老年男性高尿酸血症与胰岛素抵抗及动脉粥样硬化相关性研究

Relationship between insulin resistance and intima-media thickness in elderly male patients with hyperuricemia

目的研究老年男性高尿酸血症与胰岛素抵抗及动脉粥样硬化的相关性。方法对240例老年男性进行调查,按尿酸水平分为高尿酸组(HUA,n=58例)和正常尿酸组(对照组,n=182例),测量身高、体质量、收缩压、舒张压,并检测血尿酸、空腹血糖、甘油三酯(TG)、总胆固醇、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇、空腹血浆胰岛素(FINS)。测量颈动脉内膜中层厚度(IMT),同时计算胰岛素抵抗指数(HOMA-IR),分析临床资料及与IMT的相关性。结果①高尿酸血症检出率为24.2%;②高尿酸组TG、体质量指数(BMI)高于对照组,TG(2.28±1.41)mmol/L vs(1.49±0.87)mmol/L,BMI 25.98±2.58vs 24.58±3.10,而HDL-C低于对照组(1.33±0.33)mmol/L vs(1.46±0.39)mmol/L(P<0.05或<0.01);③高尿酸组FINS、HOMA-IR、IMT高于对照组(P<0.05或<0.01)。结论老年高尿酸血症人群的肥胖、代谢紊乱、胰岛素抵抗与IMT密切相关。

Objective To investigate the relationship between insulin resistance and intima-media thickness in patients with hyperuricemia among the old males. Methods We divided 240 cases into two groups according to the serum uric acid level： hyperuricemia （ HUA, n = 58） and normal serum uric acid （control group, n = 182）, height, body mass, systolic blood pressure, diastolic blood pressure, serum uric acid, fasting plasma glucose（FPG）, triglyceride（TG）, total cholesterol, high density lipoprotein cholesterol （HDL-C） and low density lipoprotein cholesterol and fasting insulin（FINS） were detected. IMT was examined,homeostasis rhode1 assessment of insulin resistance（HOMA-IR） was calculated at the same time. Results （1）The prevalence of hyperuricemia was 24.2± ;（2）In HUA group,the levels of TG, body mass index were signifieantly higher than those in control group TG（2.28 ± 1.41） m mol/L vs （1.49 ± 0.87） mmol/L,BMI 25.98±2.58 vs 24.58±3.10 ,and the level of HDL-C was significantly lower than that in control group （1.33±0.33） mmol/L vs （1.46±0.39） mmol/L（ P 〈0.05 or 〈0.01） （3）The levels of FINS,HOMA-IR and IMT were higher than those in control group （ P 〈0.05 or 〈0.01）. Conclusion The levels of obesity, metabolic disorder and insulin resistance are strongly associated with IMT in elderly patients with HUA.