血尿酸与糖尿病前期和新检出2型糖尿病的关系  

Relationship of serum uric acid with prediabetes and newly detected type 2 diabetes mellitus

作　　者：吴倩 关颖[2] 徐春泽[2] 王娜[1] 刘星[1] 江峰[1] 赵琦[1] 孙中兴[2] 赵根明[1] 姜永根[2] Wu Qian;Guan Ying;Xu Chunze;Wang Na;Liu Xing;Jiang Feng;Zhao Qi;Sun Zhongxing;Zhao Genming;Jiang Yonggen(School of Public Health,Fudan University,Shanghai 200032,China;Songjiang District Center for Disease Control and Prevention of Shanghai,Shanghai 201620,China)

机构地区：[1]复旦大学公共卫生学院,上海200032 [2]上海市松江区疾病预防控制中心,上海201620

出　　处：《中华流行病学杂志》2022年第10期1603-1610,共8页Chinese Journal of Epidemiology

基　　金：上海市地方高水平学科建设项目;国家重点研发计划精准医学重点专项(2017YFC0907000)。

摘　　要：目的探讨成年人血尿酸与糖尿病前期、新检出2型糖尿病之间的相关性。方法基于上海市“高峰计划”松江人群队列基线调查数据,根据基线FPG、糖化血红蛋白将符合条件的研究对象分为血糖正常组、糖尿病前期组、新检出2型糖尿病组,采用非条件logistic回归模型探索血尿酸水平对糖尿病前期和新检出2型糖尿病的影响,采用限制性立方样条(RCS)函数来探索血尿酸水平与新检出2型糖尿病、糖尿病前期之间的非线性剂量反应关系。结果纳入研究对象30375名,年龄(55.36±11.52)岁,女性占60.2%(18299名)。基线调查发现糖尿病前期患病率为38.6%(11739名),新检出2型糖尿病检出率为6.6%(1992名)。logistic回归分析结果显示,在女性中,血尿酸浓度每增加10µmol/L,患糖尿病前期、2型糖尿病的风险分别增加2.4%(OR=1.024,95%CI:1.018~1.030)、1.5%(OR=1.015,95%CI:1.005~1.025);在男性中,血尿酸浓度每增加10µmol/L,患糖尿病前期、2型糖尿病的风险分别减少0.8%(OR=0.992,95%CI:0.987~0.998)和5.0%(OR=0.950,95%CI:0.939~0.960);RCS函数显示,女性血尿酸水平与新检出2型糖尿病关联呈非线性剂量反应关系(P=0.017),但与糖尿病前期不呈非线性剂量反应关系(P=0.670),男性血尿酸水平与糖尿病前期、新检出2型糖尿病均呈非线性剂量反应关系(新检出2型糖尿病P<0.001;糖尿病前期P=0.040)。结论在女性中,随着血尿酸水平升高成年女性糖尿病前期、新检出2型糖尿病患病风险增加,在男性中,随着血尿酸水平升高成年男性新检出2型糖尿病患病风险降低,男性血尿酸水平与糖尿病前期关联无统计学意义。Objective To evaluate the relationship of serum uric acid with prediabetes and newly detected type 2 diabetes mellitus(T2DM)in adults.Methods Data were obtained from the baseline investigation of Songjiang Peak-Plan cohort.According to the baseline fasting plasma glucose and glycosylated hemoglobin,the eligible subjects were divided into normal blood sugar group,prediabetes group,and newly detected T2DM group.Unconditional logistic regression model was used to explore the effect of serum uric acid level on prediabetes and newly detected T2DM,and restricted cubic spline(RCS)function was used to explore the nonlinear dose-response relationship of serum uric acid level with the prevalence of prediabetes and newly detected T2DM.Results A total of 30375 subjects were included in the analysis,with an average age of(55.36±11.52)years,and 60.2%(18299)of them were women.The baseline survey found that the prevalence of prediabetes was 38.6%(11739 cases),and the prevalence of newly detected T2DM was 6.6%(1992 cases).Logistic regression analysis showed that,in women,for every 10µmol/L increase in serum uric acid,the risk of developing prediabetes and T2DM s increased by 2.4%(OR=1.024,95%CI:1.018-1.030),and 1.5%(OR=1.015,95%CI:1.005-1.025),respectively;in men,for every 10µmol/L increase in serum uric acid,the risk of developing prediabetes and T2DM decreased by 0.8%(OR=0.992,95%CI:0.987-0.998)and 5.0%(OR=0.950,95%CI:0.939-0.960),respectively.The RCS function showed that the serum uric acid level showed a nonlinear dose-response relationship with newly detected T2DM(P=0.017),but not with prediabetes(P=0.670)in women and showed a nonlinear dose-response relationship with both prediabetes(P=0.040)and newly detected T2DM(P<0.001)in men.Conclusions Adult women are at increased risk of prediabetes and newly detected T2DM with increase of serum uric acid level,and adult men are at decreased risk of newly diagnosed T2DM with the increase of serum uric acid level.There was no significant relationship between serum uric acid level a

关 键 词：尿酸 糖尿病 2型 糖尿病前期 限制性立方样条 

分 类 号：R587.1[医药卫生—内分泌]