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目的探讨糖尿病前期人群血尿酸水平与胰岛素敏感性的关系。方法 900例糖尿病前期患者(男451例,女449例),根据血尿酸水平将男女患者分别分为高尿酸组(HUA组)和正常尿酸组(NUA组)。75g口服葡萄糖耐量试验(OGTT)及胰岛素释放试验在0、30、120min分别测定血糖和胰岛素。用Matsuda胰岛素敏感性指数(Matsuda ISI)评估胰岛素敏感性。多重线性回归分析血清尿酸与胰岛素敏感性的关系。结果在男性和总体人群中,HUA组在OGTT各时间点的胰岛素、C-肽水平高于NUA组,而Matsuda ISI低于NUA组。在性别分组及控制了年龄、吸烟、饮酒、体重指数、甘油三酯、高密度脂蛋白胆固醇、肌酐、糖化血红蛋白等因素前、后,血清尿酸与Matsuda ISI均存在负线性关系。结论糖尿病前期人群血清尿酸水平与胰岛素敏感性独立相关,尿酸水平越高胰岛素敏感性越低。
Objective To investigate the relationship between serum uric acid level and insulin sensitivity in the pre-diabetic population. Methods Nine hundred and ten pre-diabetic patients (451 males and 449 females) were divided into two groups according to the serum uric acid level: the HUA group and the normal uric acid group (NUA group). 75g oral glucose tolerance test (OGTT) and insulin release test at 0,30,120 min were measured blood glucose and insulin. Insulin sensitivity was assessed using the Matsuda insulin sensitivity index (Matsuda ISI). Relationship between Serum Uric Acid and Insulin Sensitivity by Multiple Linear Regression. Results In male and the general population, the levels of insulin and C-peptide in HUA group were higher than those in NUA group at each time point of OGTT, while Matsuda ISI was lower than NUA group. There was a negative linear relationship between serum uric acid and Matsuda ISI before and after gender grouping and control of factors such as age, smoking, alcohol consumption, body mass index, triglyceride, high density lipoprotein cholesterol, creatinine and glycosylated hemoglobin. Conclusion Serum uric acid levels in pre-diabetic patients are independently associated with insulin sensitivity. The higher the uric acid level, the lower the insulin sensitivity.