您的位置：山东大学 -> 科技期刊社 -> 《山东大学学报（医学版）》

山东大学学报 (医学版) ›› 2022, Vol. 60 ›› Issue (12): 44-51.doi: 10.6040/j.issn.1671-7554.0.2022.0575

• • 上一篇    

简易胰岛素抵抗指标与698例2型糖尿病患者发生高尿酸血症风险的关联

赵美茹1,2,3,4,朱迪2,3,4,刘淋2,3,4,管庆波1,2,3,4,张栩2,3,4   

  1. 1.山东大学, 山东 济南 250012;2.山东第一医科大学附属省立医院内分泌代谢病科, 山东 济南 250021;3.山东省内分泌与脂代谢重点实验室, 山东 济南 250021;4.山东省糖尿病与代谢疾病临床医学研究中心, 山东 济南 250021
  • 发布日期:2022-12-01
  • 通讯作者: 张栩. E-mail:zhangxu@medmail.com.cn

Association of 4 simple insulin resistance indicators with the risk of hyperuricemia in 698 patients with type 2 diabetes mellitus

ZHAO Meiru1,2,3,4, ZHU Di2,3,4, LIU Lin2,3,4, GUAN Qingbo1,2,3,4, ZHANG Xu2,3,4   

  1. 1. Shandong University, Jinan 250012, Shandong, China;
    2. Department of Endocrine and Metabolic Diseases, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China;
    3. Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan 250021, Shandong, China;
    4. Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan 250021, Shandong, China
  • Published:2022-12-01

PDF (PC)

117

摘要： 目的 旨在探讨甘油三酯葡萄糖(TyG)指数、甘油三酯葡萄糖体质量(TyG-BMI)指数、甘油三酯/高密度脂蛋白胆固醇(TG/HDL-C)比值和胰岛素抵抗代谢(METS-IR)指数对中老年男性2型糖尿病(T2DM)患者发生高尿酸血症(HUA)风险的影响。 方法 选取2016年1月至2019年12月山东省立医院内分泌科住院的中老年男性2型糖尿病患者698例。根据血尿酸值(SUA)将698例中老年男性T2DM患者分为非高尿酸血症组(SUA<420 μmol/L,NUA组)和HUA组(SUA≥420 μmol/L)。采用多因素Logistics回归评估简易胰岛素抵抗指标及其四分位数对中老年男性T2DM患者发生HUA的影响。采用ROC曲线评估4种简易胰岛素抵抗(IR)指标对中老年男性T2DM患者发生HUA的预测价值。 结果 HUA组的TyG指数、TyG-BMI指数、TG/HDL-C比值、METS-IR指数较NUA组升高,差异有统计学意义(P<0.05)。以T2DM患者是否发生HUA(赋值:0=否,1=是)为因变量,以单因素回归分析中有统计学意义的指标为自变量进行多因素二分类Logistic回归分析,结果显示,血清肌酐(Scr)、维生素A结合蛋白(RBP)、TyG指数、TyG-BMI、TG/HDL-C和METS-IR是中老年男性T2DM患者发生HUA的独立影响因素(P<0.05)。ROC曲线显示,TyG指数对T2DM患者发生HUA的参考价值最高,AUC为0.73(95%CI:0.68~0.77),灵敏度为76.6 %,特异度为57.8%,约登指数为0.34;其次是TyG-BMI、TG/HDL-C、METS-IR。 结论 TyG指数、TyG-BMI、TG/HDL-C和METS-IR对中老年男性2型糖尿病患者发生HUA具有参考意义。

关键词: 甘油三酯葡萄糖指数, 甘油三酯葡萄糖体质量指数, 甘油三酯/高密度脂蛋白胆固醇比值, 胰岛素抵抗代谢指数, 高尿酸血症, 2型糖尿病, 胰岛素抵抗

Abstract: Objective To investigate the effects of triglyceride-glucose(TyG), triglyceride-glucose body mass index(TyG-BMI), triglyceride/high-density lipoprotein cholesterol ratio(TG/HDL-C)and metabolic score for insulin resistance(METS-IR)on the risk of hyperuricemia(HUA)in 698 patients with type 2 diabetes mellitus(T2DM). Methods A total of 698 patients with T2DM hospitalized in the Department of Endocrinology of Shandong Provincial Hospital during Jan. 2016 and Dec. 2019 were selected. According to the serum uric acid value(SUA), the patients were divided into the non-hyperuricemia group(SUA<420 μmol/L, NUA group)and HUA group(SUA≥420 μmol/L, HUA group). The reference value of TyG, TyG-BMI, TG/HDL-C and METS-IR for HUA was analyzed with multivariate Logistic regression and receiver operator characteristic(ROC)curve. Results TyG, TyG-BMI, TG/HDL-C and METS-IR were higher in HUA group than in NUA group(P<0.05). With the occurrence of HUA(assignment: 0=no, 1=yes)as the dependent variable, and the indicators with statistical significance in the univariate regression analysis as the independent variables, the multivariate binary Logistic regression analysis showed that, serum creatinine(Scr), retinol binging protein(RBP), TyG, TyG-BMI, TG/HDL-C and METS-IR were independent influencing factors of HUA in T2DM patients(P<0.05). The ROC curve showed that TyG had the highest reference value on the occurrence of HUA, with the area under the curve(AUC)of 0.73(95%CI: 0.68-0.77), sensitivity of 76.6%, specificity of 57.8 %, and Youden index of 0.34, followed by TyG-BMI, TG/HDL-C and METS-IR. Conclusion TyG, TyG-BMI, TG/HDL-C and METS-IR have reference significance for the occurrence of HUA in middle-aged and elderly male patients with T2DM.

Key words: Triglyceride-glucose index, Triglyceride glucose-body mass index, Triglyceride/high-density lipoprotein cholesterol ratio, Metabolic score for insulin resistance, Hyperuricemia, Type 2 diabetes, Insulin resistance

中图分类号: 

  • R587.1
[1] 李静. 高尿酸血症的流行病学研究[J]. 中国心血管杂志, 2016, 21(2): 83-86. LI Jing. Epidemiologic studies of hyperuricemia[J]. Chinese Journal of Cardiovascular Medicine, 2016, 21(2): 83-86.
[2] Hu X, Rong S, Wang Q, et al. Association between plasma uric acid and insulin resistance in type 2 diabetes: a mendelian randomization analysis [J]. Diabetes Res Clin Pract, 2021, 171: 108542. doi: 10.1016/j.diabres.2020.108542.
[3] Bonora E, Capaldo B, Perin PC, et al. Hyperinsulinemia and insulin resistance are independently associated with plasma lipids, uric acid and blood pressure in non-diabetic subjects. The GISIR database [J]. Nutr Metab Cardiovasc Dis, 2008, 18(9): 624-631.
[4] Sánchez-García A, Rodríguez-Gutiérrez R, Mancillas-Adame L, et al. Diagnostic accuracy of the triglyceride and glucose index for insulin resistance: a systematic review [J]. Int J Endocrinol, 2020, 2020: 4678526. doi:10.1155/2020/4678526.
[5] 李融融, 时小东, 陈伟. 新型简化胰岛素抵抗评价指标对糖代谢紊乱预测价值的比较研究[J]. 中华糖尿病杂志, 2022, 14(1): 56-62. LI Rongrong, SHI Xiaodong, CHEN Wei. A comparative study on the predictive value of new simplified insulin resistance assessment indicators in identifying glucose metabolism disturbance [J]. Chinese Journal of Diabetes, 2022, 14(1): 56-62.
[6] 孙琳, 王桂侠, 郭蔚莹. 高尿酸血症研究进展[J]. 中国老年学杂志, 2017, 37(4): 1034-1038. SUN Lin, WANG Guixia, GUO Weiying. Research progress of hyperuricemia [J]. Chinese Journal of Gerontology, 2017, 37(4): 1034-1038.
[7] 李林, 朱小霞, 戴宇翔, 等. 中国高尿酸血症相关疾病诊疗多学科专家共识[J]. 中华内科杂志, 2017, 56(3): 235-248. LI Lin, ZHU Xiaoxia, DAI Yuxiang, et al. Chinese multi-disciplinary consensus on the diagnosis and treatment of hyperuricemia and its related diseases [J]. Chinese Journal of Internal Medicine, 2017, 56(3): 235-248.
[8] Liu R, Han C, Wu D, et al. Prevalence of hyperuricemia and gout in mainland China from 2000 to 2014: a systematic review and meta-analysis [J]. Biomed Res Int, 2015, 2015: 762820. doi: 10.1155/2015/762820.
[9] Cibi cková, Langová L, Vaverková H, et al. Correlation of uric acid levels and parameters of metabolic syndrome [J]. Physiol Res, 2017, 66(3): 481-487.
[10] Adachi SI, Yoshizawa F, Yagasaki K. Hyperuricemia in type 2 diabetic model KK-Ay/Ta mice: a potent animal model with positive correlation between insulin resistance and plasma high uric acid levels [J]. BMC Res Notes, 2017, 10(1): 577.
[11] Wang Y, Yang W, Jiang X. Association between triglyceride-glucose index and hypertension: a meta-analysis [J]. Frontiers in cardiovascular medicine, 2021, 8: 644035. doi: 10.3389/fcvm.2021.644035.
[12] Zheng R, Mao Y. Triglyceride and glucose(TyG)index as a predictor of incident hypertension: a 9-year longitudinal population-based study [J]. Lipids in health and disease, 2017, 16(1): 175.
[13] Li J, Ren L, Chang C, et al. Triglyceride-glukose index predicts adverse events in patients with acute coronary syndrome: a meta-analysis of cohort studies [J]. Horm Metab Res, 2021, 53(9): 594-601.
[14] Duran Karaduman B, Ayhan H, Kele?瘙塂 T, et al. The triglyceride-glucose index predicts peripheral artery disease complexity [J]. Turkish journal of medical sciences, 2020, 50(5): 1217-1222.
[15] Sheng GT, Lu S, Xie QY, et al. The usefulness of obesity and lipid-related indices to predict the presence of Non-alcoholic fatty liver disease [J]. Lipids Heal Dis, 2021, 20(1): 134.
[16] 邹筱芳, 巫冠中. 尿酸肾损伤的分子机制研究进展[J]. 安徽医药, 2015, 19(1): 5-9. ZOU Xiaofang, WU Guanzhong. Molecular mechanism of uric acid in renal injury [J]. Anhui Medical and Pharmaceutical Journal, 2015, 19(1): 5-9.
[17] Salihefendic D, Zildzic M, Masic I. The importance of the quantity and the distribution assessment of fat tissue in a diagnosis of insulin resistance [J]. Med Arch Sarajevo Bosnia Herzegovina, 2020, 74(6): 439-443.
[18] Yamada A, Sato KK, Kinuhata S, et al. Association of visceral fat and liver fat with hyperuricemia [J]. Arthritis Care Res, 2016, 68(4): 553-561.
[19] Zong J, Sun Y, Zhang Y, et al. Correlation between serum uric acid level and central body fat distribution in patients with Type 2 diabetes [J]. Diabetes Metab Syndr Obes, 2020, 13: 2521-2531. doi: 10.2147/DMSO.S260891.
[20] 费晶, 陆昀, 黄阳, 等. 中年男性人群吸烟与血尿酸的关系探讨[J]. 中华老年医学杂志, 2020, 39(2): 151-154. FEI Jing, LU Yun, HUANG Yang, et al. The correlation between different smoking status and serum uric acid in a middle-aged male population [J]. Chinese Journal of Gerontology, 2020, 39(2): 151-154.
[21] Gu Q, Hu X, Meng J, et al. Associations of triglyceride-glucose index and its derivatives with hyperuricemia risk: a cohort study in Chinese general population [J]. Int J Endocrinol, 2020, 2020: 3214716. doi: 10.1155/2020/3214716.
[22] Mazidi M, Katsiki N, Mikhailidis DP, et al. The link between insulin resistance parameters and serum uric acid is mediated by adiposity [J]. Atherosclerosis, 2018, 270: 180-186. doi: 10.1016/j.atherosclerosis.
[23] Kim TH, Lee SS, Yoo JH, et al. The relationship between the regional abdominal adipose tissue distribution and the serum uric acid levels in people with type 2 diabetes mellitus [J]. Diabetol Metab Syndr, 2012, 4(1): 3.
[24] Huang XL, Jiang XH, Wang L, et al. Visceral adipose accumulation increased the risk of hyperuricemia among middle-aged and elderly adults: a population-based study [J]. J Transl Med, 2019, 17(1): 341.
[25] Yang L, He Z, Gu X, et al. Dose-response relationship between BMI and hyperuricemia [J]. Int J Gen Med, 2021, 14: 8065-8071. doi: 10.2147/IJGM.S341622.
[26] 杨曦, 柳怡莹, 万沁. TG/HDL-C、TyG指数对T2DM患者高尿酸血症的预测价值[J]. 天津医药, 2021, 49(6): 603-608. YANG Xi, LIU Yiying, WAN Qin. The predictive value of TG/HDL-C and TyG index for hyperuricemia in T2DM patients [J]. Tianjin Medical Journal, 2021, 49(6): 603-608.
[27] Liu XY, Wu QY, Chen ZH, et al. Elevated triglyceride to high-density lipoprotein cholesterol(TG/HDL-C)ratio increased risk of hyperuricemia: a 4-year cohort study in China [J]. Endocrine, 2020, 68(1): 71-80.
[1] 张媛 李英敏 冯月秋 常彩云 潘华伟 王束玫. 血清脂联素水平与肥胖、胰岛素抵抗的关系探讨[J]. 山东大学学报(医学版), 2209, 47(6): 124-.
[2] 于书卷,王美娟,陈丽,曹英娟,吕晓燕,刘雪燕,林鹏,颜景政. 老年2型糖尿病患者轻度认知功能障碍的影响因素[J]. 山东大学学报 (医学版), 2022, 60(11): 108-112.
[3] 吕丽,姜璐,陈诗鸿,庄向华,宋玉文,王殿辉,安文娟,李倩,潘喆. 210例绝经后2型糖尿病发生骨质疏松的相关因素[J]. 山东大学学报 (医学版), 2021, 59(7): 19-25.
[4] 郑凤杰,宋玉文,孙爱丽,潘喆,王殿辉,娄能俊,吕丽, 庄向华,陈诗鸿. 糖尿病周围神经病变与肌少症的关联性[J]. 山东大学学报 (医学版), 2021, 59(6): 38-44.
[5] 刘萍,宋玉文,王萍,田光伟,郑凤杰,吕丽,杜娇娇,张静,庄向华,陈诗鸿. 维生素D缺乏与2型糖尿病合并抑郁状态的相关性[J]. 山东大学学报 (医学版), 2021, 59(6): 51-56.
[6] 牛群,石婧婧,符江. WNT5A基因对卵巢颗粒细胞胰岛素反应性和胰岛素抵抗的调控作用[J]. 山东大学学报 (医学版), 2021, 59(6): 57-63.
[7] 哈灵侠,殷婷,吴阳阳,黎维霞,杜玉冬. 多囊卵巢综合征患者中胰岛素抵抗与子宫内膜局部炎症因子及葡萄糖转运蛋白-4表达的相关性[J]. 山东大学学报 (医学版), 2021, 59(11): 41-47.
[8] 张宝文,雷香丽,李瑾娜,罗湘俊,邹容. miR-21-5p靶向调控TIMP3抑制2型糖尿病肾病小鼠肾脏系膜细胞增殖及细胞外基质堆积[J]. 山东大学学报 (医学版), 2020, 1(7): 7-14.
[9] 王余余,高丽,陈少华. 94例2型糖尿病患者急性脑梗死后认知障碍与甲状腺功能的关联性[J]. 山东大学学报 (医学版), 2020, 58(5): 56-61.
[10] 徐红照,郝宗山, 沈德嫱,李朝苹,陈立勇. 核糖体蛋白S6激酶2沉默在乙醇诱导的心肌胰岛素抵抗中的作用[J]. 山东大学学报 (医学版), 2020, 58(4): 84-89.
[11] 金海燕,张炎,马小莉,韩羽,赵蕙琛,刘元涛,张玉超. MiR-122与miR-33a在2型糖尿病合并冠心病患者中的表达[J]. 山东大学学报 (医学版), 2020, 58(3): 94-98.
[12] 唐博,邵静,崔静,孙健平. 2型糖尿病发病与高密度脂蛋白关系的机制研究[J]. 山东大学学报 (医学版), 2020, 58(3): 99-106.
[13] 吴成威,孙博实,周军德,蒋天明,迟强. 术前口服多糖溶液对结直肠癌患者术后胰岛素抵抗的关联性研究[J]. 山东大学学报 (医学版), 2019, 57(9): 48-53.
[14] 曾雁冰,王秋鹏,方亚. 厦门市糖尿病“三师共管”模式的卫生经济学评价[J]. 山东大学学报 (医学版), 2019, 57(8): 89-94.
[15] 姜立娟,刘福强,蒋子允,李文娟,林鹏,王川,侯新国,陈丽. 达格列净改善超重及肥胖2型糖尿病患者脂代谢及内脏脂肪含量[J]. 山东大学学报 (医学版), 2019, 57(6): 87-93.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
版权所有 © 2018 《山东大学学报(医学版)》编辑部　
地址:山东大学科技期刊社（济南市历城区山大南路27号山东大学中心校区明德楼B座721室） 电话: 0531-88366918 E-mail: xbyxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发