血尿酸水平与糖尿病前期的相关研究

Correlations between serum uric acid levels and prediabetes

目的探讨成人血尿酸水平与不同糖调节受损（IGR）的关系。方法提取2007至2008年全国糖尿病和代谢紊乱研究的陕西省数据，共纳入3 002例非糖尿病人群。糖尿病前期（Pre-DM）定义依据1999年WHO标准，高尿酸血症（HUA）定义为血尿酸≥420 μmol/L（男性）或≥360 μmol/L（女性）。采用Logistic回归模型分析HUA对Pre-DM及不同血尿酸水平对各种类型IGR风险的影响。结果（1）女性和男性的HUA患病率分别为2.6%（46/1 756）和8.9%（111/1 246）。HUA人群Pre-DM患病率高于正常尿酸人群[31.2%（49/157）比16.7%（475/2 845），χ^2=21.754，P〈0.001]。（2）Logistic回归分析显示，HUA与Pre-DM患病风险相关（OR 1.692；95%CI： 1.129-2.538）。以血尿酸水平第1分位（〈198 μmol/L）作为参照，第2分位组（198-245 μmol/L）、第3分位组（246-306 μmol/L）、第4分位组（≥307 μmol/L）Pre-DM患病风险OR（95% CI）值分别为1.256（0.917-1.719）、1.323（0.961-1.822）和1.772（1.247-2.517）。（3）与糖代谢正常人群相比，血尿酸每增加59.48 μmol/L（1 mg/dl），不同IGR的患病风险OR（95% CI）分别为：单纯空腹血糖受损1.208（1.046-1.395）、单纯糖耐量减低1.160（1.042-1.292）、二者合并1.316（1.080-1.603）。结论随着血尿酸水平上升，人群Pre-DM患病风险随之升高，建议对血尿酸升高≥300 μmol/L人群应考虑Pre-DM的筛查。

Objective To investigate the correlations between serum uric acid levels and different categories of impaired glucose regulation （IGR） in adults.Methods Study data came from China National Diabetes and Metabolic Disorders Study 2007-2008 in ShaanXi Province. 3 002 participants without diabetes were enrolled. Prediabetes was defined according to 1999 WHO criteria. Hyperuricemia （HUA） was defined as serum uric acid ≥420 μmol/L in male or ≥360 μmol/L in female. The influence of hyperuricemia on the prevalence risk of prediabetes and serum uric acid levels on different categories of IGR were analyzed by logistic regression analysis.Results （1） The prevalence rates of hyperuricemia in male and female were 8.9% （46/1 756） and 2.6% （111/1 246）, respectively. The prevalence rate of prediabetes in population with hyperuricemia was significantly higher than in normal population [31.2% （49/157） vs 16.7% （475/2 845）, χ^2=21.754, P〈0.001]. （2） Logistic regression analysis showed that the prevalence risk of prediabetes was associated with hyperuricemia （OR 1.692; 95%CI： 1.129-2.538）. Compared with the first quartile of serum uric acid level （〈198 μmol/L）, the prevalence risks （OR, 95% CI） of prediabetes in the second, third and fourth quartile of serum uric acid （198-245 μmol/L, 246-306 μmol/L and ≥307 μmol/L） were 1.256（0.917-1.719）, 1.323（0.961-1.822）, 1.772（1.247-2.517）, respectively. （3） When uric acid concentration increased by 59.48 μmol/L（1 mg/dl）. The prevalence risks of different categories of IGR （OR,95% CI） were： isolated impaired fasting glucose （IFG） （1.208, 1.046-1.395）, isolated impaired glucose tolerance （IGT） （1.160, 1.042-1.292）, IFG/IGT （1.316, 1.080-1.603）, respectively.Conclusion The prevalence risk of prediabetes may increase with serum uric acid levels elevating. Prediabetes screening in population with serum uric acid ≥ 300 μmol/L should be concerned.