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Abstract：
A healthy lifestyle is related to metabolic syndrome (MetS), but the mechanism is not fully understood. This study aimed to examine the association of components of MetS with lifestyle in a Chinese population and potential mediation role of serum uric acid (SUA) in the association between lifestyle behaviors and risk of components of MetS. Data were derived from a baseline survey of the Shaanxi urban cohort in the Regional Ethnic Cohort Study in northwest China. The relationship between components of MetS, healthy lifestyle score (HLS), and SUA was investigated by logistic or linear regression. A counterfactual-based mediation analysis was performed to ascertain whether and to what extent SUA mediated the total effect of HLS on components of MetS. Compared to those with 1 or less low-risk lifestyle factors, participants with 4-5 factors had 43.6% lower risk of impaired glucose tolerance (OR = 0.564; 95%CI: 0.408~0.778), 60.8% reduction in risk of high blood pressure (OR = 0.392; 95%CI: 0.321~0.478), 69.4% reduction in risk of hypertriglyceridemia (OR = 0.306; 95%CI: 0.252~0.372), and 47.3% lower risk of low levels of HDL cholesterol (OR = 0.527; 95%CI: 0.434~0.641). SUA mediated 2.95% (95%CI: 1.81~6.16%) of the total effect of HLS on impaired glucose tolerance, 14.68% (95%CI: 12.04~18.85%) on high blood pressure, 17.29% (95%CI: 15.01~20.5%) on hypertriglyceridemia, and 12.83% (95%CI: 10.22~17.48%) on low levels of HDL cholesterol. Increased HLS tends to reduce risk of components of MetS partly by decreasing the SUA level, which could be an important mechanism by which lifestyle influences MetS.
摘要：
健康的生活方式与代谢综合征（MetS）有关，但机制还不完全清楚。这项研究旨在研究中国人群中MetS成分与生活方式的关联以及血清尿酸（SUA）在生活方式行为与MetS成分风险之间的关联中的潜在中介作用。数据来自中国西北地区区域民族队列研究中对陕西城市队列的基线调查。MetS组件之间的关系，健康生活方式评分（HLS），和SUA通过逻辑回归或线性回归进行调查。进行了基于反事实的调解分析，以确定SUA是否以及在多大程度上介导了HLS对MetS成分的总影响。与具有1个或更少的低风险生活方式因素的人相比，有4-5个因素的参与者糖耐量受损的风险降低了43.6％（OR=0.564;95CI：0.408〜0.778），高血压风险降低60.8%(OR=0.392;95CI:0.321~0.478),高甘油三酯血症风险降低69.4%(OR=0.306;95CI:0.252~0.372),低HDL胆固醇水平的风险降低47.3%(OR=0.527;95CI:0.434~0.641)。SUA介导的2.95%（95CI：1.81～6.16%）的HLS对糖耐量异常的总作用，14.68％（95CI：12.04〜18.85％）的高血压，17.29%（95CI：15.01~20.5%）高甘油三酯血症，和12.83%（95CI：10.22~17.48%）低HDL胆固醇水平。增加的HLS倾向于部分通过降低SUA水平来降低MetS成分的风险，这可能是生活方式影响MetS的重要机制。
