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甘油三酯-葡萄糖指数在评估高尿酸血症风险中的作用:来自一般人群的见解。

Usefulness of Triglyceride-glucose Index for estimating Hyperuricemia risk: Insights from a general Population.

机构信息

a Department of Cardiology , The First Affiliated Hospital of China Medical University , Shenyang , Liaoning , People's Republic of China.

b Department of Cardiovascular Diseases Prevention , Liaoning Provincial Center for Disease Control and Prevention , Shenyang , Liaoning , People's Republic of China.

出版信息

Postgrad Med. 2019 Jun;131(5):348-356. doi: 10.1080/00325481.2019.1624581. Epub 2019 Jun 3.

Abstract

: Hyperuricemia is a metabolic abnormality that has cast an enormous burden on global healthcare. Previous studies have revealed the close association between insulin resistance and hyperuricemia. Therefore, monitoring insulin sensitivity may be a possible way to prevent hyperuricemia. Recent studies have demonstrated the usefulness of triglyceride-glucose index (TyG) as a simple surrogate of insulin resistance. Hence, our study aimed to explore the impact of TyG on hyperuricemia and its value to improve the risk stratification and prevention of hyperuricemia. : This cross-sectional study included 6466 subjects (mean age: 59.57 years, 60.19% females) from northeast China between September 2017 to May 2018. TyG was determined as ln[fasting TG(mg/dL)×FPG(mg/dL)/2]. Hyperuricemia was defined as serum uric acid ≥ 357 μmol/L for females and ≥ 417 μmol/L for males. : The prevalence of hyperuricemia was 5.24%. In the full model, each SD increment of TyG caused a 12.528 μmol/L elevation of serum urate concentration and a 54.1% additional risk for hyperuricemia. When dividing TyG into quartiles, the top quartile had a 2.730 times risk for hyperuricemia than the bottom one. Moreover, smooth curve fitting demonstrated this association was linear. Additionally, subgroup analysis revealed the association was robust to several risk factors of hyperuricemia. Finally, AUC displayed an improvement when introducing TyG into clinical risk factors (0.751 vs 0.772, p < 0.001), category-free net reclassification index (0.304, 95% CI: 0.195-0.413, P < 0.001) and integrated discrimination index (0.009, 95% CI: 0.004-0.013, P < 0.001) also showed the improvement from TyG. : Our work revealed the linear and robust association between TyG and hyperuricemia. Furthermore, our results suggest the importance of simultaneous glycemic and lipids control in the prevention of hyperuricemia. Most importantly, our findings implicate the value of TyG to optimize the risk stratification and prevention of hyperuricemia.

摘要

高尿酸血症是一种代谢异常,给全球医疗保健带来了巨大负担。先前的研究表明,胰岛素抵抗与高尿酸血症密切相关。因此,监测胰岛素敏感性可能是预防高尿酸血症的一种可行方法。最近的研究表明,三酰甘油-葡萄糖指数(TyG)作为胰岛素抵抗的简单替代指标具有一定的作用。因此,本研究旨在探讨 TyG 对高尿酸血症的影响及其在高尿酸血症风险分层和预防中的价值。

本横断面研究纳入了 2017 年 9 月至 2018 年 5 月期间来自中国东北地区的 6466 名受试者(平均年龄:59.57 岁,60.19%为女性)。TyG 定义为 ln[空腹三酰甘油(mg/dL)×空腹血糖(mg/dL)/2]。高尿酸血症定义为女性血尿酸≥357 μmol/L,男性血尿酸≥417 μmol/L。

高尿酸血症的患病率为 5.24%。在全模型中,TyG 每增加 1 个标准差,血清尿酸浓度升高 12.528 μmol/L,高尿酸血症的风险增加 54.1%。将 TyG 分为四等分时,最高四分位数的高尿酸血症风险是最低四分位数的 2.730 倍。此外,平滑曲线拟合表明这种关联呈线性。此外,亚组分析显示,这种关联在高尿酸血症的几个危险因素下仍然稳健。最后,引入 TyG 后,AUC 显示出改善(0.751 比 0.772,P<0.001),无类别净重新分类指数(0.304,95%CI:0.195-0.413,P<0.001)和综合判别指数(0.009,95%CI:0.004-0.013,P<0.001)也显示出改善。

我们的研究揭示了 TyG 与高尿酸血症之间的线性和稳健关系。此外,我们的结果表明,同时控制血糖和血脂对预防高尿酸血症非常重要。最重要的是,我们的研究结果表明,TyG 对于优化高尿酸血症的风险分层和预防具有一定的价值。

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