Li Haibo, Zha Xiaojuan, Zhu Yu, Liu Mengxue, Guo Rui, Wen Yufeng
From the School of Public Health, Wannan Medical College (HL, YZ, ML, RG, YW) and Physical Examination Center, The First Affiliated Hospital of Wannan Medical College (XZ), Wuhu, China.
Medicine (Baltimore). 2016 Apr;95(16):e3456. doi: 10.1097/MD.0000000000003456.
There are some published studies focus on the invert U-shaped relationship between fasting plasma glucose (FPG) and serum uric acid (UA), while the threshold value and gender differences of this relationship were still obscure. We aimed to explore the dose-response relation between FPG level and serum UA concentration by conducted this epidemiological research in a large health check-up population in China. A total of 237,703 people were collected from January 2011 to July 2014 in our cross-sectional study; 100,348 subjects age 18 to 89 years and without known diabetes were included for the current analysis. One-way analysis of variance, generalized additive models, and 2-piecewise linear regression model were used. The mean concentration of UA with FPG of <6.1, 6.1 to 6.9, and ≥7.0 mmol/L was 240.9, 260.2, and 259.6 μmol/L in women and 349.0, 360.8, and 331.0 μmol/L in men. An invert U-shape with a threshold FPG of 7.5 (women)/6.5 (men) mmol/L was observed in the regression curve of FPG and UA, even after adjusting for potential confounders. The adjusted regression coefficients were 2.4 (95% confidence interval [CI]: 1.5 to 3.4, P < 0.001) for FPG < 7.5 mmol/L, -3.2 (95% CI: -5.0 to -1.3, P < 0.001) for FPG ≥ 7.5 mmol/L in women; while 0.8 (95% CI: -0.4 to 2.0, P = 0.19) for FPG < 6.5 mmol/L, -7.1 (95% CI: -8.0 to -6.1, P < 0.001) for FPG ≥ 6.5 mmol/L in men. Furthermore, the interaction between different FPG level and sex was significant (P < 0.05). An invert U-shape with a threshold of FPG was existed for serum UA level in Chinese adults age 18 to 89 years without known diabetes, and significant gender differences were found. Future researches should pay more attention to this relationship.
有一些已发表的研究聚焦于空腹血糖（FPG）与血清尿酸（UA）之间的倒U形关系，然而这种关系的阈值及性别差异仍不明确。我们旨在通过对中国一个大型健康体检人群进行这项流行病学研究，来探索FPG水平与血清UA浓度之间的剂量反应关系。在我们的横断面研究中，于2011年1月至2014年7月共收集了237,703人；本分析纳入了100,348名年龄在18至89岁且无已知糖尿病的受试者。采用了单因素方差分析、广义相加模型和两段式线性回归模型。FPG<6.1、6.1至6.9以及≥7.0 mmol/L时，女性UA的平均浓度分别为240.9、260.2和259.6 μmol/L，男性分别为349.0、360.8和331.0 μmol/L。即使在调整了潜在混杂因素后，在FPG与UA的回归曲线中仍观察到阈值FPG为7.5（女性）/6.5（男性）mmol/L的倒U形。女性中，FPG<7.5 mmol/L时调整后的回归系数为2.4（95%置信区间[CI]：1.5至3.4，P<0.001），FPG≥7.5 mmol/L时为-3.2（95%CI：-5.0至-1.3，P<0.001）；男性中，FPG<6.5 mmol/L时为0.8（95%CI：-0.4至2.0，P=0.19），FPG≥6.5 mmol/L时为-7.1（95%CI：-8.0至-6.1，P<0.001）。此外，不同FPG水平与性别的交互作用显著（P<0.05）。在18至89岁无已知糖尿病的中国成年人中，血清UA水平存在以FPG为阈值的倒U形，且发现了显著的性别差异。未来的研究应更多地关注这种关系。
