Department of Internal Medicine, "S. Maria delle Grazie" Hospital, Pozzuoli, Italy.
Department of Movement Sciences and Wellbeing, University "Parthenope", Naples, Italy.
Nutr Metab Cardiovasc Dis. 2021 Feb 8;31(2):675-680. doi: 10.1016/j.numecd.2020.10.007. Epub 2020 Oct 13.
The relationships between uric acid (UA) and prediabetes is poorly explored in youth. We investigated the association between UA, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), insulin resistance (IR) and low insulin sensitivity (IS) in youth with overweight/obesity (OW/OB).
A cross-sectional study was performed in 2248 youths with OW/OB (age 5-17 years). The sample was stratified in sex-specific quintiles (Q1 to Q5) of UA and the associations with fasting (FG), 2-h post-load glucose (2H-PG), IR and low IS were investigated. IR and low IS were estimated by assessment model of insulin resistance (HOMA-IR) and whole-body IS index (WBISI), respectively. IFG was defined as FG ≥ 100 < 126 mg/dL, IGT as 2H-PG ≥140 < 200 mg/dL, IR as HOMA-IR ≥75th percentile and low IS as WBISI ≤25th percentile by sex. Age, body mass index z-score, 2H-PG, HOMA-IR and WBISI, increased across sex-quintiles of UA while FG did not. The prevalence of IFG and IR were significantly increased in Q5 vs Q1 (reference quartile, P < 0.025). The prevalence of IGT increased from Q3 to Q5 vs Q1 (P < 0.025-0.0001) and that of low IS from Q2 to Q5 vs Q1 (P < 0.005-0.0001).
In youth with OW/OB, rates of IGT and low IS increased progressively across quintiles of UA. On the contrary, IFG and IR were associated only with the highest quintile of UA. Our data suggest that UA is a biomarker of impaired glucose metabolism prevalently in post-challenge condition rather than in fasting state.
尿酸（UA）与糖尿病前期的关系在年轻人中研究甚少。本研究旨在探讨超重/肥胖（OW/OB）青少年中 UA 与空腹血糖受损（IFG）、葡萄糖耐量受损（IGT）、胰岛素抵抗（IR）和低胰岛素敏感性（IS）之间的关系。
本横断面研究纳入了 2248 名 OW/OB 青少年（年龄 5-17 岁）。将 UA 按性别特异性五分位数（Q1 至 Q5）进行分层，并探讨了与空腹血糖（FG）、2 小时餐后血糖（2H-PG）、IR 和低 IS 的相关性。IR 和低 IS 分别通过胰岛素抵抗评估模型（HOMA-IR）和全身 IS 指数（WBISI）进行评估。IFG 定义为 FG≥100<126mg/dL，IGT 定义为 2H-PG≥140<200mg/dL，IR 定义为 HOMA-IR≥75 百分位数，低 IS 定义为 WBISI≤25 百分位数。UA 五分位数组中，年龄、体重指数 z 评分、2H-PG、HOMA-IR 和 WBISI 随性别逐渐增加，而 FG 无此变化。与 Q1 相比，Q5 时 IFG 和 IR 的发生率显著增加（参考四分位数，P<0.025）。与 Q1 相比，Q3 至 Q5 时 IGT 的发生率增加（P<0.025-0.0001），Q2 至 Q5 时低 IS 的发生率增加（P<0.005-0.0001）。
在 OW/OB 青少年中，UA 五分位数组中 IGT 和低 IS 的发生率呈逐渐增加趋势。相反，IFG 和 IR 仅与 UA 的最高五分位数相关。我们的数据表明，UA 是葡萄糖代谢受损的生物标志物，主要与负荷后状态相关，而非空腹状态。
