Relationship between resistance to insulin-mediated glucose uptake, urinary uric acid clearance, and plasma uric acid concentration.
Relationship between resistance to insulin-mediated glucose uptake, urinary uric acid clearance, and plasma uric acid concentration.
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DOI：
10.1001/jama.1991.03470210076036
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发表时间：
1991-12
期刊：
影响因子：
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通讯作者：
F. Facchini;Ydi Chen;C. Hollenbeck;G. Reaven
中科院分区：
文献类型：
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作者：
F. Facchini;Ydi Chen;C. Hollenbeck;G. Reaven
目的明确胰岛素介导的葡萄糖代谢与血尿酸的关系。设计健康志愿者横断面研究。单位：斯坦福(加州)大学医学中心综合临床研究中心。参与者：36名健康个体，无糖尿病，无痛风病史。测量肥胖(整体和局部)、血糖和胰岛素对75克口服葡萄糖负荷的反应、空腹尿酸浓度、血浆甘油三酯和高密度脂蛋白胆固醇浓度、收缩压和舒张压、胰岛素介导的葡萄糖处置和尿酸清除。结果胰岛素抵抗程度与血尿酸浓度显著相关(r=.69；P<.001)，当考虑到年龄、性别、总体肥胖和腹型肥胖的差异时，这种关系持续存在(r=.57；P<.001)。胰岛素抵抗与尿酸清除呈负相关(r=-.49；P<0.002)，此外，尿酸清除与血尿酸浓度呈负相关(r=-.61；P<.001)。结论正常受试者尿酸清除量与胰岛素抵抗增加成正比，导致血尿酸浓度升高。因此，胰岛素抵抗对血尿酸浓度的调节似乎是在肾脏水平上起作用的。
OBJECTIVE To define the relationship, if any, between insulin-mediated glucose disposal and serum uric acid. DESIGN Cross-sectional study of healthy volunteers. SETTING General Clinical Research Center, Stanford (Calif) University Medical Center. PARTICIPANTS Thirty-six presumably healthy individuals, nondiabetic, without a history of gout. MEASUREMENTS Obesity (overall and regional), plasma glucose and insulin responses to a 75-g oral glucose load, fasting uric acid concentrations, plasma triglyceride and high-density lipoprotein-cholesterol concentrations, systolic and diastolic blood pressure, insulin-mediated glucose disposal, and urinary uric acid clearance. RESULTS Magnitude of insulin resistance and serum uric acid concentration were significantly related (r = .69; P less than .001), and the relationship persisted when differences in age, sex, overall obesity, and abdominal obesity were taken into account (r = .57; P less than .001). Insulin resistance was also inversely related to urinary uric acid clearance (r = -.49; P less than .002), and, in addition, urinary uric acid clearance was inversely related to serum uric acid concentration (r = -.61; P less than .001). CONCLUSIONS Urinary uric acid clearance appears to decrease in proportion to increases in insulin resistance in normal volunteers, leading to an increase in serum uric acid concentration. Thus, it appears that modulation of serum uric concentration by insulin resistance is exerted at the level of the kidney.