Abreu Estela, Fonseca Maria João, Santos Ana Cristina
Departamento de Epidemiologia Clínica, Medicina Preditiva e Saúde Pública, Faculdade de Medicina da Universidade do Porto, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.
Acta Med Port. 2011 Dec;24 Suppl 2:565-74. Epub 2011 Dec 31.
An association between insulin resistance (IR) and cardiovascular risk factors has been widely described. However, the association between IR and hyperuricemia has been less studied. The objective of this study was to describe the prevalence of hyperuricemia in a community sample of Portuguese adults and evaluate its association with IR.
As part of a health and nutrition survey, 1370 community participants (852 women and 518 men) were evaluated. IR was calculated using the homeostasis model assessment index (HOMA) and IR was considered present when HOMA ≥ 1.85 (the lowest value of the upper quartile of HOMA distribution). Hyperuricemia was defined in women as uric acid ≥ 6.0 mg/dl and in men ≥ 7.0 mg/dl. Unconditional logistic regression models were computed and odds ratio (OR) and confidence intervals at 95% (95% CI) were adjusted for age, alcohol and tobacco consumption, creatinine levels, body mass index and menopausal status.
The overall prevalence of hyperuricemia was 12.8%, 9.9% in women and 17.8% in men (p < 0.001). After adjustment, individuals with hyperuricemia had a higher prevalence of IR (OR=1.84 95% CI 1.25-2.73). An increased prevalence of IR was associated with increasing levels of uric acid (p for trend <0.001). After gender stratification, only hyperuricemic men had a higher prevalence of IR (OR=2.17 95% CI 1.24-3.31). Men and women in the upper quartile of uric acid had a higher prevalence of IR (OR=2.51 95% CI 1.22-5.16 and. OR=1.88 95% CI 1.06-3.31, respectively) and a significant trend of increasing prevalence of IR with increasing quartiles of uric acid was observed (p=0.015 in women and p=0.004 in men).
Hyperuricaemic men had a higher prevalence of IR. Both men and women in the upper quartile of uric acid distribution showed positive associations with IR and an increased prevalence of IR with increasing quartiles of uric acid was observed.
胰岛素抵抗（IR）与心血管危险因素之间的关联已被广泛描述。然而，IR与高尿酸血症之间的关联研究较少。本研究的目的是描述葡萄牙成年人社区样本中高尿酸血症的患病率，并评估其与IR的关联。
作为健康与营养调查的一部分，对1370名社区参与者（852名女性和518名男性）进行了评估。使用稳态模型评估指数（HOMA）计算IR，当HOMA≥1.85（HOMA分布上四分位数的最低值）时认为存在IR。女性高尿酸血症定义为尿酸≥6.0mg/dl，男性≥7.0mg/dl。计算无条件逻辑回归模型，并对年龄、饮酒和吸烟情况、肌酐水平、体重指数和绝经状态调整95%置信区间（95%CI）的比值比（OR）。
高尿酸血症的总体患病率为12.8%，女性为9.9%，男性为17.8%（p<0.001）。调整后，高尿酸血症患者的IR患病率更高（OR=1.84，95%CI 1.25-2.73）。IR患病率增加与尿酸水平升高相关（趋势p<0.001）。按性别分层后，只有高尿酸血症男性的IR患病率更高（OR=2.17，95%CI 1.24-3,31）。尿酸上四分位数的男性和女性IR患病率更高（分别为OR=2.51，95%CI 1.22-5.16和OR=1.88，95%CI 1.06-3.31），并且观察到随着尿酸四分位数增加IR患病率有显著上升趋势（女性p=0.015，男性p=0.004）。
高尿酸血症男性的IR患病率更高。尿酸分布上四分位数的男性和女性均显示与IR呈正相关，并且观察到随着尿酸四分位数增加IR患病率升高。
