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三种非胰岛素抵抗指数与高尿酸血症的相关性研究。

Association between three non-insulin-based indexes of insulin resistance and hyperuricemia.

机构信息

The First Convalescence Area, Hangzhou Aeronautical Sanatorium of Chinese Air Force, Hangzhou, China.

Department of Rheumatology, Changhai Hospital, Naval Military Medical University (The Second Military Medical University), No. 168, Changhai Road, Yangpu District, Shanghai, 200433, China.

出版信息

Clin Rheumatol. 2019 Nov;38(11):3227-3233. doi: 10.1007/s10067-019-04671-6. Epub 2019 Jul 12.

Abstract

OBJECTIVE

The association between hyperuricemia and insulin resistance (IR) has been demonstrated by many studies, but the traditional IR indexes are too impractical to be used in clinical practice for the recognition of the IR state in individuals with hyperuricemia. Therefore, we aimed to further investigate the association between hyperuricemia and three non-insulin-based IR indexes in this large-scale cross-sectional study.

METHODS

A total of 174,695 adults without self-reported use of antihyperuricemic agents, hypoglycemic agents, or lipid-lowering drugs were included in the current analysis. The triglyceride to high-density lipoprotein cholesterol ratio (TG/HDLc), the product of fasting triglycerides and glucose (TyG), and metabolic score for IR (METS-IR) were calculated. Then, logistic regression analyses were applied to explore their association with hyperuricemia.

RESULTS

The TG/HDLc, TyG, and METS-IR all had positive correlations with uric acid level. However, only TG/HDLc and TyG were significantly associated with hyperuricemia in both sexes and body mass index (BMI) classification (the ORs of the highest quartile for each were 6.751 and 1.505 in females and 6.487 and 1.646 in males, respectively). The AUC values of TG/HDLc and TyG to discriminate hyperuricemia were also statistically significant in both sexes and BMI classification (all greater than 0.7).

CONCLUSIONS

TG/HDLc and TyG are strongly associated with hyperuricemia regardless of BMI classification. These two obtainable and cost-effective non-insulin-based IR indexes could be potential monitors during the management of hyperuricemia and prevention of its IR-driven comorbidities. Key Points • In this large-scale study, we identified TG/HDLc and TyG as indicators for identification of IR in patients with hyperuricemia. • These simple and practical IR indicators are of substantial clinical importance for implementing preventive strategies against IR-driven comorbidities of hyperuricemia.

摘要

目的

多项研究表明,高尿酸血症与胰岛素抵抗(IR)之间存在关联,但传统的 IR 指标在临床上用于识别高尿酸血症个体的 IR 状态过于不切实际。因此,我们旨在通过这项大规模横断面研究进一步探讨高尿酸血症与三种非胰岛素基础 IR 指标之间的关系。

方法

共纳入 174695 名无自述使用抗高尿酸药物、降血糖药物或降脂药物的成年人。计算甘油三酯与高密度脂蛋白胆固醇比值(TG/HDLc)、空腹甘油三酯与葡萄糖的乘积(TyG)和胰岛素抵抗代谢评分(METS-IR)。然后,应用逻辑回归分析探讨它们与高尿酸血症的关系。

结果

TG/HDLc、TyG 和 METS-IR 与尿酸水平均呈正相关。然而,只有 TG/HDLc 和 TyG 在男女和体重指数(BMI)分类中与高尿酸血症显著相关(女性最高四分位数的 OR 分别为 6.751 和 1.505,男性分别为 6.487 和 1.646)。在男女和 BMI 分类中,TG/HDLc 和 TyG 区分高尿酸血症的 AUC 值也具有统计学意义(均大于 0.7)。

结论

无论 BMI 分类如何,TG/HDLc 和 TyG 均与高尿酸血症密切相关。这两种可获得且具有成本效益的非胰岛素基础 IR 指标可能是高尿酸血症管理和预防其 IR 相关并发症的潜在监测指标。关键点:• 在这项大规模研究中,我们确定了 TG/HDLc 和 TyG 是高尿酸血症患者 IR 的指标。• 这些简单实用的 IR 指标对于实施针对高尿酸血症 IR 相关并发症的预防策略具有重要的临床意义。

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