尿酸与胰岛素抵抗、非酒精性脂肪性肝病关联性的Meta分析  

The association of uric acid with insulin resistance and non-alcoholic fatty liver disease: a Meta-analysis

作　　者：牛琪[1] 刘立新[1,2,3] 郭晓红[1,2,3] NIU Qi;LIU Lixin;GUO Xiaohong(Shanxi Medical University,Taiyuan 030001;Department of Gastroenterology,the First Hospital of Shanxi Medical University;Institute of Liver Disease and Organ Transplantation,Shanxi Medical University,China)

机构地区：[1]山西医科大学,山西太原030001 [2]山西医科大学第一医院消化内科科研实验中心 [3]山西医科大学肝病与器官移植研究所

出　　处：《胃肠病学和肝病学杂志》2021年第12期1393-1402,共10页Chinese Journal of Gastroenterology and Hepatology

基　　金：中央引导地方科技发展资金(山西省科技厅)(YDZX20201400001965)。

摘　　要：目的系统分析血清尿酸(SUA)与胰岛素抵抗(IR)、非酒精性脂肪性肝病(NAFLD)三者之间的关联性。方法检索建库以来至2020年6月在PubMed、Embase、中国知网、万方及维普等全文期刊数据库中公开发表的关于SUA与IR、NAFLD相关性的研究,对检索的结果进行二次筛选、信息提取后,采用RevMan 5.3和Stata 15.1软件进行Meta分析。结果经筛选,关于SUA与NAFLD相关性的研究共纳入24项,共291 069例患者,Meta分析结果显示,SUA升高与NAFLD的发生相关(OR=2.04,95%CI:1.87~2.22,P<0.05)。进一步行亚组分析表明,SUA升高与NAFLD之间的相关性不受研究设计类型、性别、国家地域的影响,且SUA升高与NAFLD发生的相关性在女性中更明显(OR=2.31,95%CI:1.88~2.83,P<0.05)。进行敏感性分析表明结果的稳定性良好,采用漏斗图进行发表偏倚显示可信度较高。关于SUA与IR相关性的研究纳入4篇文献,共6 788例患者,Meta分析显示,SUA升高者易发生IR(OR=1.61,95%CI:1.49~1.75,P<0.05)。结论 SUA升高与IR、NAFLD密切相关,并且SUA升高是IR、NAFLD发生的危险因素。Objective To systematically analyze the association of serum uric acid(SUA) levels with insulin resistance(IR) and non-alcoholic fatty liver disease(NAFLD). Methods PubMed, Embase, CNKI, Wanfang and VIP were searched for studies on the correlation between SUA and IR/NAFLD published from the establishment of the database to Jun. 2020, including prospective cohort studies, retrospective studies and cross-sectional studies. All data were analyzed using RevMan 5.3 and Stata 15.1 in the Meta-analysis after secondary screening of the retrieved results, risk migration assessment of research and information extraction. Results After screening, a total of 24 studies involving 291 069 cases were included on the correlation between elevated SUA and NAFLD. The results of Meta-analysis showed that elevated SUA was associated with the occurrence of NAFLD(OR=2.04, 95% CI: 1.87-2.22, P<0.05). Further subgroup analysis showed that the correlation between elevated SUA and NAFLD was not affected by research design type, gender, country and region, and the correlation between elevated SUA and NAFLD was more obvious in female(OR=2.31, 95% CI: 1.88-2.83, P<0.05). Sensitivity analysis showed that the results were stable, and funnel plot was used to show publication bias with high reliability. A total of 4 studies with 6 788 patients were included about the association between elevated SUA and IR. Meta-analysis showed that elevated SUA were prone to IR(OR=1.61, 95% CI: 1.49-1.75, P<0.05). Conclusion Elevated SUA is closely related to IR and NAFLD, and it’s a risk factor for IR and NAFLD.

关 键 词：血清尿酸 非酒精性脂肪性肝病 胰岛素抵抗 META分析 

分 类 号：R575[医药卫生—消化系统]