Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
Department of Pathology, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Medicine (Baltimore). 2024 Nov 29;103(48):e40544. doi: 10.1097/MD.0000000000040544.
Cardiovascular events are frequent among individuals with prediabetes. And the relationship between cardiovascular diseases and elevated serum uric acid (SUA) levels has been supported by extensive scientific evidence. However, there remains controversy regarding the correlation between elevated SUA and prediabetes. The aim of this study was to investigate the association between elevated SUA levels and the prevalence of prediabetes and gender differences in the association. A total of 190,891 individuals who participated in health checkups at the Health Promotion Center of Sir Run Run Shaw Hospital of Zhejiang University from January 2017 to December 2021 were included in this cross-sectional study. The health checkups were carried out by trained general practitioners and nurses. The diagnostic criteria for diabetes and prediabetes are defined in the Standards of Medical Care in Diabetes-2022. The association between SUA levels and diabetes and prediabetes was examined based on logistic regression analysis. The dose-response effect between SUA levels and diabetes and prediabetes in both sexes was assessed using a restricted cubic spline (RCS) regression model. Among 190,891 participants, this study included 106,482 males (55.8%) and 84,409 females (44.2%). There were 46,240 (24.2%) patients with prediabetes and 20,792 (10.9%) patients with diabetes. SUA was divided into quartiles (Q). Compared to the SUA Q1 group, the prevalence of prediabetes was elevated in the SUA Q4 group (OR = 1.378, 95% CI = 1.321-1.437), but diabetes risk was decreased in the SUA Q4 group (OR = 0.690, 95% CI = 0.651-0.730). We found that SUA levels were correlated with prediabetes more significantly in male subjects (OR = 1.328, 95% CI = 1.272-1.386) than in female subjects (OR = 1.184, 95% CI = 1.122-1.249) (P for interaction < .001). Higher SUA levels were strongly related to an elevated prevalence of prediabetes but a decreased prevalence of diabetes. The association of SUA in prediabetes was more significant in men.
心血管事件在糖尿病前期患者中较为常见。大量科学证据支持心血管疾病与血清尿酸(SUA)水平升高之间的关系。然而,SUA 升高与糖尿病前期之间的相关性仍存在争议。本研究旨在探讨 SUA 水平升高与糖尿病前期患病率之间的关系以及这种关系在不同性别之间的差异。
本研究纳入了 2017 年 1 月至 2021 年 12 月在浙江大学医学院附属邵逸夫医院健康促进中心参加健康检查的 190891 名个体,这些个体均由经过培训的全科医生和护士进行健康检查。糖尿病和糖尿病前期的诊断标准是根据 2022 年《糖尿病医学诊疗标准》制定的。采用 logistic 回归分析检验了 SUA 水平与糖尿病和糖尿病前期之间的关联。采用限制性三次样条(RCS)回归模型评估了 SUA 水平与两性糖尿病和糖尿病前期之间的剂量-反应关系。在 190891 名参与者中,本研究包括 106482 名男性(55.8%)和 84409 名女性(44.2%)。其中 46240 名(24.2%)患者患有糖尿病前期,20792 名(10.9%)患者患有糖尿病。SUA 被分为四等分(Q)。与 SUA Q1 组相比,SUA Q4 组的糖尿病前期患病率升高(OR=1.378,95%CI=1.321-1.437),但糖尿病风险降低(OR=0.690,95%CI=0.651-0.730)。我们发现,SUA 水平与男性糖尿病前期的相关性更为显著(OR=1.328,95%CI=1.272-1.386),而与女性糖尿病前期的相关性较弱(OR=1.184,95%CI=1.122-1.249)(P<0.001)。较高的 SUA 水平与糖尿病前期患病率升高但糖尿病患病率降低密切相关。SUA 与男性糖尿病前期的关系更为显著。