Zhao Mingyang, Ma Xiaoqing, Xia Zhang, Zhang Jinmei, Zhong Jiale, Ye Peiyu, Xu Guozheng, Qiao Sen, Shi Shulong, He Yan, Jiang Jiajia
Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.
Department of Endocrinology, Jining No.1 People's Hospital, Shandong First Medical University, Jining, Shandong, China.
BMJ Open. 2025 Jan 4;15(1):e087954. doi: 10.1136/bmjopen-2024-087954.
The association between serum uric acid (SUA) and dyslipidaemia is still unclear in patients with type 2 diabetes mellitus (T2DM). This study aimed to examine the association between SUA and dyslipidaemia and to explore whether there is an optimal SUA level corresponding to the lower risk of suffering from dyslipidaemia.
This cross-sectional study included 1036 inpatients with T2DM and the clinical data were extracted from the hospital medical records. Multivariate logistic regression analysis was performed to assess the association between hyperuricaemia and dyslipidaemia. Restricted cubic splines (RCS) analysis was performed to determine the optimal SUA level for the lower risk of dyslipidaemia.
After adjustment for the potential confounders, hyperuricaemia was significantly associated with dyslipidaemia (OR=3.72, 95% CI: 2.28, 6.07) and hypertriglyceridaemia (OR=2.63, 95% CI: 1.68, 4.12). Notably, mediation analysis revealed a significant mediating effect of SUA in this relationship (indirect effect=0.08, p<0.001), elucidating 20.1% of the total relationship.
Hyperuricaemia was positively associated with dyslipidaemia and hypertriglyceridaemia. SUA mediated the effect of insulin resistance on triglyceride metabolism in patients with T2DM. A potential benefit of stricter control of SUA levels among patients with T2DM is possibly reducing the risk of dyslipidaemia.
2型糖尿病（T2DM）患者中血清尿酸（SUA）与血脂异常之间的关联仍不明确。本研究旨在探讨SUA与血脂异常之间的关联，并探索是否存在与较低血脂异常风险相对应的最佳SUA水平。
这项横断面研究纳入了1036例T2DM住院患者，临床数据从医院病历中提取。进行多变量逻辑回归分析以评估高尿酸血症与血脂异常之间的关联。进行限制立方样条（RCS）分析以确定降低血脂异常风险的最佳SUA水平。
在对潜在混杂因素进行调整后，高尿酸血症与血脂异常（OR = 3.72，95% CI：2.28，6.07）和高甘油三酯血症（OR = 2.63，95% CI：1.68，4.12）显著相关。值得注意的是，中介分析显示SUA在这种关系中具有显著的中介作用（间接效应 = 0.08，p < 0.001），解释了总关系的20.1%。
高尿酸血症与血脂异常和高甘油三酯血症呈正相关。SUA介导了胰岛素抵抗对T2DM患者甘油三酯代谢的影响。在T2DM患者中更严格地控制SUA水平的潜在益处可能是降低血脂异常的风险。
