Usefulness of Triglyceride-glucose Index for estimating Hyperuricemia risk: Insights from a general Population
Usefulness of Triglyceride-glucose Index for estimating Hyperuricemia risk: Insights from a general Population
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甘油三酯-葡萄糖指数对于估计高尿酸血症风险的有用性：来自一般人群的见解
DOI：
10.1080/00325481.2019.1624581
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发表时间：
2019-06-02
影响因子：
4.2
通讯作者：
Liu, Shuang
中科院分区：
文献类型：
--
作者：
Shi, Wenrui;Xing, Liying;Liu, Shuang
【摘要】目的：高尿酸血症是一种代谢异常，给全球医疗保健带来了巨大的负担。先前的研究已经揭示了胰岛素抵抗和高尿酸血症之间的密切联系。因此，监测胰岛素敏感性可能是预防高尿酸血症的一种可能方法。最近的研究已经证明甘油三酯-葡萄糖指数（TyG）作为胰岛素抵抗的简单替代指标的有效性。因此，我们的研究旨在探讨TyG对高尿酸血症的影响及其对改善高尿酸血症的风险分层和预防的价值。方法：本横断面研究纳入2017年9月至2018年5月来自中国东北地区的6466名受试者，平均年龄59.57岁，女性60.19%。测定TyG为ln[空腹TG（mg/dL）×FPG(mg/dL)/2]。高尿酸血症定义为女性血清尿酸≥357 μmol/L，男性血清尿酸≥417 μmol/L。结果：高尿酸血症患病率为5.24%。在全模型中，TyG每增加SD，血清尿酸浓度升高12.528 μmol/L，高尿酸血症风险增加54.1%。当将TyG分成四分位数时，最高四分位数患高尿酸血症的风险是最低四分位数的2.730倍。此外，光滑曲线拟合表明这种关联是线性的。此外，亚组分析显示，这种关联与高尿酸血症的几个危险因素密切相关。最后，将TyG引入临床危险因素后，AUC有所改善（0.751 vs 0.772, p < 0.001），无类别净重分类指数（0.304,95% CI: 0.195 ~ 0.413, p < 0.001）和综合判别指数（0.009,95% CI: 0.004 ~ 0.013, p < 0.001）也显示TyG的改善。结论：我们的工作揭示了TyG与高尿酸血症之间的线性和强大的关联。此外，我们的研究结果表明同时控制血糖和脂质在预防高尿酸血症中的重要性。最重要的是，我们的研究结果暗示TyG在优化高尿酸血症风险分层和预防方面的价值。
ABSTRACT Objectives: Hyperuricemia is a metabolic abnormality that has cast an enormous burden on global healthcare. Previous studies have revealed the close association between insulin resistance and hyperuricemia. Therefore, monitoring insulin sensitivity may be a possible way to prevent hyperuricemia. Recent studies have demonstrated the usefulness of triglyceride-glucose index (TyG) as a simple surrogate of insulin resistance. Hence, our study aimed to explore the impact of TyG on hyperuricemia and its value to improve the risk stratification and prevention of hyperuricemia. Methods: This cross-sectional study included 6466 subjects (mean age: 59.57 years, 60.19% females) from northeast China between September 2017 to May 2018. TyG was determined as ln[fasting TG(mg/dL)×FPG(mg/dL)/2]. Hyperuricemia was defined as serum uric acid ≥ 357 μmol/L for females and ≥ 417 μmol/L for males. Results: The prevalence of hyperuricemia was 5.24%. In the full model, each SD increment of TyG caused a 12.528 μmol/L elevation of serum urate concentration and a 54.1% additional risk for hyperuricemia. When dividing TyG into quartiles, the top quartile had a 2.730 times risk for hyperuricemia than the bottom one. Moreover, smooth curve fitting demonstrated this association was linear. Additionally, subgroup analysis revealed the association was robust to several risk factors of hyperuricemia. Finally, AUC displayed an improvement when introducing TyG into clinical risk factors (0.751 vs 0.772, p < 0.001), category-free net reclassification index (0.304, 95% CI: 0.195–0.413, P < 0.001) and integrated discrimination index (0.009, 95% CI: 0.004–0.013, P < 0.001) also showed the improvement from TyG. Conclusion: Our work revealed the linear and robust association between TyG and hyperuricemia. Furthermore, our results suggest the importance of simultaneous glycemic and lipids control in the prevention of hyperuricemia. Most importantly, our findings implicate the value of TyG to optimize the risk stratification and prevention of hyperuricemia.