The Mediation Effect of Body Composition on the Association Between Menopause and Hyperuricemia: Evidence From China National Health Survey.
The Mediation Effect of Body Composition on the Association Between Menopause and Hyperuricemia: Evidence From China National Health Survey.
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身体成分对更年期与高尿酸血症之间关联的调解作用：来自中国国家健康调查的证据。
DOI：
10.3389/fendo.2022.879384
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发表时间：
2022
影响因子：
5.2
通讯作者：
中科院分区：
文献类型：
--
作者：
生殖因素已被证实与高尿酸血症有关。身体成分是影响血清尿酸（SUA）的一个关键决定因素，但在绝经过渡期间，SUA升高是否受到身体成分变化的影响，在很大程度上尚不明确。本研究作为2012年至2017年中国国民健康调查的二次分析，纳入了18997名年龄在20至80岁的女性。通过问卷调查访谈收集初潮年龄和绝经相关信息。将体重指数（BMI）、体脂百分比（BFP）、脂肪量指数（FMI）和去脂体重指数（FFMI）作为身体成分指标。高尿酸血症定义为SUA高于360微摩尔/升（约6毫克/分升）。进行中介效应分析以探究绝经对高尿酸血症的直接和间接影响。设计了一个1:2年龄匹配的病例对照数据集（n = 6202）以控制与年龄相关的混杂因素，并用于多变量分析。在调整协变量后，绝经后女性的SUA比绝经前女性高14.08（10.89 - 17.27）微摩尔/升。研究发现，超重/肥胖以及较高水平的BFP、FMI和FFMI均与高尿酸血症呈正相关。中介效应分析表明，绝经对高尿酸血症的总效应为正，但在很大程度上由身体成分指标介导。总效应的45%可归因于BMI介导的间接效应（自然间接效应（NIE）的优势比：1.09，95%置信区间：1.04 - 1.13），超过80%由BFP介导（NIE的优势比：1.23，95%置信区间：1.16 - 1.29）。然而，FFMI在这种关联中未呈现中介作用（NIE的优势比：0.99，95%置信区间：0.96 - 1.02）。研究结果显示，身体成分，尤其是脂肪量指标，在绝经与高尿酸血症的关联中起显著的中介作用。身体成分作为中介变量的作用具有临床和公共卫生意义，在为处于绝经过渡阶段的女性提供医疗保健服务时，应认识并考虑到这一点。
Reproductive factors have been demonstrated to be associated with hyperuricemia. Body composition is an essential determinant influencing serum uric acid (SUA), but it is largely unknown whether increased SUA was influenced by changed body composition during the menopausal transition. As a secondary analysis of China National Health Survey from 2012-to 2017, this study included 18,997 women aged 20 to 80. Menarche age and menopause information were collected by questionnaire interview. Body mass index (BMI), body fat percentage (BFP), fat mass index (FMI), and fat-free mass index (FFMI) were used as body composition indexes. Hyperuricemia was defined as SUA higher than 360μmol/L (approximately 6 mg/dl). Mediation analysis was performed to explore the direct and indirect effects of menopause on hyperuricemia. A 1:2 age-matched case-control data set (n=6202) was designed to control age-related confounders and was used in multivariable analyses. After adjustment of covariates, postmenopausal women had 14.08 (10.89-17.27) μmol/L higher SUA than their premenopausal counterparts. Overweight/obesity and higher levels of BFP, FMI, and FFMI were all found to be positively associated with hyperuricemia. The mediation analysis showed that the total effect of menopause on hyperuricemia was positive, but was substantially mediated by body composition indexes. Forty-five percent of the total effect can be attributed to the indirect effect mediated by BMI (OR for the natural indirect effect (NIE): 1.09, 95%CI: 1.04-1.13), and over 80% mediated by BFP (OR for NIE: 1.23, 95%CI: 1.16-1.29). However, FFMI did not present the mediated role in the association (OR for NIE: 0.99, 95%CI: 0.96-1.02). The findings revealed that body composition, especially the fat mass indexes, significantly mediated the association between menopause and hyperuricemia. The role of body composition as mediator constitutes clinical and public health significance that should be recognized and considered in healthcare for women experiencing their menopause transition.
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影响因子：
4.9
作者：
Eun Y;Kim IY;Han K;Lee KN;Lee DY;Shin DW;Kang S;Lee S;Cha HS;Koh EM;Lee J;Kim H
通讯作者：
Kim H
影响因子：
8
作者：
Greendale, Gail A.;Sternfeld, Barbara;Karlamangla, Arun S.
通讯作者：
Karlamangla, Arun S.
影响因子：
4.9
作者：
Lovejoy, J. C.;Champagne, C. M.;Smith, S. R.
通讯作者：
Smith, S. R.
影响因子：
4.9
作者：
Freedman, DS;Wang, J;Horlick, M
通讯作者：
Horlick, M
DOI：
10.1053/j.ajkd.2017.12.009
发表时间：
2018-06
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
Johnson RJ;Bakris GL;Borghi C;Chonchol MB;Feldman D;Lanaspa MA;Merriman TR;Moe OW;Mount DB;Sanchez Lozada LG;Stahl E;Weiner DE;Chertow GM
通讯作者：
Chertow GM