胰岛素抵抗替代指标对歼击机飞行人员发生高尿酸血症的预测价值  

Predictive value of insulin resistance alternative indicators in hyperuricemia among fighter pilots

作　　者：李瑾 张建平 蒋学义 何娜 徐明 LI Jin;ZHANG Jian-ping;JIANG Xue-yi;HE Na;XU Ming

机构地区：[1]联勤保障部队临潼康复疗养中心,陕西西安710600

出　　处：《中国疗养医学》2025年第5期5-10,共6页Chinese Journal of Convalescent Medicine

基　　金：临潼康复疗养中心立项课题(LLKY2023001)。

摘　　要：目的探讨三酰甘油葡萄糖指数(TyG)、三酰甘油/高密度脂蛋白胆固醇比值(TG/HDL-C)、胰岛素抵抗代谢指数(METS-IR)和三酰甘油葡萄糖体质量指数(TyG-BMI)等胰岛素抵抗(IR)替代指标对歼击机飞行人员发生高尿酸血症(HUA)的相关性,以及发生风险的评估效能。方法回顾分析2021年1月至2023年10月在临潼康复疗养中心进行健康体检的1248名歼击机飞行人员体检数据,根据是否患有HUA分为HUA组和非HUA组。收集两组对象的基本信息和体检资料,使用单因素二元Logistics回归分析评估4种IR替代指标及其四分位数对歼击机飞行人员发生HUA的影响,采用ROC曲线评估IR替代指标对歼击机飞行人员发生HUA的预测价值。结果男性歼击机飞行人员HUA患病率为27.5%。HUA组的BMI、收缩压、血尿酸、三酰甘油、血肌酐、丙氨酸氨基转移酶、TyG、METS-IR、TG/HDL-C、TyG-BMI水平及脂肪肝患病率明显高于非HUA组,差异具有统计学意义(P均<0.05),而高密度脂蛋白胆固醇(HDL-C)低于非HUA组,差异有统计学意义(P<0.001)。以Q1组为参照进行Logistic分析,Q2、Q3、Q4组的HUA患病风险均不同程度升高,差异具有统计学意义(P均<0.05)。ROC曲线分析结果显示,IR替代指标均有一定的预测价值,且在30~39岁年龄段中预测价值最高,TyG-BMI(AUC=0.685,95%CI:0.639,0.731)、METS-IR(AUC=0.681,95%CI:0.635,0.727)效果优于其他2个指标。结论TyG、METS-IR、TG/HDL-C、TyG-BMI等IR替代指标水平升高与歼击机飞行人员HUA患病风险呈正相关,是HUA发生较好的预测指标,其中METS-IR和TyG-BMI预测能力较好,对30~39岁年龄段预测效果优于其他年龄段。Objective To investigate the correlation of alternative indicators of insulin resistance(IR),such as triglyceride-glucose index(TyG),triglyceride/high-density lipoprotein cholesterol ratio(TG/HDL-C),metabolic score for insulin resistance(METS-IR)and triglyceride-glucose body mass index(TyG-BMI)with the risk of hyperuricemia(HUA)in fighter pilots,and to evaluate the predictive efficacy of the IR alternative indicators in predicting HUA.Methods Physical examination data of 1248 fighter pilots at Lintong Rehabilitation and Recuperation Center from January 2021 to October 2023 were retrospectively analyzed.According to the presence or absence of HUA,fighter pilots were divided into the HUA group and non-HUA group.Clinical characteristics and physical examination data were collected.The influence of four IR alternative indicators and their quartiles on the occurrence of HUA in fighter pilots was analyzed with univariate logistic regression.The potential of IR alternative indicators in predicting HUA in fighter pilots was assessed by plotting the receiver operator characteristic(ROC)curve.Results The prevalence of HUA among male fighter pilots was 27.5%.The levels of body mass index(BMI),systolic blood pressure,serum uric acid,triglyceride,serum creatinine,alanine aminotransferase,TyG,METS-IR,TG/HDL-C,TyG-BMI,and the incidence of fatty liver in the HUA group were significantly higher than those of the non-HUA group(P<0.05),while high-density lipoprotein cholesterol was significantly lower(P<0.001).Logistic analysis was conducted with Q1 group as a reference,and the risk of HUA significantly increased to varying degrees in Q2,Q3,and Q4 groups(P<0.05).The ROC curve results showed that IR alternative indicators had certain predictive value in the occurrence of HUA.The TyG-BMI(AUC=0.685,95%CI:0.639,0.731)and METS-IR(AUC=0.681,95%CI:0.635,0.727)had a higher predictive value in the age range of 30~39 years old than the others.Conclusion TyG,METS-IR,TG/HDL-C,and TyG-BMI are positively correlated with the risk of HUA in male f

关 键 词：胰岛素抵抗 飞行人员 高尿酸血症 

分 类 号：R85[医药卫生—航空、航天与航海医学]