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2型糖尿病患者血清尿酸水平与中心性体脂分布的相关性

Correlation Between Serum Uric Acid Level and Central Body Fat Distribution in Patients with Type 2 Diabetes.

作者信息

Zong Jing, Sun Yi, Zhang Yiqian, Yuan Jin, Wang Xinlei, Zhang Rongping, Zhao Xiaoqin, Zhao Xuying, Gu Yunjuan

机构信息

Department of Endocrinology and Metabolism, The Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, People's Republic of China.

Geriatric Department, Nantong First Geriatric Hospital, Nantong, Jiangsu Province, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2020 Jul 16;13:2521-2531. doi: 10.2147/DMSO.S260891. eCollection 2020.

Abstract

BACKGROUND

The aim of this study was to investigate the correlation between serum uric acid level and central body fat distribution in patients with type 2 diabetes (T2DM).

METHODS

A total of 867 patients with T2DM were enrolled. Measurements of central fat distribution were obtained by dual energy X-ray absorptiometry. Patients were stratified into three groups according to their levels of serum uric acid (SUA). Multiple linear regression analysis was used to determine the association between SUA and central body fat distribution. Logistic regression analysis was used to estimate the risk factors for hyperuricemia (HUA). Mediation analysis was applied to assess the overall, direct, and indirect mediators of SUA levels.

RESULTS

Multiple linear regression analysis showed that SUA levels were significantly positively correlated with waist circumference (WC), body mass index (BMI), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), Android fat mass, Gynoid fat mass, fasting c-peptide (F-CP), and area under the curve of C-peptide (P < 0.05 for all). VAT [odds ratio (OR), 2.367; 95% confidence interval (CI), 1.078-5.197; P < 0.001)], WC (OR, 1.041; 95% CI, 1.011-1.072; P < 0.001), high-density lipoprotein (OR, 0.274; 95% CI, 0.104-0.727; P < 0.001), and estimated glomerular filtration rate (OR, 0.966; 95% CI, 0.959-0.973; P < 0.001) were found to be independent risk factors for T2DM patients with HUA. After mediation analysis, BMI and central obesity were found to have different partial effects on the association between SUA and F-CP (P < 0.001).

CONCLUSION

In patients with T2DM, HUA was positively correlated with F-CP and central body fat distribution, especially VAT. These results suggest that central obesity may play a role in the positive correlation between HUA and insulin resistance (IR).

摘要

背景

本研究旨在探讨2型糖尿病(T2DM)患者血清尿酸水平与中心性体脂分布之间的相关性。

方法

共纳入867例T2DM患者。通过双能X线吸收法测量中心性脂肪分布。根据血清尿酸(SUA)水平将患者分为三组。采用多元线性回归分析确定SUA与中心性体脂分布之间的关联。采用逻辑回归分析评估高尿酸血症(HUA)的危险因素。应用中介分析评估SUA水平的总体、直接和间接中介因素。

结果

多元线性回归分析显示,SUA水平与腰围(WC)、体重指数(BMI)、内脏脂肪组织(VAT)、皮下脂肪组织(SAT)、男性型脂肪量、女性型脂肪量、空腹C肽(F-CP)及C肽曲线下面积均呈显著正相关(均P<0.05)。VAT[比值比(OR),2.367;95%置信区间(CI),1.078-5.197;P<0.001]、WC(OR,1.041;95%CI,1.011-1.072;P<0.001)、高密度脂蛋白(OR,0.274;95%CI,0.104-0.727;P<0.001)及估算肾小球滤过率(OR,0.966;95%CI,0.959-0.973;P<0.001)被发现是T2DM合并HUA患者的独立危险因素。中介分析后发现,BMI和中心性肥胖对SUA与F-CP之间的关联具有不同的部分效应(P<0.001)。

结论

在T2DM患者中,HUA与F-CP及中心性体脂分布呈正相关,尤其是与VAT相关。这些结果表明,中心性肥胖可能在HUA与胰岛素抵抗(IR)的正相关中起作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c365/7372004/807209b8191b/DMSO-13-2521-g0001.jpg

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