代謝危險因子、青春期、含糖飲料攝取及尿酸易感性基因與國中學童血清尿酸與高尿酸血症之相關

Association of metabolic risk factors, puberty, sugar-sweetened beverage intake and urate-susceptible genes with adolescent serum uric acid and hyperuricemia

楊惇閔(Tun-Min Yang)

指導教授 ： 李建宏

高雄醫學大學/健康科學院/公共衛生學系公共衛生學碩士班/碩士(2018年)

摘要

背景
根據李建宏教授研究指出南臺灣國中學童高尿酸血症( 男性血尿酸濃度 > 7.0mg/dL，女性> 6.0 mg/dL)盛行率男性平均為46.7%，女性則約為21.6%。近年有一項流行病學研究利用四個Cohort study指出，在青少年時代謝症候群可預測未來成人時的代謝症候群，而危險因子包含肥胖、高血壓、血脂異常、高血糖等等，而造成以上生化指數異常包含攝取含糖飲料、血清尿酸值異常或基因變異。
材料與方法
本研究選取高雄市、屏東縣市及台東縣市7-9年級國中生(約12-16歲)為研究對象，總計22間學校共2627位國中學童參與人體測量檢查及生活型態因子問卷調查並發放血液生化同意書徵詢監護人之同意參與研究。
監護人同意國中學童進行血液及尿液檢查為1927位，採檢率為73.4%，由於經費有限，此研究隨機選取1490位國中學童之血液資料進行DNA之萃取及分析。
結果
在研究對象背景描述發現男女性在青春期、腰臀比、身體質量指數、總膽固醇、低密度膽固醇、高密度膽固醇、空腹血糖、血清尿酸值及高尿酸血症具有顯著差異。
在男性學童中，rs1014290及rs3733589與高尿酸血症具有顯著高的風險，且與三酸甘油脂有顯著交互作用。在女性學童中，rs2231142、rs3733591、rs1014290及rs3733589與高尿酸血症具有顯著高的風險。
結論
在國中學童中，基因變異與高尿酸血症之相關有顯著高的風險。且與三酸甘油脂有顯著交互作用。

關鍵字

高尿酸血症 ； 尿酸

並列摘要

Increased serum uric acid (SUA) levels or hyperuricemia have been associated with an increased risk of gout, type 2 diabetes, cardiovascular disease and kidney disease. Epidemiological studies have found that genetic factors have noticeable contribution to the inter-individual disparity in SUA levels. SLC2A9, SLC22A12 and ABCG2 are 3 urate transporter-related genes, which have been linked to the regulation of SUA and urate transport disorders. In Taiwan, the prevalence of hyperuricemia for male and female adolescents was reported to be as high as 59.8% and 30.3%, respectively, according to data from nationwide survey. This study was conducted to evaluate the association of adolescent hyperuricemia with the single-nucleotide polymorphisms (SNPs) of renal uric acid reabsorption genes SLC2A9 (rs3733591, rs3733589 and rs1014290) and SLC22A12 (rs475688), and the SNPs of renal uric acid excretion gene ABCG2 (rs2231142) and metabolic risk factors and puberty and sugar-sweetened beverage intake. We studied 1458 adolescents aged 12 to 16 years who were randomly selected from 22 junior high schools in Taiwan, using a multistage stratified cluster selecting strategy. Comprehensive demographic factors, and anthropometric and clinical parameters of each adolescent were obtained. Hyperuricemia was defined as SUA ≥7.0 mg/dL in boys and SUA ≥6.0 mg/dL in girls. Multivariable logistic regression models and linear regression were used to evaluate the association. Adjusting for covariates, we found that the SNPs rs1014290 (OR, 2.0; 95% CI: 1.3-3.0), rs3733591 (OR, 1.7; 95% CI: 1.2-2.5), rs3733589 (OR, 1.9; 95% CI: 1.3-2.9) of SLC2A9 gene in boys were associated with a higher risk of hyperuricemia, and rs1014290 , rs3733589 with TG have interaction. The SNP rs2231142 (OR, 1.8, 95% CI: 1.0-3.0) of ABCG2 gene and the SNPs rs1014290 (OR, 2.5; 95% CI: 1.2-5.1), rs3733591 (OR, 2.3; 95% CI: 1.3-4.1), rs3733589 (OR, 2.2; 95% CI: 1.1-4.4) of SLC2A9 gene in girls were associated with a higher risk of hyperuricemia. Our findings show that SLC2A9 and ABCG2 genes might have a physiologic role in adolescents with a high prevalence of hyperuricemia in Taiwan.

並列關鍵字

hyperuricemia ； serum uric acid

參考文獻

參考文獻

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