Study On The Correlation And Interaction Between Serum Uric Acid,blood Lipids In Relation To Hypertension In Non-obese Middle-aged And Young People Undergoing Medical Checkups

Background and objective:In recent years,due to the continuous increase in the incidence of cardiovascular diseases,it has brought a serious disease burden to China and even the world,and is also the primary cause of disability and death caused by diseases.Therefore,people are increasingly paying attention to the prevention and treatment of cardiovascular diseases,becoming the hottest focus of attention in the medical community.Although the diagnosis and treatment of cardiovascular diseases are also making continuous progress and the risk of death has been controlled,the incidence rate of cardiovascular diseases is still on the rise.In addition to focusing on disease treatment,more attention should be paid to disease prevention.Therefore,more and more scholars are committed to exploring the risk factors of cardiovascular diseases,and have also identified more and more related risk factors.Among them,hypertension is not only a disease,but also the primary risk factor and cause of cardiovascular diseases.From this,it can be seen that the occurrence and development of hypertension is the main cause of cardiovascular disease,and how to prevent and control hypertension is the top priority.With the trend of younger onset of hypertension,there are many risk factors,making prevention and control difficult.Among the known risk factors,such as blood lipids and uric acid,research is limited to the impact of a single risk factor on blood pressure.The development of diseases is itself caused by the interaction of multiple factors,and disease prevention also needs to be carried out in multiple aspects.Therefore,exploring the interaction between disease risk factors on the impact of diseases is very valuable.As is well known,blood lipids are a common risk factor for hypertension,blood uric acid is also a risk factor for hypertension,and it is also a risk factor for blood lipids.So,it is worth exploring whether there is an interaction between blood uric acid and blood lipids,and whether blood lipids will affect the effect of serum uric acid on hypertension,especially in young and middle-aged populations.We hope to provide more possibilities and new ideas for the prevention and treatment of hypertension.Steps and methods:1.According to the inclusion criteria,3089 young and middle-aged people were selected from the physical examination center of the First Affiliated Hospital of Dali University from July to September 2020,excluding 349 young and middle-aged people with BMI≥28kg/m²（obesity）.Finally,2740 non-obese young and middle-aged people were included as the study subjects.Relevant general data,physical examination indexes,blood biochemistry and blood routine were collected.All continuous variables were tested for normality.2.Firstly,the study subjects were divided into two groups based on whether hypertension was detected,the hypertension group and the non-hypertension group,and differences between the groups were analyzed to identify the relevant factors of hypertension.Divide the population into four groups according to the interquartile spacing of serum uric acid(P_25,P₅₀,P₇₅).Compare the distribution of various research variables between different levels of serum uric acid.3.Incorporate the above differentiated indicators into a binary logistic regression model to screen for risk factors for hypertension in non-obese middle-aged and young adults.4.Based on the analysis of risk factors for hypertension mentioned above,the population was divided into two groups according to whether TC,LDL-C,HDL-C,TG,and N-HDL-C were elevated or not,and the effect of serum uric acid levels on hypertension in different lipid levels was compared.5.To further analyze the additive interaction index of blood lipid level and hyperuricemia on non-obese middle-aged and young people with hypertension.Results:1.The study variables were all in accordance with the approximate normal distribution through the normality test,except that age,BMI and TG were skewed.2.（1）There were statistically significant differences in TC,HDL-C,LDL-C,N-HDL-C,TG,serum uric acid,fasting blood glucose,WBC,age,BMI,resting heart rate,gender,and creatinine between the non-hypertensive and hypertensive groups（P<0.050）;（2）There were statistically significant differences in TC,HDL-C,LDL-C,N-HDL-C,TG,fasting blood glucose,WBC,BMI,and creatinine among different serum uric acid levels（<0.001）,while there was no statistically significant difference in age and resting heart rate among different serum uric acid levels（P>0.050）.3.Reduced HDL-C,elevated TC,elevated LDL-C,elevated N-HDL-C,elevated TG,serum uric acid,fasting blood glucose,age,BMI,resting heart rate,male and creatinine are risk factors for hypertension（P<0.001）.4.（1）The effect of serum uric acid on hypertension at different TG levels:In the population with TG<2.3mmol/l,the population with serum uric acid in the 4th percentile increased the risk of hypertension（OR=2.99,95%CI 1.96-4.56,P<0.001）;Among the population with TG≥2.3mmol/l,those with serum uric acid at the 4th percentile level increased the risk of hypertension（OR=3.26,95%CI 1.17-9.06,P=0.024）;（2）Influence of uric acid on hypertension at different N-HDL-C levels:among the population with N-HDL-C<4.9 mmol/l,the population with serum uric acid in the 4th percentile increased the risk of hypertension（OR=3.01,95%CI 1.92-4.74,P<0.001）;In the population with N-HDL-C≥4.9 mmol/l,there was no statistically significant difference in serum uric acid（P>0.050）;（3）The effect of uric acid on hypertension at different LDL-C levels:Among the population with LDL-C<4.1mmol/l,the population in the 4th percentile of serum uric acid increased the risk of hypertension（OR=2.96,95%CI 1.98-4.42,P<0.001）;In the population with LDL-C≥4.1mmol/l,there was no statistically significant difference in serum uric acid（P>0.050）;（4）The effect of uric acid on hypertension at different TC levels:among the people with TC<6.2mmol/l,the population in the 4th percentile of serum uric acid increased the risk of hypertension（OR=2.42,95%CI1.55-3.77,P<0.001）;In the population with TC≥6.2mmol/l,there was no statistically significant difference in serum uric acid（P>0.050）;（5）The effect of uric acid on hypertension at different HDL-C levels:Among the population with HDL-C≥1mmol/l,the population in the 4th percentile of serum uric acid increased the risk of hypertension（OR=2.42,95%CI1.57-3.72,P<0.001）;In the population with HDL-C<1mmol/l,there was no statistically significant difference in serum uric acid（P>0.050）.5.（1）The risk of hypertension in people with elevated TG and hyperuricemia is 6.10 times that in people without elevated TG and hyperuricemia（95%CI 4.23-8.79）;（2）There was an additive interaction between elevated TG and hyperuricemia on the risk of hypertension in non-obese young and middle-aged people.The indicators of interaction S=1.89（95%CI1.18-3.05）,AP=0.39（95%CI 0.17-0.62）,RERI=2.41（95%CI 0.37-4.44）.Conclusion:1.Serum uric acid,TG,TC,HDL-C,LDL-C,and N-HDL-C are associated with hypertension in non-obese middle-aged and young adults.TG,HDL-C,TC,LDL-C,and N-HDL-C are associated with elevated serum uric acid levels.2.Blood uric acid,TG,TC,HDL-C,LDL-C,and N-HDL-C are risk factors for hypertension in non-obese middle-aged and young adults.3.In populations with N-HDL-C<4.9mmol/l,LDL-C<4.1mmol/l,TC<6.2mmol/l,and HDL-C≥1mmol/l,high serum uric acid levels are independent risk factors for hypertension in non-obese middle-aged and young adults;In populations with N-HDL-C≥4.9mmol/l,LDL-C≥4.1mmol/l,TC≥6.2mmol/l,and HDL-C<1mmol/l,it may alter the relationship between high serum uric acid levels and hypertension in non-obese middle-aged and young adults.4.Elevated TG and hyperuricemia have an additive interaction on the risk of hypertension in non-obese young and middle-aged people.