痛风患者血尿酸水平与胰岛素抵抗及糖、脂肪代谢紊乱的初步研究  

Study of the relationship between the level of plasma uric acid and insulin resistance,disorders of glucose and lipid metabolism from gout patients

作　　者：汤郁[1] 李晶[1] 裘影影[1] 吴忠[1] 严利文[1] 吴玲[1] 

机构地区：[1]江苏大学附属医院风湿科,江苏镇江212001

出　　处：《现代医药卫生》2006年第24期3711-3713,共3页Journal of Modern Medicine & Health

基　　金：江苏省社会发展项目(BS2005043)

摘　　要：目的:探讨痛风患者血尿酸水平与胰岛素抵抗以及糖、脂肪代谢紊乱的关系。方法:测定92例伴高尿酸血症痛风患者血尿酸、血脂、糖耐量试验、空腹及服葡萄糖后30、60、120、180分钟胰岛素和C肽等指标,并与72例健康者进行对照。结果:(1)痛风组血糖、甘油三酯、胆固醇、低密度脂蛋白和肌酐均明显高于对照组(P<0.01),高密度脂蛋白显著低于对照组(P<0.01);(2)痛风组空腹胰岛素、空腹C肽和胰岛素抵抗指数(HomaIR)显著高于对照组(P<0.01)。(3)服葡萄糖后痛风组胰岛素峰和C肽分泌峰值均明显高于对照组(P<0.01);(4)血尿酸与血甘油三酯呈正相关,与高密度脂蛋白呈负相关,与胆固醇和低密度脂蛋白无显著相关性。血尿酸与体重质量指数(BMI)、血清胰岛素水平、HomaIR和C肽呈正相关,与空腹血糖无显著相关性。结论:高尿酸血症痛风患者常伴发胰岛素抵抗,纠正糖与脂肪代谢紊乱可能对痛风的治疗有效。Objective：To investigate the relationship between plasma uric acid （UA） and insulin resistance,disorders of glucose and lipid metabolism from gout patients.Methods：Detecting the levels of plasma UA,hpid,oral glucose tolerance test （OGTT）,fasting insulin and c-peptide,insulin and c-peptide after taking glucose at 30,60,120,180,minutes from 92 gout patients with high UA and 72 normal controls.Results：①）The levels of plasma glucose,triglyceride,cholesterol,low-density lipoprotein（LDL） and UA from gout patients were all significantly higher than those from normal controls （P〈0.01）,while the level of high-density lipoprotein （HDL） was markedly lower （P〈 0.01）; ②The levels of plasma fasting insulin,fasting c-peptide and HOMA IR from gout patients were also significantly higher than those from normal controls （P〈0.01）.③The peaks of plasma insulin and c-peptide after taking glucose from gout patients were higher than those from normal controls （P〈0.01）. ④The level of plasma UA was positively correlated with triglyceride,negatively correlated with HDL,but there were no correlations between plasma UA and cholesterol and LDL.The level of plasma UA was positively correlated with Body Mass Index（BMI）,insulin,HOMA IR and c-peptide, there was no correlation between plasma UA and fasting glucose.Conclusion：Gout patients are apt to develop insulin resistance,it may be helpful to correcting the metabolism disorders of glucose and lipid in gout patients.

关 键 词：痛风 胰岛素抵抗 尿酸 

分 类 号：R5[医药卫生—内科学]