Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China.
Health Management Center, The Second Hospital of Dalian Medical University, Dalian, China.
Front Endocrinol (Lausanne). 2022 Jun 10;13:835154. doi: 10.3389/fendo.2022.835154. eCollection 2022.
Adipose tissue plays a crucial role in serum uric acid (UA) metabolism, but the relative contribution of adipose tissue insulin resistance (IR) to serum UA levels and hyperuricemia have not explicitly been illustrated. Herein, we aimed to investigate the association between the adipose tissue insulin resistance index (Adipo-IR) and hyperuricemia in this cross-sectional study. The homeostasis model assessment of insulin resistance (HOMA-IR) index, another widely applied marker to determine systemic IR, was also explored.
A total of 5821 adults were included in this study. The relationship between Adipo-IR or HOMA-IR and serum UA levels was assessed by multivariate linear regression. Binary logistic regression analyses were applied to determine the sex-specific association of the Adipo-IR tertiles and HOMA-IR tertiles with hyperuricemia. Participants were then divided into normal BMI (18.5 ≤ BMI < 24) and elevated BMI (BMI ≥ 24) groups for further analysis.
Both Adipo-IR and HOMA-IR were positively correlated with serum UA ( < 0.001). Compared with the lowest tertile, the risks of hyperuricemia increased across Adipo-IR tertiles (middle tertile: OR 1.52, 95%CI 1.24-1.88; highest tertile: OR 2.10, 95%CI 1.67-2.63) in men after full adjustment ( for trend < 0.001). In women, only the highest tertile (OR 2.09, 95%CI 1.52-2.87) was significantly associated with hyperuricemia. Those associations remained significant in participants with normal BMI status. As for HOMA-IR, only the highest tertile showed positive relationships with hyperuricemia in both genders after full adjustment ( for trend < 0.001). The association between HOMA-IR and hyperuricemia disappeared in men with normal BMI status.
Adipo-IR was strongly associated with serum UA and hyperuricemia regardless of BMI classification. In men with normal BMI, Adipo-IR, rather than HOMA-IR, was closely associated with hyperuricemia. Altogether, our finding highlights a critical role of adipose tissue IR on serum UA metabolism and hyperuricemia.
脂肪组织在血清尿酸（UA）代谢中起着至关重要的作用，但脂肪组织胰岛素抵抗（IR）对血清 UA 水平和高尿酸血症的相对贡献尚未明确说明。在此，我们旨在通过这项横断面研究，探讨脂肪组织胰岛素抵抗指数（Adipo-IR）与高尿酸血症之间的关系。同时，还探讨了另一种广泛应用于确定全身 IR 的标志物——稳态模型评估的胰岛素抵抗（HOMA-IR）指数。
共纳入 5821 名成年人进行研究。采用多元线性回归评估 Adipo-IR 或 HOMA-IR 与血清 UA 水平的关系。应用二分类 logistic 回归分析评估 Adipo-IR 三分位和 HOMA-IR 三分位与高尿酸血症的性别特异性关联。然后，根据 BMI 将参与者分为正常 BMI（18.5≤BMI＜24）和升高 BMI（BMI≥24）两组进行进一步分析。
Adipo-IR 和 HOMA-IR 均与血清 UA 呈正相关（<0.001）。与最低三分位相比，男性中随着 Adipo-IR 三分位的升高，高尿酸血症的风险逐渐增加（中三分位：OR 1.52，95%CI 1.24-1.88；最高三分位：OR 2.10，95%CI 1.67-2.63），经完全调整后差异有统计学意义（趋势检验<0.001）。在女性中，仅最高三分位（OR 2.09，95%CI 1.52-2.87）与高尿酸血症显著相关。在 BMI 正常的参与者中，这些关联仍然显著。对于 HOMA-IR，仅最高三分位与男女经完全调整后的高尿酸血症呈正相关（趋势检验<0.001）。在 BMI 正常的男性中，HOMA-IR 与高尿酸血症之间的关联消失。
Adipo-IR 与血清 UA 和高尿酸血症密切相关，无论 BMI 分类如何。在 BMI 正常的男性中，Adipo-IR 与高尿酸血症密切相关，而不是 HOMA-IR。总之，我们的研究结果强调了脂肪组织 IR 对血清 UA 代谢和高尿酸血症的关键作用。
