血糖正常中国人血尿酸和葡萄糖代谢率的相关性研究  

Association of uric acid level and glucose disposal rate in euglycemic Chinese individuals

作　　者：袁涛 刘诗璇 董颖越 付勇 唐彦 赵维纲 Yuan Tao;Liu Shixuan;Dong Yingyue;Fu Yong;Tang Yan;Zhao Weigang(Department of Endocrinology,Key Laboratory of Endocrinology of National Health Commission,Peking Union Medical College Hospital,Peking Union Medical College&Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Parmacy,Peking Union Medical College Hospital,Peking Union Medical College&Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院内分泌科,国家卫生健康委员会内分泌重点实验室,100730 [2]中国医学科学院,北京协和医学院,北京协和医院药剂科,100730

出　　处：《中华临床营养杂志》2020年第5期268-274,共7页Chinese Journal of Clinical Nutrition

基　　金：中国医学科学院医学与健康科技创新工程项目,中国医学科学院中央级公益性科研院所基本科研业务费专项资金(2016-I2M-4-001);国家"十三五"重大新药创制专项课题"创新药物全过程临床评价示范性技术平台建设"(2019ZX09734001);中国医学科学院中央级公益性科研院所基本业务费(2017PT32020,2018PT32001)。

摘　　要：目的研究利用高胰岛素正糖钳夹技术评估胰岛素抵抗的程度,并探究其与血尿酸(SUA)水平的关系。方法共纳入19例正常血糖的受试者,并通过体格检查、实验室化验及标准化问卷采集临床资料。用高胰岛素正糖钳夹技术测得的葡萄糖代谢率评价胰岛素抵抗。通过空腹血糖、胰岛素水平及3 h口服葡萄糖耐量试验,计算其他胰岛素抵抗的间接评估指标。采用多元线性回归分析探讨SUA水平与胰岛素敏感性的关系。结果根据SUA水平中位数(SUA=288μmol/L)将受试者分为高SUA组和低SUA组。相比较于低SUA组,高SUA组的收缩压(P=0.035)、腰围(P=0.009)、腰臀比(P=0.004)、体重(P=0.01)、血肌酐(P=0.05)和有饮酒习惯患者百分比(P=0.03)均显著升高。高SUA组的葡萄糖代谢率(P=0.041)和高密度脂蛋白胆固醇(P=0.09)水平显著降低。间接反应胰岛素抵抗的指数在两组间差异无统计学意义。此外,SUA水平与葡萄糖代谢率(r=-0.666,P=0.002)和高密度脂蛋白胆固醇(r=-0.619,P=0.005)呈负相关,与腰围(r=0.615,P=0.005),收缩压(r=0.521,P=0.022)和血肌酐(r=-0.550,P=0.015)呈正相关。逐步多元回归分析显示,在男性和女性血糖正常的受试者中,SUA和葡萄糖代谢率之间存在独立的相关性。结论血糖正常中国人的SUA水平与葡萄糖代谢率有显著相关性,提示SUA与胰岛素抵抗相关。Objective We examined the relationship between serum uric acid(SUA)levels and insulin resistance as evaluated by hyperinsulinemic euglycemic clamp technique.Methods 19 non-diabetic Chinese subjects were included in this study.Physical examination,laboratory measurements and standardized questionnaire were adopted to obtain participants'anthropometric measurements and lifestyle information.Insulin resistance was evaluated by glucose disposal rate(M)obtained with hyperinsulinemic euglycemic clamp technique.Other indices of insulin resistance were also calculated with fasting blood glucose,insulin levels and the data obtained by 3-hour oral glucose tolerance test(OGTT).Multiple linear regression analysis was used to examine the relation between SUA levels and insulin sensitivity.Results Subjects were divided into two groups based on the median SUA level(SUA=288μmol/L).The level of systolic blood pressure(P=0.035),waist circumference(P=0.009),waist-to-hip ratio(P=0.004),weight(P=0.01),serum creatinine(P=0.05)and the percentage of drinking habits(P=0.03)were all significantly increased in high SUA group.The level of M value(P=0.041)and high-density lipoprotein cholesterolhigh-density lipoprotein cholesterol(P=0.09)were significantly decreased in high SUA group.There were no significant differences in indirect indices of insulin resistance between groups.In addition,the SUA levels were negatively correlated with M value(r=-0.666,P=0.002)and high-density lipoprotein cholesterol(r=-0.619,P=0.005),positively correlated with waist circumference(r=0.615,P=0.005),systolic blood pressure(r=0.521,P=0.022)and serum creatinine(r=0.550,P=0.015)levels.Stepwise multiple regression analysis showed the independent association between SUA and M value in both male and female euglycemic Chinese subjects.Conclusion There is a significant correlation between SUA levels and glucose disposal rate value in euglycemic Chinese individuals,which suggested that SUA was associated with insulin resistance even in non-diabetic individuals.

关 键 词：尿酸 胰岛素抵抗 葡萄糖代谢率 

分 类 号：R587.1[医药卫生—内分泌]