护士群体胰岛素抵抗与新发高尿酸血症的关联性

Correlation between insulin resistance and new-onset hyperuricemia in nurses

目的探讨护士群体胰岛素抵抗(IR)与新发高尿酸血症(HUA)的关联性。方法本研究为回顾性队列研究, 选取2021年1至7月调查的华中科技大学同济医学院附属同济医院3 792例护士人群数据, 将其中于2023年成功随访并符合纳排标准的2 995例护士作为研究对象, 将各个IR指标[甘油三酯葡萄糖乘积指数(TyG)、甘油三酯葡萄糖-体重指数(TyG-BMI)、甘油三酯/高密度脂蛋白胆固醇指数(TG/HDL-C)、IR代谢指数(METS-IR)]依据其四分位数分为4组:Q1~Q4组, 采用Cox回归评估各IR指标对HUA发生风险的影响, 采用受试者工作特征(ROC)曲线评价和比较各指标的预测效能。结果纳入研究的2 995例护士中, 男性65例, 女性2 930例, 年龄为(33.19±6.67)岁。中位随访时间1.95(1.87, 2.03)年, 新发HUA152例, 发病密度26.02/1 000例年。Cox风险回归模型分析结果显示, 在调整了各混杂因素后, 以TyG、TyG-BMI、TG/HDL-C、METS-IR的Q1组为参照, 其Q4组的HUA发生风险HR(95%CI)依次为:2.20(1.34~3.63)、4.95(2.76~8.90)、3.24(1.92~5.45)、6.15(3.34~11.33)。TyG、TyG-BMI、TG/HDL-C、METS-IR水平对护士群体HUA发生风险预测的ROC曲线下面积分别为0.71、0.73、0.72、0.74。结论护士群体胰岛素抵抗与新发HUA呈正相关, 各IR指标对HUA具有一定的预测效能。

Objectivee To explore the association between insulin resistance(IR)and new-onset hyperuricemia(HUA)in nurses.Methods A retrospective cohort study was conducted on 3792 nurses from Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,who were surveyed from January to July in 2021.A total of 2995 nurses who were successfully followed up in 2023 and met the inclusion criteria were selected for the study.The nurses were divided into four groups based on their quantiles(Q1 to Q4)for each indicator of insulin resistance(IR),including the triglyceride glucose(TyG),the triglyceride glucose-body mass index(TyG-BMI),the triglyceride/high-density lipoprotein-cholesterol index(TG/HDL-C),and the metabolic score for insulin resistance(METS-IR):groups.The impact of each IR indicator on the risk of HUA was assessed by using Cox regression analysis,while the receiver operating characteristic(ROC)curve was employed to evaluate and compare the predictive power of each indicator.Results Of the 2995 nurses,there were 65 males and 2930 females,with a mean age of(33.19±6.67)years.During the follow-up period of 1.95(1.87,2.03)years,152 new-onset HUA cases were identified,resulting in an incidence density of 26.02 per 1000 person-years.After adjusting for various confounding factors,the Cox risk regression model analysis indicated that the hazard ratios(95%Cn)for the risk of HUA in the highest quartile(Q4)compared to the lowest quartile(Q1)were as follows:2.20(1.34,3.63)for TyG,4.95(2.76,8.90)for TyG-BMI,3.24(1.92,5.45)for TG/HDL-C,and 6.15(3.34,11.33)for METS-IR.The areas under the ROC curves for TyG,TyG-BMI,TG/HDL-C,and METS-IR levels in predicting the risk of HUA in nurses was 0.71,0.73,0.72,and 0.74,respectively.ConclusionTThe IR is positively correlated with new-onset HUA in nurses,and each IR index demonstrates a certain predictive efficacy for risk of HUA.