Xiong Fang, Yu Chao, Zhu Ling-Juan, Wang Tao, Zhou Wei, Bao Hui-Hui, Cheng Xiao-Shu
Nursing Department,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China.
Center for Prevention and Treatment of Cardiovascular Diseases,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2023 Jun;45(3):390-398. doi: 10.3881/j.issn.1000-503X.15414.
Objective To explore the relationship between insulin resistance (IR) indexes and hyperuricemia (HUA) among the people with hypertension. Methods From July to August in 2018,hypertension screening was carried out in Wuyuan county,Jiangxi province,and the data were collected through questionnaire survey,physical measurement,and biochemical test.Logistic regression was performed to analyze the relationship between HUA and IR indexes including metabolic score for IR (METS-IR),triglyceride-glucose (TyG) index,TyG-body mass index (BMI),TyG-waist circumference (WC),visceral adiposity index (VAI),triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C),and lipid accumulation product (LAP).The penalty spline method was used for the curve fitting between IR indexes and HUA.The area under the receiver operating characteristic curve (AUC) was employed to reveal the correlation between each index and HUA. Results The 14 220 hypertension patients included 6 713 males and 7 507 females,with the average age of (63.8±9.4) years old,the average uric acid level of (418.9±120.6) mmol/L,and the HUA detection rate of 44.4%.The HUA group had higher proportions of males,current drinking,current smoking,diabetes,and using antihypertensive drugs,older age,higher diastolic blood pressure,WC,BMI,homocysteine,total cholesterol,TG,low-density lipoprotein cholesterol,blood urea nitrogen,creatinine,aspartate aminotransferase,alanine aminotransferase,total protein,albumin,total bilirubin,direct bilirubin, METS-IR, TyG, TyG-BMI, TyG-WC, VAI, TG/HDL-C, and LAP, and lower systolic blood pressure and HDL-C than the normal uric acid group (all <0.05).Multivariate Logistic regression showed that METS-IR (=1.049,95%=1.038-1.060, <0.001), TyG (=1.639,95%=1.496-1.797, <0.001), TyG-BMI (=1.008,95%=1.006-1.010, <0.001), TyG-WC (=1.003,95%=1.002-1.004, <0.001), lnVAI (=1.850, 95%=1.735-1.973, <0.001), ln(TG/HDL-C) (=1.862,95%=1.692-2.048, <0.001),and lnLAP (=1.503,95%=1.401-1.613,<0.001) were associated with the risk of HUA.Curve fitting indicated that METS-IR,TyG,TYG-BMI,TYG-WC,lnVAI,ln(TG/HDL-C),and lnLAP were positively correlated with HUA (all <0.001),and the AUC of TyG index was higher than that of other IR indexes (all <0.05). Conclusion Increased IR indexes,especially TyG,were associated with the risk of HUA among people with hypertension.
目的 探讨高血压患者胰岛素抵抗(IR)指标与高尿酸血症(HUA)之间的关系。方法 2018年7至8月,在江西省婺源县开展高血压筛查,通过问卷调查、体格检查及生化检测收集数据。采用Logistic回归分析HUA与IR指标(包括IR代谢评分(METS-IR)、甘油三酯-血糖(TyG)指数、TyG-体重指数(BMI)、TyG-腰围(WC)、内脏脂肪指数(VAI)、甘油三酯(TG)/高密度脂蛋白胆固醇(HDL-C)及脂质蓄积产物(LAP))之间的关系。运用惩罚样条法对IR指标与HUA进行曲线拟合。采用受试者工作特征曲线(AUC)下面积揭示各指标与HUA之间的相关性。结果 纳入14 220例高血压患者,其中男性6 713例,女性7 507例,平均年龄(63.8±9.4)岁,平均尿酸水平(418.9±120.6)mmol/L,HUA检出率为44.4%。与血尿酸正常组相比,HUA组男性、当前饮酒、当前吸烟、糖尿病及使用降压药物的比例更高,年龄更大,舒张压、WC、BMI、同型半胱氨酸、总胆固醇、TG、低密度脂蛋白胆固醇、血尿素氮、肌酐、天门冬氨酸氨基转移酶、丙氨酸氨基转移酶、总蛋白、白蛋白、总胆红素、直接胆红素、METS-IR、TyG、TyG-BMI、TyG-WC、VAI、TG/HDL-C及LAP更高,收缩压及HDL-C更低(均P<0.05)。多因素Logistic回归显示,METS-IR(β=1.049,95%CI=1.0381.060,P<0.001)、TyG(β=1.639,95%CI=1.4961.797,P<0.001)、TyG-BMI(β=1.008,95%CI=1.0061.010,P<0.001)、TyG-WC(β=1.003,95%CI=1.0021.004,P<0.001)、lnVAI(β=1.850,95%CI=1.7351.973,P<0.001)、ln(TG/HDL-C)(β=1.862,95%CI=1.6922.048,P<0.001)及lnLAP(β=1.503,95%CI=1.401~1.613,P<0.001)与HUA风险相关。曲线拟合表明,METS-IR、TyG、TYG-BMI、TYG-WC、lnVAI、ln(TG/HDL-C)及lnLAP与HUA呈正相关(均P<0.001),且TyG指数的AUC高于其他IR指标(均P<0.05)。结论 IR指标升高,尤其是TyG,与高血压患者HUA风险相关。