Zhou Ya, Wang Haixiao, Gao Weiyi
Department of endocrinology, qilu Hospital (Qingdao), cheeloo College of Medicine, Shandong University, Qingdao, Shandong, People's Republic of China.
Department of Health Care, qilu Hospital (Qingdao), cheeloo College of Medicine, Shandong University, Qingdao, Shandong, People's Republic of China.
Diabetes Metab Syndr Obes. 2024 Nov 28;17:4553-4563. doi: 10.2147/DMSO.S472686. eCollection 2024.
Uric acid and blood glucose are important indicators of metabolic disorders. Numerous studies have elucidated the association between them, but the focus on their relationship through examination of urinary glucose and uric acid excretion has been limited. In this study, we conducted a comprehensive analysis on these indicators to explain the relationship.
This study involved the recruitment of 2498 patients who underwent fractional excretion of uric acid (FEUA) testing during their hospitalization at the Health Department of Qilu Hospital (Qingdao), Shandong University, between January 2017 and November 2023, with 1416 subjects being included in the final analysis. The included subjects were analyzed based on different genders. One-way analysis of variance, multiple linear regression analysis, and restricted cubic spline were adopted for data analysis.
Higher FEUA and lower serum uric acid (SUA) levels were observed in diabetic patients with urinary glucose than in diabetic patients without urinary glucose and the nondiabetic population. FEUA exhibited a proportional increase with elevated blood glucose levels, even including cases that lacked urinary glucose. After adjustment for potential confounding factors, SUA levels did not increase with the increase in fasting blood glucose (FBG) levels, and once FBG levels surpassed a certain threshold leading to glucosuria, FEUA was further elevated, accompanied with a subsequent reduction in SUA levels. There is a stronger linear relationship between SUA or FEUA and FBG levels in women than that in men after adjusting for confounding factors.
Hyperglycemia is not considered a risk factor for hyperuricemia. Regardless of the presence of urinary glucose, elevated blood glucose levels can stimulate renal excretion of uric acid. Upon reaching a threshold that induces glucosuria, the SUA levels decrease substantially. Meanwhile, there are some differences in the relationship between SUA or FEUA and FBG among different genders.
尿酸和血糖是代谢紊乱的重要指标。众多研究已阐明它们之间的关联，但通过检测尿糖和尿酸排泄来关注二者关系的研究有限。本研究对这些指标进行综合分析以阐释二者关系。
本研究纳入了2017年1月至2023年11月期间在山东大学齐鲁医院（青岛）卫生科住院时接受尿酸排泄分数（FEUA）检测的2498例患者，最终分析纳入1416例受试者。根据不同性别对纳入的受试者进行分析。采用单因素方差分析、多元线性回归分析和受限立方样条进行数据分析。
尿糖阳性的糖尿病患者与尿糖阴性的糖尿病患者及非糖尿病人群相比，FEUA更高，血清尿酸（SUA）水平更低。即使在无尿糖的情况下，FEUA也随血糖水平升高呈比例增加。在调整潜在混杂因素后，SUA水平并未随空腹血糖（FBG）水平升高而增加，一旦FBG水平超过导致糖尿的阈值，FEUA进一步升高，随后SUA水平降低。调整混杂因素后，女性SUA或FEUA与FBG水平之间的线性关系比男性更强。
高血糖不被视为高尿酸血症的危险因素。无论有无尿糖，血糖升高均可刺激肾脏尿酸排泄。当达到诱导糖尿的阈值时，SUA水平大幅下降。同时，不同性别SUA或FEUA与FBG之间的关系存在一些差异。
