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中国心血管代谢疾病和癌症队列研究(4C 研究):一般中国人群中血糖指数与血清尿酸水平之间呈倒 U 型关联。

Inverted U-Shaped Associations between Glycemic Indices and Serum Uric Acid Levels in the General Chinese Population: Findings from the China Cardiometabolic Disease and Cancer Cohort (4C) Study.

机构信息

Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.

The First Hospital of Jilin University, Changchun 130021, Jinlin, China.

出版信息

Biomed Environ Sci. 2021 Jan 20;34(1):9-18. doi: 10.3967/bes2021.003.

Abstract

OBJECTIVE

The relationship between serum uric acid (SUA) levels and glycemic indices, including plasma glucose (FPG), 2-hour postload glucose (2h-PG), and glycated hemoglobin (HbA1c), remains inconclusive. We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population.

METHODS

The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study. A total of 105,922 community-dwelling adults aged ≥ 40 years underwent the oral glucose tolerance test and uric acid assessment. The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models.

RESULTS

A total of 30,941 men and 62,361 women were eligible for the current analysis. Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels, but with different inflection points in men and women. The thresholds for FPG, 2h-PG, and HbA1c for men and women were 6.5/8.0 mmol/L, 11.0/14.0 mmol/L, and 6.1/6.5, respectively (SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices).

CONCLUSION

An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes, while the inflection points were reached earlier in men than in women.

摘要

目的

血清尿酸(SUA)水平与血糖指标(包括空腹血糖(FPG)、餐后 2 小时血糖(2h-PG)和糖化血红蛋白(HbA1c))之间的关系尚未明确。本研究旨在探讨中国一般人群中血糖指标与 SUA 水平之间的关系。

方法

本研究是使用中国心血管代谢疾病和癌症队列研究的首次随访调查数据进行的横断面分析。共有 105922 名年龄≥40 岁的社区居民接受了口服葡萄糖耐量试验和尿酸评估。使用广义加性模型探讨了血糖指标与 SUA 水平之间的非线性关系。

结果

共有 30941 名男性和 62361 名女性符合当前分析的条件。广义加性模型验证了血糖指标与 SUA 水平之间存在倒 U 型关系,但男性和女性的拐点不同。男性和女性的 FPG、2h-PG 和 HbA1c 的阈值分别为 6.5/8.0 mmol/L、11.0/14.0 mmol/L 和 6.1/6.5(在拐点之前,SUA 水平随血糖指标的增加而增加,然后随着血糖指标的进一步增加而最终降低)。

结论

在两性中均观察到主要血糖指标与尿酸水平之间存在倒 U 型关系,而男性的拐点早于女性。

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