不同尿AD7c-NTP水平的体检人群血尿酸水平与胰岛素抵抗的关系

Relationship between serum uric acid level and insulin resistance in population undergoing physical examination with different levels of urine AD7c-NTP

目的探讨不同尿液阿尔茨海默病相关神经丝蛋白(AD7c-NTP)水平的受试者血尿酸(BUA)水平和胰岛素抵抗(IR)之间的关系。方法选取该院检测尿AD7c-NTP的体检者1185例,采用全自动酶标分析仪[酶联免疫吸附试验(ELISA)法]及全自动生化分析仪分别检测尿AD7c-NTP和BUA、空腹血糖(FPG)及肝功能相关指标。并根据受试者意愿抽取142份血清标本,其中AD7c-NTP正常(<1.50 ng/mL)29份和升高(≥1.50 ng/mL)113份,检测空腹胰岛素(FINS),计算胰岛素抵抗指数(HOMA-IR)。结果AD7c-NTP升高组(n=196)BUA水平(中位值348μmol/L)高于AD7c-NTP正常组(n=989,中位值333μmol/L),差异有统计学意义(U=2.21,P<0.05)。多元逐步回归分析发现,FPG、ALT等6个变量对BUA水平有明显的影响(P<0.05),FPG、FINS水平及HOMA-IR升高组的BUA均高于该指标正常组,但差异均无统计学意义(P>0.05);而FPG正常,HOMA-IR升高的窗口期受试者BUA水平较FPG正常HOMA-IR正常受试者升高(t=2.03,P<0.05)。结论高尿酸可加重糖代谢损伤,BUA水平升高是IR前期预警。

Objective To investigate the relationship between blood uric acid level(BUA)and insulin resistance(IR)in the subjects with different levels of urine Alzheimer-associated neuronal thread protein(AD7c-NTP).Methods A total of 1185 persons undergoing the physical examination with AD7c-NTP detection in this hospital were selected.The blood biochemical indicators such as AD7c-NTP,BUA,fasting plasma glucose(FPG)and aminotransferases were detected by adopting the automatic enzyme labeling analyzer(ELISA method)and automatic biochemical analyzer,respectively.According to the subject′s wish,142 serum samples were extracted,in which 29 samples were normal AD7c-NTP(<1.50 ng/mL)and 113 samples were increase(≥1.50 ng/mL).Then the fasting insulin(FINS)was detected and HOMA-IR was calculated.Results The BUA level in the AD7c-NTP increase group(n=196)was median 348μmol/L,which was higher than 333μmol/L in the AD7c-NTP normal group(n=989),and the difference was statistically significant(U=2.21,P<0.05).The multiple stepwise regression analysis revealed that the six variables such as FPG and aminotransferases had significant effect on BUA value(P<0.05).The FPG,FINS and BUA levels in the HOMA-IR increase group were higher than those in the this indicator normal group,but ther differences were not statistically significant(P>0.05).In the subjects with normal FPG and HOMA-IR increase during the window period,the BUA level was increased(t=2.03,P<0.05).Conclusion Hyperuricemia aggravates the glucose metabolism injury and the increase of BUA level is a prophase early warning of IR.