Avula Naveen Reddy, Shenoy Damodar
Post Graduate, Department of Internal Medicine, Kasturba Medical College , Mangalore, Karnataka, India .
Professor and Head, Department of Internal Medicine, Kasturba Medical College , Mangalore, Karnataka, India .
J Clin Diagn Res. 2016 Dec;10(12):OC32-OC34. doi: 10.7860/JCDR/2016/22182.9113. Epub 2016 Dec 1.
The prevalence of Metabolic Syndrome (MetS) ranges from <10% to as much as 84% depending on region and composition of the population studied. The MetS is a growing public health problem in the world.
To evaluate association of hyperuricaemia with components of MetS and insulin resistance.
Sixty patients with MetS were conveniently recruited. MetS was defined as per Adult Treatment Panel III (ATP III) guidelines. For the purpose of analysis study participants were grouped into, group-I (controls - normal serum uric acid levels) and group-II (cases - hyperuricaemia). Hyperuricaemia was defined with cut-off >6.8mg/dl in both men and women. Associated work up for MetS and insulin resistance like fasting blood sugar, fasting lipid profile, fasting insulin, serum uric acid was done. Blood pressure and anthropometric measurements including weight, height and waist circumferences were measured and BMI was calculated. HOMA IR method was used to measure the degree of insulin resistance. Logistic regression analysis was used to evaluate association of hyperuricaemia with MetS and insulin resistance. Receiver Operating Curve (ROC) was plotted to find out optimum cut-off value for insulin resistance.
A significant increase in systolic blood pressure (p < 0.001) and triglyceride levels (p=0.027) were observed in hyperuricaemia subjects when compared to controls. After adjusting for potential confounders, Insulin resistance (HOMA IR >3.4) was independently associated with hyperuricaemia (OR=5.79, 95% CI=1.6- 20.69, p=0.007).
Insulin resistance beyond a threshold is independently associated with hyperuricaemia in subjects with MetS.
代谢综合征（MetS）的患病率因研究人群的地区和构成不同，范围从低于10%到高达84%。MetS在全球范围内是一个日益严重的公共卫生问题。
评估高尿酸血症与MetS各组分及胰岛素抵抗之间的关联。
便利选取60例MetS患者。MetS按照成人治疗小组第三次报告（ATP III）指南进行定义。为便于分析，研究参与者被分为两组，第一组（对照组——血清尿酸水平正常）和第二组（病例组——高尿酸血症）。高尿酸血症的定义为男性和女性血清尿酸水平均高于6.8mg/dl。对MetS和胰岛素抵抗进行相关检查，包括空腹血糖、空腹血脂谱、空腹胰岛素、血清尿酸。测量血压及人体测量指标，包括体重、身高和腰围，并计算体重指数（BMI）。采用稳态模型评估法（HOMA IR）测量胰岛素抵抗程度。采用逻辑回归分析评估高尿酸血症与MetS及胰岛素抵抗之间的关联。绘制受试者工作特征曲线（ROC）以确定胰岛素抵抗的最佳截断值。
与对照组相比，高尿酸血症患者的收缩压显著升高（p<0.001），甘油三酯水平升高（p=0.027）。在对潜在混杂因素进行校正后，胰岛素抵抗（HOMA IR>3.4）与高尿酸血症独立相关（比值比[OR]=5.79，95%可信区间[CI]=1.6 - 20.69，p=0.007）。
在患有MetS的受试者中，超过阈值的胰岛素抵抗与高尿酸血症独立相关。
