The Clinical Research Of The Relationship Between Uric Acid Levels And Metabolic Diseases

Part 1 The relationship between serum uric acid levels and prediabetes:a cross-sectional survey based on epidemiological survey in shaanxi provinceObjectiveHyperuricemia(HUA)was associated with metabolic diseases such as insulin resistance,type 2 diabetes(T2DM),and metabolic syndrome(MS).However,it lacks large samples to support the association between the levels of serum uric acid(SUA)and prediabetes(Pre-DM)and different categories of impaired glucose regulation(IGR).So our study was aimed to investigate associations between SUA levels and Pre-DM and different categories of IGR in adults.MethodsStudy data was from China National Diabetes and Metabolic Disorders Study 2007-2008in Shaanxi province.3 002 participants who did not suffer from diabetes were included.According to 1999 World Health Organization(WHO)criteria,Pre-DM was defined.HUA was defined as SUA≥420μmol/L in male or SUA≥360μmol/L in female.The influence of HUA on the prevalence risk of Pre-DM and SUA levels on different categories of IGR were analyzed by logistic regression analysis.Results(1)The prevalence rates of HUA were 8.9%(46/1 756)and 2.6%(111/1 246),respectively in male and female.In total population,the prevalence of Pre-DM was significantly higher in HUA group than in normouricemia(NUA)group[31.2%(49/157)vs 16.7%(475/2 845),χ~2=21.754,P<0.001].Logistic regression analysis showed that the prevalence risk of Pre-DM was associated with HUA(OR 1.692;95%CI:1.129~2.538).Compared with the first quartile of SUA level(<198μmol/L),the prevalence risks(OR,95%CI)of Pre-DM in the second,third and fourth quartile of SUA(198~245μmol/L,246~306μmol/L and≥307μmol/L)were respectively(1.256,0.917~1.719),(1.323,0.961~1.822),(1.772,1.247~2.517).Additionally,compared with total population with normal glucose metabolism,when SUA concentration increased by 59.48μmol/L(1 mg/dl),the prevalence risks of different categories of IGR(OR,95%CI)were:isolated impaired fasting glucose(i-IFG)(1.208,1.046~1.395),isolated impaired glucose tolerance(i-IGT)(1.160,1.042~1.292),combined IFG and IGT(IFG/IGT)(1.316,1.080~1.603)respectively.(2)In male population,the prevalence of Pre-DM was significantly higher in HUA group than in NUA group[27.9%(31/111)vs 17.1%(194/1 135),χ~2=8.023,P<0.05].Logistic regressions analysis showed that the prevalence risk of Pre-DM was not associated with HUA(OR 1.484;95%CI:0.898~2.452).Compared with the first quartile of SUA level(≤250μmol/L),the prevalence risks(OR,95%CI)of Pre-DM in the second,third and fourth quartile of SUA(251~303μmol/L,304~355μmol/L and≥356μmol/L)were respectively(0.845,0.535~1.335),(0.797,0.501~1.335),(1.340,0.840~2.138).Additionally,compared with male population with normal glucose metabolism,when SUA concentration increased by 59.48μmol/L(1 mg/dl),the prevalence risks of different categories of IGR(OR,95%CI)were:i-IFG(1.156,0.960~1.392),i-IGT(1.102,0.937~1.296),IFG/IGT(1.146,0.841~1.561),respectively.(3)In female population,the prevalence of Pre-DM was significantly higher in HUA group than in NUA group[39.1%(18/46)vs16.4%(281/1 710),χ~2=16.335,P<0.001].Logistic regression analysis showed that the prevalence risk of Pre-DM was associated with HUA(OR 2.079;95%CI:1.015~4.256).Compared with the first quartile of SUA level(<178μmol/L),the prevalence risks(OR,95%CI)of Pre-DM in the second,third and fourth quartile of SUA(178~214μmol/L,215~255μmol/L and≥256μmol/L)were respectively(1.437,0.931~2.217),(1.624,1.065~2.476),(1.829,1.203~2.779).Additionally,compared with female population with normal glucose metabolism,when SUA concentration increased by 59.48μmol/L(1 mg/dl),the prevalence risks of different categories of IGR(OR,95%CI)were:i-IFG(1.267,0.995~1.613),i-IGT(1.209,1.043~1.401),IFG/IGT(1.502,1.151~1.96),respectively.ConclusionAccompanying with SUA levels elevating,the prevalence risk of Pre-DM increased.So we suggest clinician should pay attention to screen Pre-DM in the population with SUA≥300μmol/L.SUA was associated with Pre-DM in female,but not in male.So we suggest clinician should pay more attention to screen Pre-DM in female with SUA≥215μmol/L.Part2 Cardiovascular risk analysis in male patients with metabolic syndrome complicated with hyperuricemia: a cross-sectional survey based on national epidemiological surveyObjective Lots of researches showed that HUA was a main cause of gout,and it was closely related to major components of MS such as obesity,hyperglycaemia,hyperlipidemia,hypertension,etc.It suggested that HUA might be an active risk factor for MS and cardiac-cerebral vascular disease.However,whether HUA is an independent component of MS or merely an accompanying epiphenomenon remains unclear.We evaluated whether HUA is independently associated with MS and evaluated the impact of HUA on cardiovascular risk in the population presence or absence of MS.Methods Study data was from China National Diabetes and Metabolic Disorders Study2007-2008.5 898 male participants were enrolled in Estimated 10-year Framingham risk score(FRS)for cardiovascular event.According to 2009 international Joint Interim Statement(JIS)criteria,MS was defined.HUA was defined as SUA≥420 μmol/L in male.The associations between HUA and MS and components were analyzed by logistic regression analysis.The impact of HUA on the Estimated 10-year cardiovascular risk(FRS≥10%)in the population presence or absence of MS were analyzed by logistic regression analysis.Results(1)Compared to NUA group,HUA group showed higher prevalence of MS in male[49.9%(343/688)vs 29.1%(1515/5 210),P<0.001].Logistic regression analysis showed that adjusted by age,smoking habits,daily alcohol consumption and physical activity,the associations(OR,95% CI)between HUA and MS and components in male were: MS(2.697,2.285~3.184),abdominal obesity(2.617,2.198~3.115),hyperglycaemia(1.062,0.884~1.276),hypertension(1.823,1.536~2.164),hypertriglyceridemia(2.891,2.450~3.411),and low HDL cholesterol(1.831,1.520~2.207),respectivly.Futher adjusted by known risks,the association between HUA and MS in male disappeared(OR 1.242,95%CI : 0.978~1.577,P=0.075).(2)In male population absence of MS,HUA group showed higher prevalence of10-year cardiovascular event than NUA group [33%(114/345)vs 27.5%(1016/3 695),P=0.028].In male population presence of MS,HUA group showed lower prevalence of 10 year cardiovascular event than NUA group [44.6%(153/343)vs 55.3%(838/1 515),P<0.001].Logistic regression analysis showed that HUA was associated(OR,95% CI)with 10-year cardiovascular risk in male,in the population absence of MS(1.301,1.028~1.647)and presence of MS(0.807,0.722~0.901),while adjusted by traditional cardiac-cerebral vascular risks,the associations(OR,95% CI)disappeared,in the population absence of MS(1.536,0.918~2.471)and presence of MS(1.228,0.732~2.061).Conclusion HUA was associated with MS depending on known risks in male.HUA was associated with 10-year cardiovascular risk depending on traditional cardiac-cerebral vascular risks in male patients with MS.Thus,our results didn’t suggest that HUA be an independent component of MS or allowed to further cardiovascular risk stratification of patients with MS.