Vuorinen-Markkola H, Yki-Järvinen H
J Clin Endocrinol Metab. 1994 Jan;78(1):25-9. doi: 10.1210/jcem.78.1.8288709.
The associates of gout-obesity, hypertriglyceridemia, glucose intolerance, and hypertension, strikingly resemble those of insulin resistance. In the present study we determined whether hyperuricemia is associated with insulin resistance and, if so, whether this association can be explained by other components of the syndrome. For this purpose we quantitated insulin sensitivity (euglycemic clamp) in 37 nondiabetic subjects (aged 30-68 yr) exhibiting varying degrees of the metabolic syndrome (body mass index, 21.5-35.7 kg/m2; serum triglycerides, 0.4-22.0 mmol/L; high density lipoprotein cholesterol 0.38-1.86 mmol/L; blood pressure, 190-100/116-60 mm Hg). In simple linear regression analysis, the serum uric acid concentration (range, 182-568 mumol/L) was inversely correlated with insulin sensitivity (rate of glucose utilization; r = -0.61; P < 0.001) and positively with serum triglycerides (r = 0.68; P < 0.001), but not with body mass index, age, or the plasma glucose concentration. In multiple linear regression analysis, both insulin sensitivity (P < 0.05) and serum triglycerides (P < 0.005) were independently associated with the serum uric acid concentration, and together explained 50% of its variation. Addition of body mass index or age to the model did not improve the degree of explanation. Acute elevation of serum triglycerides about 3-fold, of plasma FFA about 9-fold, or of serum insulin about 28-fold had no effect on the serum uric acid concentration in healthy volunteers. The data indicate that hyperuricemia is indeed an inherent component of the metabolic syndrome and could also be used as a simple marker of insulin resistance.
痛风与肥胖、高甘油三酯血症、糖耐量异常及高血压并存的情况，与胰岛素抵抗的表现极为相似。在本研究中，我们确定了高尿酸血症是否与胰岛素抵抗相关，若相关，这种关联是否可由该综合征的其他组分来解释。为此，我们对37名非糖尿病受试者（年龄30 - 68岁）进行了胰岛素敏感性定量测定（正常血糖钳夹技术），这些受试者呈现出不同程度的代谢综合征（体重指数，21.5 - 35.7 kg/m²；血清甘油三酯，0.4 - 22.0 mmol/L；高密度脂蛋白胆固醇0.38 - 1.86 mmol/L；血压，190 - 100/116 - 60 mmHg）。在简单线性回归分析中，血清尿酸浓度（范围，182 - 568 μmol/L）与胰岛素敏感性（葡萄糖利用率；r = -0.61；P < 0.001）呈负相关，与血清甘油三酯呈正相关（r = 0.68；P < 0.001），但与体重指数、年龄或血浆葡萄糖浓度无关。在多元线性回归分析中，胰岛素敏感性（P < 0.05）和血清甘油三酯（P < 0.005）均与血清尿酸浓度独立相关，二者共同解释了其50%的变异。将体重指数或年龄纳入模型并未提高解释程度。在健康志愿者中，血清甘油三酯急性升高约3倍、血浆游离脂肪酸急性升高约9倍或血清胰岛素急性升高约28倍，对血清尿酸浓度均无影响。这些数据表明，高尿酸血症确实是代谢综合征的一个内在组分，也可作为胰岛素抵抗的一个简单标志物。
