Department of Medicine, School of Medicine, Stanford University, Palo Alto, California, USA.
Am J Epidemiol. 2012 Jul 15;176(2):108-16. doi: 10.1093/aje/kws002. Epub 2012 Jul 2.
The objective of this study was to assess the utility of hyperuricemia as a marker for diabetes and prediabetes (impaired fasting glucose) and insulin resistance in young adults. Using Cox proportional hazards regression models, the authors analyzed 15-year follow-up data on 5,012 persons in 4 US cities who were aged 18-30 years and diabetes-free at the time of enrollment. At baseline (1986), 88% of participants had a body mass index (weight (kg)/height (m)(2)) less than 30. During the follow-up period (through 2001), the incidence rates of diabetes and prediabetes (insulin resistance and impaired fasting glucose) were higher among persons with greater serum urate concentrations. In multivariable Cox regression analyses that adjusted for age, gender, race, body mass index, family history of diabetes, diastolic blood pressure, total cholesterol, smoking, and alcohol use, the hazard ratios for diabetes, insulin resistance, and prediabetes among persons with hyperuricemia (serum urate level >7 mg/dL vs. ≤7.0 mg/dL) were 1.87 (95% confidence interval (CI): 1.33, 2.62), 1.36 (95% CI: 1.23, 1.51), and 1.25 (95% CI: 1.04, 1.52), respectively. This observation was generally consistent across subgroups. The authors conclude that hyperuricemia in the midtwenties is an independent marker for predicting diabetes and prediabetes among young adults in the subsequent 15 years.
本研究旨在评估高尿酸血症作为糖尿病和糖尿病前期（空腹血糖受损）及胰岛素抵抗的标志物在年轻人中的作用。作者采用 Cox 比例风险回归模型，对 4 个美国城市中年龄在 18-30 岁且入组时无糖尿病的 5012 名参与者进行了 15 年随访。在基线（1986 年）时，88%的参与者体重指数（体重（kg）/身高（m）(2)）<30。在随访期间（截至 2001 年），血清尿酸浓度较高者发生糖尿病和糖尿病前期（胰岛素抵抗和空腹血糖受损）的发生率更高。在多变量 Cox 回归分析中，校正年龄、性别、种族、体重指数、糖尿病家族史、舒张压、总胆固醇、吸烟和饮酒后，高尿酸血症（血清尿酸水平>7mg/dL 与≤7.0mg/dL）者的糖尿病、胰岛素抵抗和糖尿病前期的风险比分别为 1.87（95%置信区间：1.33，2.62）、1.36（95%置信区间：1.23，1.51）和 1.25（95%置信区间：1.04，1.52）。这一观察结果在各亚组中基本一致。作者得出结论，20 多岁时的高尿酸血症是预测年轻人在随后 15 年内发生糖尿病和糖尿病前期的独立标志物。
