Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
Department of Endocrinology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
Nutr J. 2023 Sep 22;22(1):45. doi: 10.1186/s12937-023-00874-5.
Obesity and type 2 diabetes mellitus (T2DM) are risk factors for hyperuricemia. However, which anthropometric indices can better predict incident hyperuricemia in patients with T2DM remains inconsistent. This study aimed to examine the associations between hyperuricemia and different anthropometric indices in middle-aged and older male patients with T2DM.
In this retrospective study, a total of 1447 middle-aged (45-65 years, n = 791) and older (≥ 65 years, n = 656) male patients with T2DM were collected from December 2015 to January 2020 at Shanghai Xinhua Hospital. Hyperuricemia was defined as a serum uric acid level above 7.0 mg/dL. Weight, height, waist circumference (WC) and hip circumference (HC) were measured by trained nurses at visit.
The median uric acid level of subjects was 5.6 (interquartile ranges: 4.7-6.7) mg/dl, and 279 (19.3%) were hyperuricemia, with 146 (18.5%) in the middle-aged group, and 133 (20.3%) in the older group. After adjusting for age, duration of T2DM, fasting plasma glucose and insulin, homeostasis model assessment-β, aspartate aminotransferase, triglycerides, high-density lipoprotein cholesterol and estimated glomerular filtration rate, body mass index (BMI), WC, HC, and waist-to-height ratio (WHtR) were associated with a higher risk of hyperuricemia in both middle-aged and older group (P < 0.05). After further adjusting for BMI and WC, HC still showed a positive relationship with the risk of hyperuricemia (Odds Ratio = 1.51, 95% confidence intervals: 1.06-2.14) in the middle-aged group, but such relationship was not found in the older group. Moreover, according to receiver operating characteristic analysis, the optimal cutoff value was 101.3 cm of HC for hyperuricemia screening in the middle-aged male patients with T2DM.
In middle-aged male patients with T2DM, more attention should be paid to HC with the cutoff value of 101.3 cm in clinical practice for early recognition of individuals with a high risk of hyperuricemia for targeted guidance on disease prevention, such as community screening.
肥胖和 2 型糖尿病(T2DM)是高尿酸血症的危险因素。然而,哪种人体测量指标能更好地预测 T2DM 患者的高尿酸血症发病情况仍不一致。本研究旨在探讨中年和老年男性 T2DM 患者高尿酸血症与不同人体测量指标的关系。
本回顾性研究共纳入 2015 年 12 月至 2020 年 1 月在上海新华医院就诊的 1447 名中年(45-65 岁,n=791)和老年(≥65 岁,n=656)男性 T2DM 患者。高尿酸血症定义为血清尿酸水平高于 7.0mg/dL。由经过培训的护士在就诊时测量体重、身高、腰围(WC)和臀围(HC)。
受试者的中位尿酸水平为 5.6(四分位间距:4.7-6.7)mg/dL,279 例(19.3%)为高尿酸血症,其中中年组 146 例(18.5%),老年组 133 例(20.3%)。在调整年龄、T2DM 病程、空腹血糖和胰岛素、稳态模型评估-β、天冬氨酸氨基转移酶、甘油三酯、高密度脂蛋白胆固醇和估算肾小球滤过率后,体质指数(BMI)、WC、HC 和腰高比(WHtR)与中年和老年组高尿酸血症的风险增加相关(P<0.05)。进一步调整 BMI 和 WC 后,HC 与中年组高尿酸血症的风险仍呈正相关(比值比=1.51,95%置信区间:1.06-2.14),但在老年组未发现这种关系。此外,根据受试者工作特征分析,最佳截断值为 101.3cm 的 HC 可用于筛查中年男性 T2DM 患者的高尿酸血症。
在中年男性 T2DM 患者中,临床实践中应更加关注 HC,其最佳截断值为 101.3cm,以便早期识别高尿酸血症高危人群,从而针对疾病预防进行有针对性的指导,如社区筛查。