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Objective:To analyze the correlation between hyperuricemia and obesity in young college students.Methods:A total of 19 673 students receiving enrolment physical examinations in Nanjing University from 2018 to 2019 were included in the study. The subjects were divided into underweight, normal, overweight, and obesity groups according to their body mass index. Fasting blood were taken to detect alanine aminotransferase (ALT), serum uric acid, urea nitrogen, and creatinine. The differences between serum uric acid and metabolic parameters among different groups as well as the correlation between body mass index and hyperuricemia were analyzed by using multivariate linear regression and logistic regression analysis.Results:The prevalence of hyperuricemia was 32.35% for the college students, while for the males it reached up to 57.30% that was significantly higher than female ones (6.51%, P<0.01). With the increasing of body mass index, the prevalence of hyperuricemia increased significantly( Ptrend<0.01), as well as serum uric acid in both male and female students ( Ptrend<0.01). Serum uric acid was positively correlated with body mass index in both genders( P<0.01). The odds ratio ( OR) and 95% confidence interval( CI) for overweight, obesity, and underweight body mass index groups were 2.30(95% CI 1.99-2.66), 4.35(95% CI 3.22-5.89), and 0.70(95% CI 0.60-0.82), respectively, compared to the normal body mass index group by adjusting possible factors such as gender, age, ALT, urea nitrogen, creatinine, as well asestimated glomerular filtration rate. Conclusion:The prevalence of hyperuricemia in young students is high. Obesity seems to be an independent risk factor of hyperuricemia.
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BACKGROUND: Our objective was to compare the effect of a restricted intravenous fluid regimen adjusted by serum lactate level with a standard restricted regimen on complications after major elective surgery for gastrointestinal malignancy. METHODS: This is a randomized, observer-blinded, single-center trial conducted across a time span of 13 months. A total of 299 patients were allocated to either a restricted intravenous fluid regimen with supplementary intravenous fluids given based on serum lactate level (group A) or a standard restricted regimen (group R). In group A, the serum lactate level was monitored closely postoperatively to maintain a normal pre-operative serum lactate level. Group R involved patients treated with a restricted fluid regimen in whom additional fluid and electrolytes were administered when deemed necessary based on the usual clinical criteria. The primary outcome measure was complications; the secondary measures were death and adverse effects. RESULTS: Additional fluid supplementation was needed in some patients in both groups (group A [28%] vs group R [26%]). In group A, the time for additional fluid infusion occurred earlier in the postoperative period than group R. Patients in group A received their first supplementary fluid treatment within the first 12 h more commonly than those in group R (74% vs 37%, respectively; P < .004). The regimen adjusted by serum lactate decreased systemic postoperative complications in group A versus group R (10% vs 22%, respectively; P = .023) but not overall total complications (23% vs 33%, respectively; P = .090). In contrast, in patients who required additional fluid infusion, the difference in complications between the 2 groups was greater (overall complication, 45% vs 85%, respectively; P = .023; major complication, 16% vs 44%, respectively; P = .018; systemic complications, 19% vs 63%, respectively; P = .001). One patient died in group A and 4 died in group R (1% vs 4%, respectively; P = .206). CONCLUSION: A fluid-restricted regimen after elective gastrointestinal operations for malignancy may lead to fluid insufficiency and low tissue perfusion in up to 28% of patients. Close monitoring of serum lactate levels with adjustment of intravenous fluid administration intraoperatively and in the early postoperative period may improve the early detection and correction of inadequate tissue perfusion, thereby decreasing the rate of complications.
