高尿酸血症病人胰岛β细胞功能分析

目的了解单纯高尿酸血症（HUA）病人胰岛β细胞功能,探讨血尿酸水平与胰岛素抵抗的关系.方法采用左旋精氨酸刺激法和口服75 g葡萄糖耐量试验（OGTT）,观察HUA组56例胰岛β细胞第一和第二分泌时相变化,并与正常对照组40例进行比较.结果经左旋精氨酸兴奋后两组均在2 min达分泌峰值,4 min开始下降,HUA组胰岛素峰值明显高于对照组（t=3.71,P＜0.01）;HUA组空腹胰岛素、OGTT120 min血糖、胰岛素、新β细胞功能指数、胰岛素抵抗指数（HOMA-IR）均明显高于对照组（t=2.46～5.56,P值均＜0.05）;多元回归分析显示血尿酸与低密度脂蛋白胆固醇（LDL-C）、HOMA-IR、男性、平均动脉压及肌酐呈正相关关系（t=2.15～3.60,P＜0.05）.结论HUA病人胰岛β细胞功能代偿性增高,且血尿酸水平与胰岛素抵抗呈正相关.

An analysis of islet beta-cell function in hyperuricemia

OBJECTIVE: To study the islet beta-cell function in patients with simple hyperuricemia (HUA) and to explore the relationship between the level of serum uric acid and insulin resistance. METHODS: The first and second phases of insulin secretion of beta-cell were observed after L-arginine stimulation test and oral glucose tolerance test (OGTT) in 56 hyperuricemic patients and 40 healthy controls. RESULTS: The peak value of insulin secretion in both groups was at the 2nd min and it began to decrease at the 4th min after L-arginine stimulation. However, the peak value in the HUA group was significantly higher than that in the control group (t = 3.71, P < 0.01). Fasting plasma insulin, 120-min plasma glucose and 120-min insulin during OGTT as well as modified beta-cell function index and Homa-insulin resistance (HOMA-IR) in the HUA group were obviously higher than those in the control group (t = 2.46-5.56, P < 0.05, P < 0.01). Multiple step regression analysis showed that serum uric acid was positively correlated with low density lipoprotein-cholesterol, HOMA-IR, male sex, mean arterial pressure and creatinine (t = 2.15-3.60, P < 0.05). CONCLUSION: The islet beta-cell function in hyperuricemic patients increases compensatively and the serum uric acid level is positively correlated with insulin resistance.