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中华临床医师杂志(电子版) ›› 2020, Vol. 14 ›› Issue (10) : 808 -812. doi: 10.3877/cma.j.issn.1674-0785.2020.10.011

所属专题： 文献；

临床研究

正常体质量人群简单胰岛素抵抗指数与高尿酸血症的相关性研究
朱建琴1, 李国青2,†(), 缪逸1   
  1. 1. 214500　江苏靖江，扬州大学医学院附属靖江市人民医院风湿免疫科
    2. 225000　江苏扬州，扬州大学医学院附属医院风湿免疫科
  • 收稿日期:2020-04-11 出版日期:2020-10-15
  • 通信作者: 李国青

Association of simple insulin resistance index with hyperuricemia in normal-weight individuals

Jianqin Zhu1, Guoqing Li2,†(), Yi Miao1   

  1. 1. Department of Rheumatology, Jingjiang People's Hospital Affiliated to Yangzhou University Medical College, Jingjiang 214500, China; Department of Rheumatology, Affiliated Hospital of Yangzhou University Medical College, Yangzhou 225000, China
    2.
  • Received:2020-04-11 Published:2020-10-15
  • Corresponding author: Guoqing Li
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朱建琴, 李国青, 缪逸. 正常体质量人群简单胰岛素抵抗指数与高尿酸血症的相关性研究[J/OL]. 中华临床医师杂志(电子版), 2020, 14(10): 808-812.

Jianqin Zhu, Guoqing Li, Yi Miao. Association of simple insulin resistance index with hyperuricemia in normal-weight individuals[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(10): 808-812.

目的

探讨简单胰岛素抵抗（IR）评估指标在正常体质量人群中与高尿酸血症（HUA）的相关性。

方法

选择11 098名于2016年8月至2019年12月期间在扬州大学医学院附属靖江市人民医院接受健康体检且体质量正常者为研究对象，通过公式计算3个IR指标：三酰甘油/高密度脂蛋白胆固醇（TG/HDL-C）、糖脂指数（TyG）和胰岛素抵抗代谢指数（METS-IR）。利用偏相关分析和Logistic回归模型对连续变量和分类变量的相关性进行分析。

结果

TG/HDL-C、TyG和METS-IR与尿酸水平均呈显著正相关（P均＜0.001）；HUA组3个IR指标的均值均显著高于正常组，且HUA的比例随着3个IR指标四分位区间（Q）的增加而显著增加。回归分析提示只有TyG和METS-IR与HUA显著相关；TyG的Q4的OR值分别为男性1.665（95% CI：1.147~2.418），女性2.894（95% CI：1.486~5.637）；METS-IR的Q4的OR值分别为男性2.172（95% CI：1.670~2.826），女性1.997（95% CI：1.107~3.603）。

结论

TyG和METS-IR在正常体质量人群中与HUA具有较好的相关性，有望作为正常体质量HUA患者的分级管理工具。

关键词: 高尿酸血症, 非肥胖, 胰岛素抵抗
Objective

To explore the relationship between simple insulin resistance (IR) assessment tools and hyperuricemia (HUA) in normal-weight people.

Methods

A total of 11098 people with a normal body weight who underwent a physical examination at Jingjiang People's Hospital Affiliated to Yangzhou University School of Medicine from August 2016 to December 2019 were included. The triglycerides to high-density lipoprotein cholesterol ratio (TG/HDL-C), product of fasting triglycerides and glucose (TyG), and metabolic score for IR (METS-IR) were calculated by the corresponding formula. Partial correlation analysis and logistic regression model were used to analyze the correlation between continuous and categorical variables.

Results

TG/HDL-C, TyG, and METS-IR were significantly correlated with uric acid levels; the mean values of the three IR indicators in the HUA group were significantly higher than those of the normal group, and the proportion of patients with HUA increased significantly with the increase of the interquartile range (Q) of the three IR indicators. Regression analysis showed that only TyG and METS-IR were significantly associated with HUA; the odds ratio (OR) values of Q4 of TyG were 1.665 (95% CI: 1.147-2.418) for men and 2.894 (95% CI: 1.486-5.637) for women; the OR values of Q4 of METS-IR were 2.172 (95% CI: 1.670-2.826) for men and 1.997 (95% CI: 1.107-3.603) for women.

Conclusion

TyG and METS-IR are robustly associated with HUA in non-obese individuals, which are expected to be used as a classification management tool for normal-weight HUA patients.

Key words: Hyperuricemia, Normal weight, Insulin resistance
表1 体质量正常男性尿酸正常组与HUA组基本资料比较（
xˉ
±s）
组别 例数 年龄（岁） 体质量指数（kg/m2） 腰围（cm） 收缩压（mmHg） 舒张压（mmHg） 空腹血糖（mmol/L） 尿酸（μmol/L）
尿酸正常组 5675 44.2±13.0 21.9±1.6 77.3±5.8 126.9±6.3 77.7±6.6 5.56±1.16 337.6±48.1
HUA组 1361 45.0±13.5 22.4±1.4 79.4±5.4 126.6±6.5 78.7±6.4 5.43±0.78 470.0±45.4
t值 -1.905 -11.201 -11.392 1.553 -5.034 3.953 -92.119
P值 0.057 ＜0.001 ＜0.001 0.120 ＜0.001 ＜0.001 ＜0.001
组别 例数 总胆固醇（mmol/L） TG（mmol/L） HDL-C（mmol/L） LDL-C（mmol/L） TG/HDL-C TyG METS-IR
尿酸正常组 5675 4.61±0.82 1.29±0.86 1.53±0.32 2.64±0.71 0.93±0.86 8.50±0.53 30.99±3.73
HUA组 1361 4.80±0.93 1.73±1.29 1.46±0.29 2.70±0.79 1.30±1.24 8.74±0.59 32.60±3.58
t值 -7.783 -15.192 7.356 -2.731 -12.724 -14.553 -14.413
P值 ＜0.001 ＜0.001 ＜0.001 0.006 ＜0.001 ＜0.001 ＜0.001
表2 体质量正常女性尿酸正常组与HUA组基本资料比较（
xˉ
±s）
组别 例数 年龄（岁） 体质量指数（kg/m2） 腰围（cm） 收缩压（mmHg） 舒张压（mmHg） 空腹血糖（mmol/L） 尿酸（μmol/L）
尿酸正常组 3821 52.4±11.8 21.8±1.6 73.5±5.5 124.4±9.6 74.8±8.3 5.81±1.21 282.3±51.3
HUA组 241 47.2±12.8 22.2±1.4 74.2±5.7 122.3±10.4 75.7±8.2 5.75±0.69 415.5±49.7
t值 6.650 -3.413 -1.768 3.219 -1.723 0.73 -39.139
P值 ＜0.001 0.001 0.077 0.001 0.085 0.466 ＜0.001
组别 例数 总胆固醇（mmol/L） TG（mmol/L） HDL-C（mmol/L） LDL-C（mmol/L） TG/HDL-C TyG METS-IR
尿酸正常组 3821 5.21±0.97 1.78±0.85 1.54±0.32 2.78±0.80 1.25±1.01 8.94±0.35 31.67±3.39
HUA组 241 5.21±0.99 2.14±1.25 1.46±0.28 2.70±0.83 1.61±1.32 9.08±0.43 32.98±3.49
t值 0.068 -6.141 3.884 1.404 -5.177 -6.036 -5.821
P值 0.945 ＜0.001 ＜0.001 0.16 ＜0.001 ＜0.001 ＜0.001
图1 3个胰岛素抵抗指标四分位区间内高尿酸血症比例的变化 图a为男性，图b为女性
图2 3个胰岛素抵抗指标与高尿酸血症回归分析结果 图a为男性，图b为女性
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