HYPERURICEMIA AND INSULIN-RESISTANCE
HYPERURICEMIA AND INSULIN-RESISTANCE
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DOI：
10.1210/jc.78.1.25
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发表时间：
1994-01-01
影响因子：
5.8
通讯作者：
YKIJARVINEN, H
中科院分区：
文献类型：
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作者：
VUORINENMARKKOLA, H;YKIJARVINEN, H
痛风肥胖、高甘油三酯血症、葡萄糖不耐症和高血压的相关症状与胰岛素抵抗的相关症状惊人地相似。在本研究中，我们确定高尿酸血症是否与胰岛素抵抗有关，如果是，这种关联是否可以用该综合征的其他组成部分来解释。为此，我们对 37 名表现出不同程度代谢综合征的非糖尿病受试者（年龄 30-68 岁）的胰岛素敏感性（正常血糖钳夹）进行了定量（体重指数，21.5-35.7 kg/m(2)；血清甘油三酯，0.4-22.0 mmol/L；高密度脂蛋白胆固醇 0.38-1.86 mmol/L；血压， 190-100/116-60 毫米汞柱）。简单线性回归分析显示，血清尿酸浓度（范围：182-568 μmol/L）与胰岛素敏感性（葡萄糖利用率；r = -0.61；P < 0.001）呈负相关，与血清甘油三酯呈正相关（r = 0.68；P < 0.001），但与体重指数、年龄或血浆葡萄糖浓度无关。在多元线性回归分析中，胰岛素敏感性（P < 0.05）和血清甘油三酯（P < 0.005）均与血清尿酸浓度独立相关，并共同解释了其变异的50%。在模型中添加体重指数或年龄并没有提高解释程度。在健康志愿者中，血清甘油三酯急性升高约8倍，血浆FFA约g倍，或血清胰岛素约28倍急性升高，对血清尿酸浓度没有影响。数据表明，高尿酸血症确实是代谢综合征的固有组成部分，也可以用作胰岛素抵抗的简单标志。
The associates of gout-obesity, hypertriglyceridemia, glucose intolerance, and hypertension, strikingly resemble those of insulin resistance. In the present study we determined whether hyperuricemia is associated with insulin resistance and, if so, whether this association can be explained by other components of the syndrome. For this purpose we quantitated insulin sensitivity (euglycemic clamp) in 37 nondiabetic subjects (aged 30-68 yr) exhibiting varying degrees of the metabolic syndrome (body mass index, 21.5-35.7 kg/m(2); serum triglycerides, 0.4-22.0 mmol/L; high density lipoprotein cholesterol 0.38-1.86 mmol/L; blood pressure, 190-100/116-60 mm Hg). In simple linear regression analysis, the serum uric acid concentration (range, 182-568 mu mol/L) was inversely correlated with insulin sensitivity (rate of glucose utilization; r = -0.61; P < 0.001) and positively with serum triglycerides (r = 0.68; P < 0.001), but not with body mass index, age, or the plasma glucose concentration. In multiple linear regression analysis, both insulin sensitivity (P < 0.05) and serum triglycerides (P < 0.005) were independently associated with the serum uric acid concentration, and together explained 50% of its variation. Addition of body mass index or age to the model did not improve the degree of explanation. Acute elevation of serum triglycerides about 8-fold, of plasma FFA about g-fold, or of serum insulin about 28-fold had no effect on the serum uric acid concentration in healthy volunteers. The data indicate that hyperuricemia is indeed an inherent component of the metabolic syndrome and could also be used as a simple marker of insulin resistance.