[基于C肽的胰岛素抵抗指数在评估健康体检人群胰岛素抵抗与血清尿酸水平相关性中的价值]
[Value of C-peptide-based insulin resistance index for evaluating correlation between insulin resistance and serum uric acid level in individuals undergoing health examination].
作者信息
Fang F, Wang N, Liu X, Wang W, Sun J, Li H, Sun B, Gu Z, Fu X, Yan S
机构信息
Department of Health Care, Second Medical Center of Chinese PLA General Hospital, Beijing 100853, China.
Department of Health Management, Second Medical Center of Chinese PLA General Hospital, Beijing 100853, China.
出版信息
Nan Fang Yi Ke Da Xue Xue Bao. 2023 Sep 20;43(9):1509-1514. doi: 10.12122/j.issn.1673-4254.2023.09.08.
OBJECTIVE
To investigate the value of C-peptide-based insulin resistance index in evaluating the correlation between insulin resistance and serum uric acid (Ua) level in subjects undergoing health examination.
METHODS
The data of 46 017 subjects undergoing health examination were retrospectively collected from the Second Medical Center of PLA General Hospital from January, 2017 to December, 2021. The subjects were divided into Ua≤420 μmol/L group and Ua>420 μmol/L group for comparison of HOMA insulin resistance index (HOMA2-IR) and HOMA insulin resistance-C peptide (HOMA2 IR-CP). The correlations of HOMA2-IR and HOMA2 IR-CP with Ua level were analyzed using Pearson correlation analysis and linear regression analysis. Hierarchical interaction analysis was conducted to assess the differences in the association between insulin resistance index and Ua level in different subgroups. The ROC curve was used to evaluate the predictive ability of insulin resistance index for an increased Ua level.
RESULTS
The levels of HOMA2-IR and HOMA2 IR-CP were significantly lower in Ua≤420 μmol/L group than in Ua>420 μmol/L group. Univariate Pearson correlation analysis showed a weak correlation of HOMA2-IR with Ua (=0.262, <0.001) and moderate correlation of HOMA2 IR-CP with Ua (=0.409, <0.001). Multivariate linear regression analysis, after adjustment for confounding factors, demonstrated that HOMA2-IR (=0.445, <0.001) and HOMA2 IR-CP (=0.461, <0.001) were both factors affecting Ua level. Hierarchical interaction analysis showed that the association of insulin resistance index with Ua level varied significantly with gender, age, and glucose metabolism (<0.001). ROC curve showed that the areas under the curve predicted an increased Ua level by HOMA2-IR and HOMA2 IR-CP were 0.662 and 0.722, respectively.
CONCLUSIONS
HOMA2 IR-CP is a more accurate indicator for assessing the correlation between insulin resistance and Ua level.
目的
探讨基于C肽的胰岛素抵抗指数在评估健康体检人群胰岛素抵抗与血清尿酸（Ua）水平相关性中的价值。
方法
回顾性收集2017年1月至2021年12月解放军总医院第二医学中心46017例健康体检者的数据。将研究对象分为Ua≤420 μmol/L组和Ua>420 μmol/L组，比较两组的稳态模型评估胰岛素抵抗指数（HOMA2-IR）和稳态模型评估胰岛素抵抗- C肽（HOMA2 IR-CP）。采用Pearson相关分析和线性回归分析方法分析HOMA2-IR和HOMA2 IR-CP与Ua水平的相关性。进行分层交互分析，评估不同亚组中胰岛素抵抗指数与Ua水平之间关联的差异。采用ROC曲线评估胰岛素抵抗指数对Ua水平升高的预测能力。
结果
Ua≤420 μmol/L组的HOMA2-IR和HOMA2 IR-CP水平显著低于Ua>420 μmol/L组。单因素Pearson相关分析显示，HOMA2-IR与Ua呈弱相关（r = 0.262，P<0.001），HOMA2 IR-CP与Ua呈中度相关（r = 0.409，P<0.001）。多因素线性回归分析在调整混杂因素后表明，HOMA2-IR（β = 0.445，P<0.001）和HOMA2 IR-CP（β = 0.461，P<0.001）均为影响Ua水平的因素。分层交互分析显示，胰岛素抵抗指数与Ua水平的关联在性别、年龄和糖代谢方面差异显著（P<0.001）。ROC曲线显示，HOMA2-IR和HOMA2 IR-CP预测Ua水平升高的曲线下面积分别为0.662和0.722。
结论
HOMA2 IR-CP是评估胰岛素抵抗与Ua水平相关性的更准确指标。
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