糖负荷后血尿酸与胰岛素分泌及胰岛素敏感性/抵抗的相关性分析

目的研究不同糖负荷人群血尿酸(SUA)水平与胰岛素分泌及胰岛素抵抗的关系。方法 389例符合要求的研究对象行口服糖耐量试验(OGTT),测量空腹SUA,OGTT 0、30、60、120min血糖(GLU)和胰岛素(INS)水平,按照OGTT结果将研究对象分为糖耐量正常组(NGT组,n=88)、糖尿病前期组(preDM,n=119)、糖尿病组(DM,n=182),计算研究对象的胰岛素分泌指数(IGI)、120min胰岛素分泌指数(AUC INS_(120)/AUC GLU_(120))、胰岛素抵抗指数(HOMA-IR)、及Matsuda指数;将SUA按四分位水平分组,比较各糖负荷组不同SUA水平胰岛素分泌及胰岛素抵抗差异;计算SUA与胰岛素分泌及HOMA-IR的直线回归方程。结果 DM组SUA水平低于PreDM组(346.66±90.60)mmol/Lvs.(367.36±92.34)mmol/L],但是略高于NGT组(339.34±89.51)mmol/L,差异有统计学意义(P0.01);DM组IGI指数、AUC INS_(120)/AUC GLU_(120)指数随着SUA升高有降低趋势(P0.01),Matsuda指数随着SUA水平升高有降低趋势(P0.05)。SUA与IGI、AUC INS_(120)/AUC GLU_(120)、HOMAIR、Matsuda指数的二元一次方程分别是Y=4.050+0.144 X,Y=2.343+0.206 X,Y=1.288+0.176 X,Y=129.373-0.202 X。结论 SUA与胰岛素分泌及胰岛素敏感性显著相关,DM组胰岛素分泌随着SUA水平升高而升高,胰岛素敏感性随着SUA水平升高而降低。SUA与胰岛素分泌及胰岛素敏感性的二元一次方程可大概评估胰岛素功能。

Correlation analysis of serum uric acid and insulin secretion or insulin sensitivity/resistance after glucose load

Objective To investigate the relationship between serum uric acid (SUA) levels and insulin secretion and insulin re-sistance in subjects with different glucose loads .Methods Totally 389 patients met the requirements ,and the subjects underwent o-ral glucose tolerance test (OGTT) to measure fasting SUA ,OGTT 0 ,30 ,60 ,120 min glucose (GLU) and insulin (INS) .According to the results of OGTT ,the subjects were divided into normal glucose tolerance group (NGT group ,n= 88) ,pre diabetes group (preDM group ,n=109) and diabetes mellitus (DM group ,n= 182) ,the insulin secretion index (IGI) ,120 min insulin secretion (AUC INS120/AUC GLU120 ) ,insulin resistance index (HOMA-IR) and Matsuda index were calculated .Calculated the quartile of SUA to divide the subjects to four groups ,the levels of insulin secretion and insulin resistance were compared between different glu-cose loading groups at different levels of SUA .The linear regression equation between SUA and insulin secretion and HOMA-IR was calculated .Results The SUA in DM group was lower than that of PreDM group (346 .66 ± 90 .60)mmol/L vs .(367 .36 ± 92 .34)mmol/L] ,but slightly higher than that of NGT group(339 .34 ± 89 .51)mmol/L] ,the difference was statistically significant (P<0 .01) .The IGI index and AUC INS120/AUC GLU120 index of DM group decreased with the increase of SUA (P<0 .01) ,and the Matsuda index decreased with the increase of SUA level (P<0 .05) .The linear equation of SUA and the IGI ,AUC INS120/AUC GLU120 ,HOMA-IR ,Matsuda index was Y=4 .050+0 .144X ,Y=2 .343+0 .206X ,Y =1 .288+0 .176X ,Y=129 .373-0 .202X re-spectively .Conclusion SUA was significantly associated with insulin secretion and insulin sensitivity .Insulin secretion in group DM increased with increasing SUA levels ,and insulin sensitivity decreased with increasing SUA levels .The linear equation of SUA and insulin secretion ,insulin sensitivity may be used to assess insulin function .