1型糖尿病患者与非1型糖尿病患者青少年及成人的血清尿酸与胰岛素敏感性
Serum uric acid and insulin sensitivity in adolescents and adults with and without type 1 diabetes.
作者信息
Bjornstad Petter, Snell-Bergeon Janet K, McFann Kimberly, Wadwa R Paul, Rewers Marian, Rivard Christopher J, Jalal Diana, Chonchol Michel B, Johnson Richard J, Maahs David M
机构信息
Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO.
Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO; Barbara Davis Center for Diabetes, University of Colorado Denver, Aurora, CO.
出版信息
J Diabetes Complications. 2014 May-Jun;28(3):298-304. doi: 10.1016/j.jdiacomp.2013.12.007. Epub 2013 Dec 27.
HYPOTHESIS
Decreased insulin sensitivity (IS) exists in type 1 diabetes. Serum uric acid (SUA), whose concentration is related to renal clearance, predicts vascular complications in type 1 diabetes. SUA is also inversely associated with IS in non-diabetics, but has not been examined in type 1 diabetes. We hypothesized SUA would be associated with reduced IS in adolescents and adults with type 1 diabetes.
METHODS
The cross-sectional and longitudinal associations of SUA with IS were investigated in 254 adolescents with type 1 diabetes and 70 without in the Determinants of Macrovascular Disease in Adolescents with Type 1 Diabetes Study, and in 471 adults with type 1 diabetes and 571 without in the Coronary Artery Calcification in Type 1 diabetes (CACTI) study.
RESULTS
SUA was lower in subjects with type 1 diabetes (p<0.0001), but still remained inversely associated with IS after multivariable adjustments in adolescents (β±SE: -1.99±0.62, p=0.001, R2 =2%) and adults (β±SE: -0.91±0.33, p=0.006, R2 = 6%) with type 1 diabetes, though less strongly than in non-diabetic controls (adolescents: β±SE: -2.70±1.19, p=0.03, R2 = 15%, adults: β±SE: -5.99±0.75, p<0.0001, R2 =39%).
CONCLUSION
We demonstrated a significantly weaker relationship between SUA and reduced IS in subjects with type 1 diabetes than non-diabetic controls.
假说
1型糖尿病存在胰岛素敏感性（IS）降低的情况。血清尿酸（SUA）浓度与肾脏清除率相关，可预测1型糖尿病的血管并发症。在非糖尿病患者中，SUA也与IS呈负相关，但尚未在1型糖尿病患者中进行研究。我们推测SUA与1型糖尿病青少年及成人的IS降低有关。
方法
在1型糖尿病青少年血管疾病决定因素研究中，对254例1型糖尿病青少年和70例非1型糖尿病青少年进行了SUA与IS的横断面和纵向关联研究；在1型糖尿病冠状动脉钙化（CACTI）研究中，对471例1型糖尿病成人和571例非1型糖尿病成人进行了相关研究。
结果
1型糖尿病患者的SUA较低（p<0.0001），但在对青少年（β±SE：-1.99±0.62，p=0.001，R2 =2%）和成人（β±SE：-0.91±0.33，p=0.006，R2 = 6%）1型糖尿病患者进行多变量调整后，SUA仍与IS呈负相关，尽管其相关性不如非糖尿病对照组（青少年：β±SE：-2.70±1.19，p=0.03，R2 = 15%，成人：β±SE：-5.99±0.75，p<0.0001，R2 =39%）。
结论
我们证明，与非糖尿病对照组相比，1型糖尿病患者中SUA与IS降低之间的关系明显较弱。
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