初诊2型糖尿病患者血尿酸水平与新型胰岛素抵抗替代指标的相关性研究

Correlation between Serum Uric Acid Levels and New Surrogate Markers of Insulin Resistance in Newly Diagnosed Type 2 Diabetes Patients

目的新探讨初诊2型糖尿病(T2DM)人群中TyG、TG/HDL-C及两者衍生指标三酰甘油葡萄糖-体质指数(TyG-BMI)、三酰甘油与高密度脂蛋白胆固醇比率-体质指数(TG/HDL-C-BMI)与血尿酸(UA)水平的相关性。方法选取2019年8月—2021年8月于苏州大学附属第一医院内分泌科住院的初诊T2DM患者114例,根据血尿酸水平分为T2DM组和T2DM合并HUA组。统计各组病例的临床资料及实验室指标,并对二者的差异性进行观察,行Spearman相关性和Logistic回归模型分析上述胰岛素抵抗替代指标与UA的相关性,通过ROC曲线下面积评估胰岛素抵抗替代指标对HUA的预测价值。结果T2DM合并HUA组TyG、TG/HDL-C、TyG-BMI、TG/HDL-C-BMI及HOMA-IR显著高于T2DM组,差异有统计学意义(P<0.05)。相关性分析显示上述指标均与UA呈正相关(P<0.05)。采用Logistic回归分析调整混杂因素后显示高三分位组发生HUA的风险高于低三分位组(P<0.05)。ROC曲线显示TyG-BMI(AUC=0.760)、TG/HDL-C-BMI(AUC=0.725)对HUA的预测价值高于TyG(AUC=0.707)、TG/HDL-C(AUC=0.677)、HOMA-IR(AUC=0.663)。结论TyG、TG/HDL-C及两者衍生指标是T2DM合并HUA的独立危险因素,均可作为HUA的预测指标。TyG、TG/HDL-C与BMI结合可提高对HUA的预测价值,TyG-BMI对HUA的预测价值高于其他胰岛素抵抗指标。

Objective Investigated TyG,TG/HDL-C and their derivatives triacylglycerol glucose-body mass index(TyG-BMI),triacylglycerol and high-density lipoprotein cholesterol ratio-body mass index(TG/HDL-C-BMI)in newly diagnosed type 2 diabetes mellitus(T2DM)population correlation with serum uric acid(UA)levels.Methods A total of 114 newly diagnosed T2DM patients who were hospitalized in the Endocrinology Department of the First Affiliated Hospital of Soochow University from August 2019 to August 2021 were selected.The patients were divided into T2DM group and T2DM combined with HUA group according to serum uric acid level.The clinical data and laboratory indexes of each group of cases were counted,and the differences between the two were observed.Spearman correlation and Logistic regression models were used to analyze the correlation between the above surrogate indicators of insulin resistance and UA.The predictive value of insulin resistance surrogate indicators for HUA was assessed by the area under the ROC curve.Results TyG,TG/HDL-C,TyG-BMI,TG/HDL-C-BMI and HOMA-IR in T2DM combined with HUA group were significantly higher than those in T2DM group,the difference was statistically significant(P<0.05).Correlation analysis showed that the above indicators were positively correlated with UA(P<0.05).Logistic regression analysis showed that the risk of HUA in the high tertile group was higher than that in the low tertile group after adjusting for confounding factors(P<0.05).The ROC curve showed that the predictive value of TyG-BMI(AUC=0.760),TG/HDL-C-BMI(AUC=0.725)for HUA was higher than that of TyG(AUC=0.707),TG/HDL-C(AUC=0.677),HOMA-IR(AUC=0.663).Conclusion TyG,TG/HDL-C and their derived indexes are independent risk factors of HUA in T2DM,and can be used as predictors of HUA.The combination of TyG,TG/HDL-C and BMI can improve the predictive value of HUA,and the predictive value of TyG-BMI for HUA is higher than that of other insulin resistance indicators.