Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China.
J Diabetes. 2019 Jun;11(6):431-439. doi: 10.1111/1753-0407.12863. Epub 2018 Nov 4.
BACKGROUND: Several studies have revealed conflicting results regarding the relationship between serum uric acid (SUA) and blood glucose concentrations. The aim of this study was to identify the shape of the curve between SUA and either fasting plasma glucose (FPG) or HbA1c in diabetic and non-diabetic participants. METHODS: This cross-sectional study of the relationship between SUA and diabetes and non-diabetes was conducted in 10 266 participants. Data from the national baseline survey of the China Health and Retirement Longitudinal Study (CHARLS; 2011-12) were used. Restrictive cubic spline regression and two piecewise linear regression models were used to detect non-linear trends and calculate the slope of each segment. RESULTS: After adjusting for all confounding factors in all subjects, an L-shaped relationship was found between FPG and SUA in males (β = 3.47, P < 0.01) and females (β = 5.84, P < 0.01), as well as between HbA1c and SUA in males (β = 0.10, P = 0.03) and females (β = 0.12, P = 0.02). In non-diabetic individuals, there was a positive linear correlation between FPG and SUA in females (β = 0.62, P = 0.02). After a diagnosis of diabetes, a negative linear relationship was found between SUA and blood glucose in males, and a nearly L-shaped curve was found in females. CONCLUSIONS: An L-shaped association was found between SUA and blood glucose in both genders. Stratified analysis revealed an L-shaped curve only in diabetic females. Further studies are warranted to investigate the mechanisms of the association between uric acid and blood glucose levels.
背景:几项研究表明,血清尿酸(SUA)与血糖浓度之间的关系存在矛盾。本研究旨在确定糖尿病和非糖尿病患者 SUA 与空腹血浆葡萄糖(FPG)或糖化血红蛋白(HbA1c)之间的曲线形状。
方法:本研究为一项关于 SUA 与糖尿病和非糖尿病关系的横断面研究,共纳入 10266 名参与者。使用中国健康与养老追踪调查(CHARLS)的全国基线调查数据(2011-12 年)。采用限制性立方样条回归和两段线性回归模型来检测非线性趋势并计算各段斜率。
结果:在所有受试者中调整所有混杂因素后,发现男性(β=3.47,P<0.01)和女性(β=5.84,P<0.01)的 FPG 与 SUA 之间呈 L 形关系,男性(β=0.10,P=0.03)和女性(β=0.12,P=0.02)的 HbA1c 与 SUA 之间也呈 L 形关系。在非糖尿病个体中,女性 FPG 与 SUA 之间呈正线性相关(β=0.62,P=0.02)。在诊断为糖尿病后,男性 SUA 与血糖之间呈负线性关系,而女性则呈近乎 L 形曲线。
结论:在两性中均发现 SUA 与血糖之间呈 L 形关联。分层分析显示,仅在糖尿病女性中存在 L 形曲线。需要进一步研究来探讨尿酸与血糖水平之间关联的机制。