高尿酸血症及痛风病人血尿酸与胰岛素抵抗的关系

①目的　明确高尿酸血症及痛风病人血尿酸水平与胰岛素抵抗关系。②方法　对 4 0例原发性高尿酸血症及 32例痛风病人血尿酸 ,空腹及左旋 精氨酸兴奋后 2、4、6min胰岛素和C 肽等指标进行测定 ,并与 72例健康者进行对照。③结果　高尿酸血症及痛风组体质量指数 (BMI)、收缩压、舒张压、血糖、胆固醇、三酰甘油、载脂蛋白B、纤溶酶原、血肌酐和白细胞 (WBC)均明显高于对照组 (t=2 .0 7～ 1 3.0 1 ,P <0 .0 5、0 .0 1 ) ,空腹胰岛素、空腹C 肽和胰岛素抵抗指数 (Homa IR)亦明显高于对照组 (t=7.4 5～ 1 0 .95 ,P <0 .0 1 )。经左旋 精氨酸兴奋后高尿酸血症及痛风组胰岛素峰值和C 肽分泌峰值均明显高于对照组 (t =2 .82～ 1 0 .95 ,P <0 .0 1 ) ,而胰岛素和C 肽分泌曲线斜率却低于对照组 (t =2 .82～ 7.76 ,P <0 .0 1 )。血尿酸与男性、三酰甘油、BMI、高脂饮食、饮酒、Homa IR和血肌酐呈正相关关系 (t=2 .2 8～ 4 .4 8,P <0 .0 5 )。④结论　胰岛素抵抗是引起高尿酸血症因素之一 ,减轻体质量、低脂饮食、减少乙醇的摄入是预防高尿酸血症及痛风发作的重要措施

RELATIONSHIP BETWEEN THE SERUM URIC ACID AND INSULIN RESISTANCE IN PATIENTS WITH HYPERURICEMIA AND GOUT

Objective To clarify the relationship between serum uric acid and insulin resistance in patients with hyperuricemia and gout. Methods A control study was done in 40 hyperuricemia patients and 32 gout patients (HG group) and 32 healthy controls. Results Body mass index, systolic and diastolic blood pressure, blood glucose, total cholesterol, triglycerides apo lipoprotein(B), plasminogen, creatinine, white blood cell in the HG group were higher than those in the control group( t= 2.07- 13.01;P <0.05,0.01). Fasting serum insulin, C peptide and Homa insulin resistance(Homa IR) in the HG group increased significantly compared with those in the control. The peak value of insulin and C peptide stimulated by L arginine in the HG group was higher than that of the control ( t=2.82-7.76,P <0.01). However, the slop of insulin and C peptide secretion curve of the former decreased( t=2.82-10.95,P <0.01). Multiple step regression analysis showed that serum uric acid was positively correlated with male, triglycerides, Homa IR, creatinine, high fat intake, and alcohol drinking. Conclusion Insulin resistance is one of the factors of hyperuricemia. Measures such as decrease body weight, low fat and little alcohol intake should be taken to improve insulin resistance so to prevent hyperuricemia and gout.