2型糖尿病患者血尿酸水平与胰岛素抵抗的相关性分析

Relationship between Serum Uric Acid Level and Insulin Resistance in Patients with Type 2 Diabetes Mellitus

目的:回顾性分析2型糖尿病(T2DM)人群高尿酸(UA)血症患者血UA水平与胰岛素抵抗(IR)之间的关系。方法:收集2016-01-2018-05共1 273例住院T2DM患者病历资料,根据血UA水平分为正常UA组(NHG组,n=698)和高UA血症组(HG组,n=575),比较两组一般资料和血UA水平等指标的差异,分析高UA血症患者血UA水平等与稳态模型评估的胰岛抵抗指数(HOMA-IR)的相关性。结果:1 273例患者中高UA血症575例(占45.2%),与NHG组相比,HG组HOMA-IR、血UA、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、尿素氮(BUN)、肌酐(Cr)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、体重指数(BMI)和吸烟史均显著升高(P<0.05),高密度脂蛋白胆固醇(HDL-C)明显降低(P<0.05);而且UA、FBG、HbA1c、FINS、BUN、Cr、TC、LDL-C、BMI和吸烟史均与HOMA-IR水平呈明显正相关(P<0.05),与HDL-C呈负相关(P<0.05)。但经过增加变量BMI、LDL-C、HbA1c、FBG、FINS的多元Logistic回归分析显示,血UA与HOMA-IR并无明显相关性(P>0.05)。结论:高UA血症与IR呈正相关,但可能并不是IR的独立危险因素。

Objective:To evaluate relationship between serum uric acid(UA)levels and insulin resistance(IR)in the Chinese type 2 diabetes(T2DM)patients based on the homeostasis model assessment(HOMA).Method:1273 patients who were hospitalized for the type 2 diabetes during Jan 2016 to May 2018 were induded.According to the level of UA,they were divided into normal UA group(NHG group,n=698)and hyperuricemia group(HG group,n=575).The differences between the general data and UA indicators were compared between the two groups.Correlation and logistic analysis models were used to evaluate the relationship between UA and HOMA-IR.Results:Of the 1 273 patients,575(45.2%)had a hyperuricemia.Compared to the NHG group,HOMA-IR,blood UA,fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),fasting insulin(FINS),urea nitrogen(BUN),creatinine(Cr),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),body mass index(BMI)and smoking history were significantly increased(P<0.05),high-density lipoprotein cholesterol(HDL-C)was significantly decreased(P<0.05)in HG group;and UA,FBG,HbA1c,FINS,BUN,Cr,TC,LDL-C,BMI and smoking history were positively correlated with HOMA-IR level(P<0.05),and negatively correlated with HDL-C(P<0.05).While doing a logistic regression with BMI,LDL-C,HbA1c,FBG and FINS as variables,UA was not an independently risky factor for IR(P>0.05).Conclusion:It is sugguested that hyperuricemia was associated with HOMA-IR,but it was not an independently risky factor for insulin resistance in Chinese type 2 diabetes individuals.