of the hyperuricemia group were significantly higher than those of the non-hyperuricemia group. Serum UA levels were positively correlated with the body-mass index, TSF thickness, and serum BUN and phosphate levels. Conclusions: Our results show that the factors associated with a higher serum UA level were a greater TSF thickness, and higher serum BUN, phosphate, and TG levels in CPD patients. In clinical care, we suggest to improve the factors caused to hyperuricemia and reach the effect of treatment and previention.