Lin Jen-Der, Chiou Wen-Ko, Chang Hung-Yu, Liu Feng-Hsuan, Weng Hsiao-Fen
Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Kweishan, Taoyuan Hsien, Taiwan 333, ROC.
Metabolism. 2007 Jun;56(6):751-6. doi: 10.1016/j.metabol.2007.01.006.
This study investigates the impact of uric acid (UA) on the risk factors associated with metabolic syndrome. In addition, this study explores the relationship between UA and insulin resistance and serum leptin levels in metabolic syndrome. A total of 470 subjects (252 women and 218 men) were recruited from the Department of Health Management at Chang Gung Medical Center (Linkou, Taiwan). Metabolic syndrome was defined using a modified Adult Treatment Panel III (ATP III) definition. The formula for the homeostasis model assessment of insulin resistance (HOMA-IR) is as follows: fasting serum insulin (microU/mL) x fasting plasma glucose (mmol/L)/22.5. Diabetes mellitus was diagnosed in 45 subjects (9.6%); 82 subjects (17.4%) had hypertension. Hyperuricemia was diagnosed in 144 subjects (30.6%). Of these subjects, 115 (63 females and 52 males) (24.5%) were diagnosed as having metabolic syndrome. Patients with hyperuricemia had increased body mass index, waist-to-hip ratio, and triglyceride (Tg) level. The subjects also had lower high-density lipoprotein and greater hypertension. Hormone assays showed an elevation of leptin, immunoreactive insulin (IRI), and HOMA-IR in the hyperuricemia group. Uric acid appeared to be better correlated with Tg, blood pressure (both systolic and diastolic), obesity, immunoreactive insulin, and HOMA-IR. Uric acid did not correlate with leptin or blood glucose levels. Metabolic syndrome and Tg/high-density lipoprotein ratio showed a statistically significant difference in HOMA-IR using 3.8 as a cutoff value. Otherwise, there was no difference in leptin value. In conclusion, serum UA is significantly related to risk factors of metabolic syndrome except for blood glucose. Waist-to-hip ratio and HOMA-IR were statistically different in subjects with and without metabolic syndrome.
本研究调查尿酸（UA）对与代谢综合征相关的危险因素的影响。此外，本研究还探讨了代谢综合征中UA与胰岛素抵抗及血清瘦素水平之间的关系。从长庚医疗中心（台湾林口）健康管理部招募了470名受试者（252名女性和218名男性）。代谢综合征采用改良的成人治疗小组第三次报告（ATP III）定义来界定。胰岛素抵抗稳态模型评估（HOMA-IR）的公式如下：空腹血清胰岛素（微单位/毫升）×空腹血糖（毫摩尔/升）/22.5。45名受试者（9.6%）被诊断为糖尿病；82名受试者（17.4%）患有高血压。144名受试者（30.6%）被诊断为高尿酸血症。在这些受试者中，115名（63名女性和52名男性）（24.5%）被诊断患有代谢综合征。高尿酸血症患者的体重指数、腰臀比和甘油三酯（Tg）水平升高。这些受试者的高密度脂蛋白水平也较低，高血压患病率更高。激素检测显示，高尿酸血症组的瘦素、免疫反应性胰岛素（IRI）和HOMA-IR升高。尿酸似乎与Tg、血压（收缩压和舒张压）、肥胖、免疫反应性胰岛素和HOMA-IR的相关性更好。尿酸与瘦素或血糖水平无相关性。以3.8为临界值时，代谢综合征和Tg/高密度脂蛋白比值在HOMA-IR方面显示出统计学显著差异。否则，瘦素值无差异。总之，血清UA与代谢综合征的危险因素显著相关，但与血糖无关。有或无代谢综合征的受试者在腰臀比和HOMA-IR方面存在统计学差异。
