正常糖调节人群血尿酸水平与早相胰岛素分泌的相关性研究  

The correlation between serum uric acid level and early-phase insulin secretion in subjects with normal glucose regulation

作　　者：卢乐[1,2] 郑芬萍[1] 李红[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院内分泌科,杭州310016 [2]浙江省丽水市中心医院内分泌科,323000

出　　处：《中华内科杂志》2016年第5期345-348,共4页Chinese Journal of Internal Medicine

基　　金：国家科技支撑计划（2009BAI80B01）;浙江省重大科技专项重点社会发展项目（2009C0310-4）

摘　　要：目的 探讨正常糖调节人群血尿酸（SUA）水平与早相胰岛素分泌的相关性.方法 选择某社区居民（367例）为研究对象,行口服75g葡萄糖耐量试验及胰岛素释放试验,以稳态模型评估的胰岛素抵抗指数（HOMA-IR）评估胰岛素的敏感性,以糖负荷后早相胰岛素分泌功能指数（ΔI30/ΔG30）评估早相胰岛素分泌功能.按SUA水平四分位数分为4组,比较不同组别间早相胰岛素水平、ΔI30/ΔG30、HOMA-IR等的差异.结果 随着SUA水平的升高,年龄、BMI、腰围、收缩压、舒张压、空腹胰岛素（FINS）、餐后30 min胰岛素（30 minINS）、餐后2h胰岛素（2hINS）、HOMA-IR、TG逐渐升高（P＜0.01）,而HDL-C逐渐下降（P＜0.01）;SUA与年龄（r=0.157,P＜0.01）、BMI（r=0.262,P＜0.01）、腰围（r=0.372,P＜0.01）、收缩压（r=0.200,P＜0.01）、舒张压（r=0.254,P＜0.01）、餐后30 min血糖（r=0.118,P=0.023）、FINS（r=0.249,P＜0.01）、30 minINS（r=O.189,P＜0.01）、2hINS（r =0.206,P＜0.01）、糖化血红蛋白（HbAlc,r=0.106,P=0.042）、HOMA-IR（r=0.244,P＜0.01）、TG（r=0.350,P＜0.01）、ΔI30/ΔG30（r=0.144,P＜0.01）呈正相关,而与HDL-C呈负相关（r=-0.321,P＜0.01）.多元逐步回归分析结果显示,ΔI30/ΔG30与SUA（β=0.292,P＜0.01）、HOMA-IR（β=29.821,P＜0.01）呈正相关.结论 正常糖调节人群SUA水平与早相胰岛素分泌密切相关.Objective To investigate the correlation between serum uric acid （SUA） level and early-phase insulin secretion in subjects with normal glucose regulation （NGR）.Methods Totally 367 community NGR residents confirmed by a 75g oral glucose tolerance test were enrolled.The insulin resistance index （HOMA-IR） and the early-phase insulin secretion index after a glucose load （ΔI30/ΔG30） were used to estimate the insulin sensitivity and the early-phase insulin secretion, respectively.The subjects were divided into 4 groups according to the SUA level quartiles.Differences in early-phase insulin levels, ΔI30/ΔG30, and HOMA-IR were compared among the 4 groups.Results Age, BMI, waist circumference, systolic blood pressure, diastolic blood pressure, fasting insulin （FINS）, 30 minutes postprandial insulin （30 minINS）, 2 hours postprandial insulin（2hlNS）, HOMA-IR and TG levels increased across the rising categories of SUA levels, while the HDL-C was decreased across the SUA groups （P ＜ 0.01）.The SUA level was positively correlated with age （r =0.157, P ＜ 0.01）, BMI （r =0.262, P ＜ 0.01）, waist circumference（r =0.372, P ＜ 0.01）, systolic blood pressure （r =0.200, P ＜ 0.01）, diastolic blood pressure（r =0.254,P ＜ 0.01） , 30 minutes postprandial plasma glucose（r =0.118 ,P =0.023）, FINS（r =0.249, P ＜ 0.01）, 30minlNS （r =0.189, P ＜ 0.01） ,2hlNS （r =0.206, P ＜ 0.01）, glycosylated hemoglobin （HbAlc, r=0.106,P =0.042）, HOMA-IR（r =0.244,P ＜0.01）, TG（r =0.350,P ＜0.01）, ΔI30/ΔG30 （r =0.144, P ＜ 0.01）, and negatively correlated with HDL-C level （r =-0.321, P ＜ 0.01）.Multiple stepwise regression analysis showed that SUA （β =0.292, P ＜ 0.01） and HOMA-IR （β3 =29.821, P ＜ 0.01）were positively associated with ΔI30/ΔG30.Conclusion SUA level is closely related with the early-phase insulin secretion in NGR subjects.

关 键 词：尿酸 早相胰岛素分泌 正常糖调节 

分 类 号：R589.7[医药卫生—内分泌]