Department of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, 801 Heqin Road, Shanghai, 200240, China.
Endocrine Metabolism Department, the Second People's Hospital of Kashgar Prefecture, No. 1, Health Road, Kashi City, Kashi Region, Xinjiang, 844000, China.
Reprod Biol Endocrinol. 2024 Aug 27;22(1):108. doi: 10.1186/s12958-024-01278-8.
Our aim was to explore the relationship between serum uric acid (UA) levels in early pregnancy and the development of gestational diabetes mellitus (GDM), and to further explore whether there is a causal relationship.
684 pregnant women with GDM and 1162 pregnant women without GDM participated in this study. 311 pregnant women with GDM and 311 matched controls were enrolled in a 1:1 case-control study. We used conditional logistic regression to explore the relationship between UA levels and the risk of developing GDM. The causal relationship between the two was examined by two-sample Mendelian randomization (MR) analysis.
In the 1:1 matched population, the odds ratio (OR) of developing GDM compared with the extreme tertiles of UA levels was 1.967 (95% confidence interval [CI]: 1.475-2.625; P < 0.001). Restricted cubic spline analyses showed a linear relationship between UA and GDM when UA exceeded 222 µmol/L. GDM and UA levels maintained a statistically significant positive correlation in different stratified regression analyses (P < 0.001). However, no evidence of a causal relationship between uric acid and GDM was found by MR analyses with an OR of 1.06 (95% CI: 0.91-1.25) per unit increase in UA.
There is a positive correlation between UA levels in early pregnancy and the subsequent risk of developing GDM. However, no genetic evidence was found to support a cause-effect relationship between UA and GDM.
本研究旨在探讨早孕期血清尿酸（UA）水平与妊娠期糖尿病（GDM）发展之间的关系，并进一步探讨两者之间是否存在因果关系。
本研究纳入了 684 例 GDM 孕妇和 1162 例非 GDM 孕妇。其中 311 例 GDM 孕妇和 311 例匹配对照者纳入了 1:1 的病例对照研究。我们采用条件 logistic 回归探讨 UA 水平与 GDM 发病风险之间的关系。采用两样本 Mendelian 随机化（MR）分析来检验两者之间的因果关系。
在 1:1 匹配人群中，与 UA 水平极端三分位相比，UA 水平升高与 GDM 发病风险的比值比（OR）为 1.967（95%置信区间 [CI]：1.475-2.625；P<0.001）。受限立方样条分析显示，当 UA 超过 222 µmol/L 时，UA 与 GDM 之间呈线性关系。在不同分层回归分析中，GDM 和 UA 水平之间均保持统计学显著的正相关关系（P<0.001）。然而，MR 分析并未发现 UA 与 GDM 之间存在因果关系，UA 每增加 1 个单位，OR 为 1.06（95% CI：0.91-1.25）。
早孕期 UA 水平与随后发生 GDM 的风险呈正相关。然而，没有遗传证据支持 UA 与 GDM 之间存在因果关系。
