School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
Qi-Huang Chinese Medicine School, Beijing University of Chinese Medicine, Beijing, China.
Front Endocrinol (Lausanne). 2024 Aug 7;15:1422470. doi: 10.3389/fendo.2024.1422470. eCollection 2024.
To explore the relationship between estradiol (E2) and the incidence of hyperuricemia (HUA) in adult women and to explore whether glucolipid metabolism disorders play a mediating role in mediating this relationship.
A total of 2,941 participants aged 20-65 years were included in the National Health and Nutrition Examination Survey (NHANES) 2013-2016. Multivariate logistic regression analysis was performed to evaluate the correlations of E2 with HUA. Multivariate linear regression analysis was performed to evaluate the associations between E2 and triglyceride (TG), total cholesterol (TC), and the triglyceride-glucose index (TyG). The restricted cubic spline (RCS) model was used to further explore the association between E2 and HUA and between TG, TC, and TyG and HUA. Mediation analyses were performed to examine whether TC, TG, and TyG mediated the relationship between E2 and HUA.
After adjusting for covariates, logistic regression revealed that ln(E2) was significantly associated with HUA in the female subgroup ( = 0.035) and that the incidence of HUA tended to increase with decreasing ln(E2) ( for trend = 0.026). Linear regression showed that E2 was significantly associated with TC ( = 0.032), TG ( = 0.019), and TyG ( = 0.048). The RCS model showed that ln(E2) was linearly correlated with the incidence of HUA (-overall = 0.0106, -non-linear = 0.3030). TC and TyG were linearly correlated with HUA (TC: -overall = 0.0039, -non-linear = 0.4774; TyG: -overall = 0.0082, -non-linear = 0.0663), whereas TG was non-linearly correlated with HUA. Mediation analyses revealed that TC, TG, and TyG significantly mediated the relationship between ln(E2) and HUA (TC, indirect effect: -0.00148, 7.5%, = 0.008; TG, indirect effect: -0.00062, 3.1%, = 0.004; TyG, indirect effect: -0.00113, 5.6%, = 0.016).
In conclusion, this study demonstrated that compared with women aged 20-45 years, women aged 45-55 years and 55-65 years had lower E2 levels and a greater incidence of HUA. E2 levels and the incidence of HUA were negatively associated in female individuals but not in male individuals. In addition, TC, TG, and TyG, which are markers of glucolipid metabolism, played a mediating role in the association between E2 and HUA.
探讨雌二醇（E2）与成年女性高尿酸血症（HUA）发病率之间的关系，并探讨糖脂代谢紊乱是否在其中发挥中介作用。
共纳入 2013-2016 年国家健康与营养调查（NHANES）中 2941 名 20-65 岁的参与者。采用多变量 logistic 回归分析评估 E2 与 HUA 的相关性。采用多变量线性回归分析评估 E2 与甘油三酯（TG）、总胆固醇（TC）和甘油三酯-葡萄糖指数（TyG）之间的关系。采用限制性立方样条（RCS）模型进一步探讨 E2 与 HUA 之间以及 TG、TC 和 TyG 与 HUA 之间的关联。进行中介分析以检验 TC、TG 和 TyG 是否介导了 E2 与 HUA 之间的关系。
调整协变量后，logistic 回归显示 ln（E2）与女性亚组的 HUA 显著相关（ = 0.035），且随着 ln（E2）的降低，HUA 的发病率呈上升趋势（趋势 = 0.026）。线性回归显示 E2 与 TC（ = 0.032）、TG（ = 0.019）和 TyG（ = 0.048）显著相关。RCS 模型显示 ln（E2）与 HUA 的发病率呈线性相关（-总体 = 0.0106，-非线性 = 0.3030）。TC 和 TyG 与 HUA 呈线性相关（TC：-总体 = 0.0039，-非线性 = 0.4774；TyG：-总体 = 0.0082，-非线性 = 0.0663），而 TG 与 HUA 呈非线性相关。中介分析显示 TC、TG 和 TyG 显著介导了 ln（E2）与 HUA 之间的关系（TC，间接效应：-0.00148，7.5%， = 0.008；TG，间接效应：-0.00062，3.1%， = 0.004；TyG，间接效应：-0.00113，5.6%， = 0.016）。
综上所述，本研究表明，与 20-45 岁女性相比，45-55 岁和 55-65 岁女性的 E2 水平较低，HUA 发病率较高。女性个体中 E2 水平与 HUA 的发病率呈负相关，但男性个体中则无此相关性。此外，糖脂代谢标志物 TC、TG 和 TyG 在 E2 与 HUA 之间的关联中发挥了中介作用。
