Li Yuexi, Luo Yuhan, Wang Qiaoli, Liu Xiaoqin
Health Management Center, Deyang People's Hospital, No. 173, Taishan North Road, Deyang, Sichuan, China.
Int J Endocrinol. 2022 Sep 16;2022:1673335. doi: 10.1155/2022/1673335. eCollection 2022.
Hyperuricemia acts as an independently known risk factor for diabetes, cardiovascular disease, and gout. It was previously reported that the ratio of triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) is not only an important marker of cardiovascular disease, stroke, atherosclerosis, and insulin resistance but is also associated with an elevated level of serum uric acid. However, it is still poorly understood what the association is between TG/HDL-C and serum uric acid levels. Hence, the aim of this research was to determine this association.
A total of 5,402 participants who underwent physical examinations in 2021 were analyzed during our cross-sectional research. In order to verify this correlation between TG/HDL-C and uric acid, we performed both a generalized additive model (GAM) and a smoothing curve fit. We also performed receiver operating characteristic (ROC) curves for evaluation of differences in clinical risk factor models in identifying hyperuricemia risk before and after the introduction of TG/HDL-C.
Upon adjustment for confounders, we found that there was a nonlinear positive correlation between TG/HDL-C and the level of uric acid, and the inflection point was 1.41. When TG/HDL-C was less than 1.41, the effect size was 40.56 (19.08-62.04, = 0.0002), whereas when TG/HDL-C was more than 1.41 the effect size was 17.18 (3.70-30.65, =0.0125). As shown by the ROC curve, a significant increase in the area under the curve (AUC) was observed upon the introduction of TG/HDL-C into the established risk factor model which elevated from 0.7206(0.7053-0.7359, < 0.05) to 0.8291 (0.8175-0.8407, < 0.05).
Therefore, TG/HDL-C is positively and nonlinearly correlated to the level of uric acid, and the inflection point is 1.41. Furthermore, TG/HDL-C leads to an improvement in hyperuricemia risk stratification.
高尿酸血症是已知的糖尿病、心血管疾病和痛风的独立危险因素。此前有报道称，甘油三酯与高密度脂蛋白胆固醇的比值（TG/HDL-C）不仅是心血管疾病、中风、动脉粥样硬化和胰岛素抵抗的重要标志物，还与血清尿酸水平升高有关。然而，TG/HDL-C与血清尿酸水平之间的关联仍知之甚少。因此，本研究的目的是确定这种关联。
在我们的横断面研究中，对2021年接受体检的5402名参与者进行了分析。为了验证TG/HDL-C与尿酸之间的这种相关性，我们进行了广义相加模型（GAM）和平滑曲线拟合。我们还绘制了受试者工作特征（ROC）曲线，以评估在引入TG/HDL-C前后临床危险因素模型在识别高尿酸血症风险方面的差异。
在对混杂因素进行调整后，我们发现TG/HDL-C与尿酸水平之间存在非线性正相关，拐点为1.41。当TG/HDL-C小于1.41时，效应大小为40.56（19.08 - 62.04，P = 0.0002），而当TG/HDL-C大于1.41时，效应大小为17.18（3.70 - 30.65，P = 0.0125）。如ROC曲线所示，在既定的危险因素模型中引入TG/HDL-C后，曲线下面积（AUC）显著增加，从0.7206（0.7053 - 0.7359，P < 0.05）增加到0.8291（0.8175 - 0.8407，P < 0.05）。
因此，TG/HDL-C与尿酸水平呈正非线性相关，拐点为1.41。此外，TG/HDL-C有助于改善高尿酸血症风险分层。
