Han Yingdong, Han Xinxin, Yin Yue, Cao Yu, Di Hong, Wu Juan, Zhang Yun, Zeng Xuejun
Department of Family Medicine and Division of General Internal Medicine, Department of Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, China.
Front Med (Lausanne). 2022 Jun 9;9:905085. doi: 10.3389/fmed.2022.905085. eCollection 2022.
There is a limited number of studies on the dose-response relationship between serum uric acid and impaired glucose metabolism in people without diabetes, and no large-scale research exploring the relationship in women without diabetes is based on menopausal status. Consequently, the present study aimed to investigate the above relationship in United States adults without diabetes.
Data from 2,498 men and 2,650 women aged ≥20 years were obtained from the National Health and Nutrition Examination Survey 2011-2016 conducted in the United States. Binary logistic regression analysis was applied to evaluate the association between uric acid and impaired glucose metabolism. Restricted cubic spline analysis, sensitivity analysis, and stratified analysis by menopausal status were performed to explore the above relationships.
A positive correlation was found between uric acid and the risk of insulin resistance in all participants ( < 0.05). In binary logistic regression analysis, after adjusting for confounding factors, compared with the lowest quartile of uric acid, the odds ratio (95% confidence intervals) of insulin resistance in the highest quartile was 1.9 (1.1-3.1) and 2.2 (1.2-4.3) in men and women, respectively. A significant positive relationship was also observed between uric acid and impaired fasting glucose and hyperinsulinemia in women, while in men, uric acid was positively associated with the risk of hyperinsulinemia but not impaired fasting glucose. Restricted cubic spline showed that the odds ratios of insulin resistance and hyperinsulinemia increased with elevating uric acid levels in both men and women. When stratified by menopause, the association remained significant in pre-menopausal women aged ≥20, but insignificant in post-menopausal women.
Uric acid was positively associated with the risk of impaired glucose metabolism in a cohort of United States adults, and uric acid increased the risk of insulin resistance in pre-menopausal, but not in post-menopausal women.
关于无糖尿病者血清尿酸与糖代谢受损之间剂量反应关系的研究数量有限，且尚无基于绝经状态探索无糖尿病女性中该关系的大规模研究。因此，本研究旨在调查美国无糖尿病成年人中的上述关系。
数据来自于在美国进行的2011 - 2016年全国健康与营养检查调查，共纳入2498名年龄≥20岁的男性和2650名年龄≥20岁的女性。采用二元逻辑回归分析评估尿酸与糖代谢受损之间的关联。进行限制立方样条分析、敏感性分析以及按绝经状态进行分层分析以探索上述关系。
在所有参与者中，尿酸与胰岛素抵抗风险呈正相关（<0.05）。在二元逻辑回归分析中，调整混杂因素后，与尿酸最低四分位数组相比，尿酸最高四分位数组中男性和女性胰岛素抵抗的优势比（95%置信区间）分别为1.9（1.1 - 3.1）和2.2（1.2 - 4.3）。在女性中，尿酸与空腹血糖受损和高胰岛素血症之间也观察到显著的正相关关系，而在男性中，尿酸与高胰岛素血症风险呈正相关，但与空腹血糖受损无关。限制立方样条显示，男性和女性中胰岛素抵抗和高胰岛素血症的优势比均随尿酸水平升高而增加。按绝经状态分层时，该关联在年龄≥20岁的绝经前女性中仍然显著，但在绝经后女性中不显著。
在美国成年人队列中，尿酸与糖代谢受损风险呈正相关，且尿酸增加绝经前女性而非绝经后女性的胰岛素抵抗风险。
