背景:先前的研究表明,血清尿酸与高密度脂蛋白胆固醇之比(UHR)与代谢综合征有关。然而,现有的研究还没有研究UHR与胰岛素抵抗(IR)之间的关系.因此,本研究旨在探讨2型糖尿病(T2DM)患者的UHR与IR之间的关系。
方法:纳入2型糖尿病患者(男性1,532例,女性1,013例)。通过胰岛素抵抗的稳态模型评估(HOMA-IR)来测量胰岛素抵抗,并定义为HOMI-IR≥2.69。皮尔逊相关性,多元逻辑回归,ROC分析,和亚组分析用于评估UHR和IR之间的关联。
结果:UHR与2型糖尿病患者的HOMA-IR相关(pearson的相关系数在男性中为0.274,在女性中为0.337,P<0.001)。多因素logistic回归分析显示,UHR与胰岛素抵抗显著相关(男性OR=1.06,95CI=1.03~1.08,女性OR=1.11,95CI=1.08~1.15)。UHR的ROC曲线下面积(AUC)(男性AUC=0.665,女性AUC=0.717,所有P<0.01)在胰岛素抵抗中与UA和HDL-C相比最大。亚组分析显示,BMI≥24kg/m2的受试者之间呈显著正相关,年龄<60岁,HbA1c<7%,非高血压,或女性科目。
结论:UHR升高与胰岛素抵抗显著相关,可作为2型糖尿病患者胰岛素抵抗的指标。
BACKGROUND: Previous studies have shown that the serum uric acid-to-high-density lipoprotein cholesterol ratio (UHR) is related to metabolic syndrome. However, no existing study has examined the relationship between UHR and insulin resistance (IR). Therefore, this study aims to explore the association between the UHR and IR in patients with type 2 diabetes mellitus (T2DM).
METHODS: Patients with type 2 diabetes mellitus (1,532 males and 1,013 females) were enrolled. Insulin resistance was measured by homeostatic model assessment of insulin resistance (HOMA-IR) and was defined as HOMI-IR ≥ 2.69. Pearson correlation, multiple logistic regression, ROC analysis, and subgroup analysis were used to evaluate the association between UHR and IR.
RESULTS: UHR was associated with HOMA-IR in patients with type 2 diabetes mellitus (pearson\'s correlation coefficient = 0.274 in males and 0.337 in females, P < 0.001). Multiple logistic regression analysis showed that UHR was significantly correlated with insulin resistance (OR = 1.06, 95%CI = 1.03-1.08 in males and OR = 1.11, 95%CI = 1.08-1.15 in females). The area under the ROC curve (AUC) of UHR (AUC = 0.665 for males and 0.717 for females, all P < 0.01) was the largest compared with that of UA and HDL-C in insulin resistance. Subgroup analysis showed that there was a more significantly positive correlation among subjects with BMI ≥ 24 kg/m2 , age < 60 years old, HbA1c < 7%, non-hypertension, or in female subjects.
CONCLUSIONS: Elevated UHR is significantly correlated with insulin resistance, which can be used as an indicator of insulin resistance in patients with type 2 diabetes mellitus.