Hospital Universitario Gral. San Martín, La Plata, Buenos Aires, Argentina.
Metab Syndr Relat Disord. 2012 Feb;10(1):39-46. doi: 10.1089/met.2011.0072. Epub 2011 Sep 20.
Identifying insulin-resistant (IR) individuals is an issue of particular interest in the assessment of cardiometabolic risk, but there is no simple way to accomplish this task. Our aims were to determine the relationship between uric acid and insulin resistance and to define the optimal uric acid cutoff to identify insulin resistance in women.
A population-based sample of 588 women without cardiovascular diseases, diabetes, or low glomerular filtration rate (GFR) was divided according to uric acid tertiles. Systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose, low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), TG/HDL-C ratio, insulin [fasting plasma insulin (FPI)], and homeostasis model assessment of insulin resistance (HOMA-IR) were compared between the mentioned tertiles. Receiver operating characteristic (ROC) curves were constructed to determinate the optimal cutoff of uric acid and identify IR individuals defined by the top tertile of FPI and HOMA-IR. The same variables were compared using the top tertile of uric acid and the maximum Youden index as cutoffs. The P values were adjusted by age, GFR, and body mass index (BMI) using analysis of covariance (ANCOVA).
FPI, HOMA-IR, and all of the cardiometabolic risk factors increased through uric acid tertiles. Both cutoffs of uric acid, estimated by the top tertile and by ROC, were identical (4.0 mg/dL). FPI, HOMA-IR, SBP, DBP, TG, TG/HDL-C ratio, and fasting glucose were higher, whereas HDL-C was lower in women who had uric acid levels >4.0 mg/dL. All of the differences remained significant after the adjustment by age and GFR.
In healthy women, uric acid levels >4.0 mg/dL were associated with all the markers of IR.
在评估心脏代谢风险时，识别胰岛素抵抗（IR）个体是一个特别关注的问题，但目前还没有一种简单的方法来完成这项任务。我们的目的是确定尿酸与胰岛素抵抗之间的关系，并确定尿酸最佳截断值以识别女性中的胰岛素抵抗。
在没有心血管疾病、糖尿病或低肾小球滤过率（GFR）的人群中，选择了 588 名女性作为基础样本，根据尿酸三分位进行分组。比较了所述三分位之间的收缩压（SBP）、舒张压（DBP）、空腹血糖、低密度脂蛋白胆固醇（LDL-C）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、TG/HDL-C 比值、空腹血浆胰岛素（FPI）和稳态模型评估的胰岛素抵抗（HOMA-IR）。构建了受试者工作特征（ROC）曲线，以确定尿酸的最佳截断值，并确定 FPI 和 HOMA-IR 最高三分位数的 IR 个体。使用尿酸最高三分位数和最大 Youden 指数作为截断值比较了相同的变量。使用协方差分析（ANCOVA）调整了年龄、GFR 和体重指数（BMI）后的 P 值。
FPI、HOMA-IR 和所有心血管代谢危险因素均随尿酸三分位数的增加而增加。尿酸最高三分位数和 ROC 估计的两个截断值（4.0mg/dL）相同。尿酸水平>4.0mg/dL 的女性 FPI、HOMA-IR、SBP、DBP、TG、TG/HDL-C 比值和空腹血糖较高，而 HDL-C 较低。所有差异在调整年龄和 GFR 后仍然显著。
在健康女性中，尿酸水平>4.0mg/dL 与所有 IR 标志物相关。
