2型糖尿病患者四种非胰岛素抵抗指数与血清尿酸的关系：一项横断面研究
Relationship Between Four Non-Insulin-Based Indexes of Insulin Resistance and Serum Uric Acid in Patients with Type 2 Diabetes: A Cross-Sectional Study.
作者信息
Han Rongfeng, Zhang Yang, Jiang Xia
机构信息
Department of Endocrinology, Tianjin First Center Hospital, Tianjin, 300192, People's Republic of China.
出版信息
Diabetes Metab Syndr Obes. 2022 May 9;15:1461-1471. doi: 10.2147/DMSO.S362248. eCollection 2022.
AIM
The aim of this study was to investigate the association between serum uric acid (SUA) levels and four insulin resistance surrogates in patients with type 2 diabetes (T2DM). The four non-insulin-based indexes of insulin resistance (IR) include the glucose and triglycerides index (TyG), TyG index with body mass index (TyG-BMI), ratio of triglycerides to high-density lipoprotein cholesterol (TG/HDL-c) and metabolic score for insulin resistance (METS-IR).
METHODS
A total of 687 patients with T2DM were enrolled in the current study. Patients were stratified into three groups according to their levels of SUA. Spearman correlation was used to analyze the correlation between SUA and clinical variables. Multiple linear regression analysis was used to assess the association between SUA and the four insulin resistance surrogates. Receiver operating characteristic (ROC) analyses and the area under the ROC curve (AUC) were then used to assess the ability of TyG, TyG-BMI, TG/HDL-c, and METS-IR to discriminate hyperuricemia (HUA) in T2DM.
RESULTS
SUA in T2DM was significantly positively correlated with TyG (r 0.406 P < 0.01), TyG-BMI (r 0.272 P < 0.01), TG/HDL-c (r 0.493 P < 0.01), and METS-IR (r 0.238 P < 0.01). Furthermore, higher values of the four insulin resistance surrogates were independently correlated with higher SUA levels in T2DM patients (P < 0.01 for all) after adjusting for confounding factors. TyG, TyG-BMI, TG/HDL-c, and METS-IR all had a significant discriminative ability for HUA in patients with T2DM. The AUC values were 0.693 (95% CI 0.645-0.741), 0.649 (95% CI 0.599-0.699), 0.768 (95% CI 0.726-0.811), and 0.660 (95% CI 0.609-0.710), respectively.
CONCLUSION
The present study suggests that TyG, TyG-BMI, TG/HDL-c and METS-IR had a significant correlation with SUA in T2DM. TG/HDL-c was the best marker among the four insulin resistance surrogates for the identification of HUA in T2DM.
目的
本研究旨在调查2型糖尿病（T2DM）患者血清尿酸（SUA）水平与四种胰岛素抵抗替代指标之间的关联。四种基于非胰岛素的胰岛素抵抗（IR）指标包括血糖与甘油三酯指数（TyG）、结合体重指数的TyG指数（TyG-BMI）、甘油三酯与高密度脂蛋白胆固醇之比（TG/HDL-c）以及胰岛素抵抗代谢评分（METS-IR）。
方法
本研究共纳入687例T2DM患者。根据SUA水平将患者分为三组。采用Spearman相关性分析SUA与临床变量之间的相关性。采用多元线性回归分析评估SUA与四种胰岛素抵抗替代指标之间的关联。然后采用受试者工作特征（ROC）分析及ROC曲线下面积（AUC）评估TyG、TyG-BMI、TG/HDL-c和METS-IR区分T2DM患者高尿酸血症（HUA）的能力。
结果
T2DM患者的SUA与TyG（r = 0.406，P < 0.01）、TyG-BMI（r = 0.272，P < 0.01）、TG/HDL-c（r = 0.493，P < 0.01）和METS-IR（r = 0.238，P < 0.01）显著正相关。此外，在调整混杂因素后，T2DM患者中四种胰岛素抵抗替代指标的较高值均与较高的SUA水平独立相关（均P < 0.01）。TyG、TyG-BMI、TG/HDL-c和METS-IR在T2DM患者中对HUA均具有显著的鉴别能力。AUC值分别为0.693（95%CI 0.645 - 0.741）、0.649（95%CI 0.599 - 0.699）、0.768（95%CI 0.726 - 0.811）和0.660（95%CI 0.609 - 0.710）。
结论
本研究表明，TyG、TyG-BMI、TG/HDL-c和METS-IR与T2DM患者的SUA显著相关。TG/HDL-c是四种胰岛素抵抗替代指标中识别T2DM患者HUA的最佳标志物。
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