Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Endocrinology and Metabolism, The People's Hospital of Xiangyun, Shanghai, China.
Front Endocrinol (Lausanne). 2020 Feb 20;11:55. doi: 10.3389/fendo.2020.00055. eCollection 2020.
In assessing the development of hyperuricemia in diabetic adults, the role of the sex steroid axis is underappreciated. Furthermore, dehydroepiandrosterone (DHEA) has been recommended as a nutritional supplement. However, is DHEA suitable for diabetic adults with hyperuricemia? This issue has received little attention. The objective of this study was to investigate the associations between gonadal hormones and uric acid (UA) levels in diabetic adults, paying particular attention to the association between DHEA and UA levels. We analyzed 4,426 participants out of 4,813 diabetic adults enrolled from seven communities in a cross-sectional survey conducted in 2018. Participants underwent several examinations, including assessments of anthropometric parameters, blood pressure, glucose, lipid profiles, UA, total testosterone (TT), estradiol (E2), the follicle-stimulating hormone (FSH), the luteinizing hormone (LH), and dehydroepiandrosterone (DHEA). Among men and compared with individuals in the first quartile, participants in the fourth quartile of TT and FSH had odds of hyperuricemia that were significantly decreased by so much as 48 and 34%, respectively (both < 0.05). However, participants in the fourth quartile of DHEA had 79% increased odds of hyperuricemia ( < 0.05). Among postmenopausal women, participants in the fourth quartile of DHEA, TT, and LH had odds of hyperuricemia that were significantly increased by 155, 99, and 76%, respectively (all < 0.05). These associations were adjusted for potential confounding factors. Sex differences were found in the associations between gonadal hormones and UA levels in diabetic men and postmenopausal women, which should be monitored to prevent hyperuricemia when sex hormone treatment, especially DHEA, is administered. Further studies are needed.
在评估成年糖尿病患者高尿酸血症的发展时,性甾体激素轴的作用被低估了。此外,已推荐脱氢表雄酮(DHEA)作为营养补充剂。但是,DHEA 是否适合患有高尿酸血症的成年糖尿病患者?这个问题很少受到关注。本研究旨在探讨性腺激素与成年糖尿病患者尿酸(UA)水平之间的关系,特别关注 DHEA 与 UA 水平之间的关系。我们分析了 2018 年从七个社区招募的 4813 名成年糖尿病患者中的 4426 名参与者,这些参与者参加了一项横断面调查,接受了多项检查,包括人体测量参数、血压、血糖、血脂谱、UA、总睾酮(TT)、雌二醇(E2)、卵泡刺激素(FSH)、黄体生成素(LH)和脱氢表雄酮(DHEA)。在男性中,与第一四分位的个体相比,TT 和 FSH 四分位的第四分位参与者的高尿酸血症风险分别显著降低了 48%和 34%(均<0.05)。然而,DHEA 四分位的第四分位参与者的高尿酸血症风险增加了 79%(<0.05)。在绝经后女性中,DHEA、TT 和 LH 四分位的第四分位参与者的高尿酸血症风险分别显著增加了 155%、99%和 76%(均<0.05)。这些关联在调整了潜在混杂因素后仍然存在。在成年糖尿病男性和绝经后女性中,性腺激素与 UA 水平之间的关联存在性别差异,在进行性激素治疗,特别是 DHEA 治疗时,应监测这些差异以预防高尿酸血症。需要进一步研究。