南方医科大学学报

南方医科大学学报 ›› 2023, Vol. 43 ›› Issue (9): 1509-1514.doi: 10.12122/j.issn.1673-4254.2023.09.08

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基于C肽的胰岛素抵抗指数可准确评估健康体检者的胰岛素抵抗与血尿酸水平的相关性

方福生，王 宁，刘星宇，王 薇，孙 菁，李 红，孙般若，谷昭艳，傅晓敏，闫双通   

  1. 解放军总医院第二医学中心保健一科，健康医学科，内分泌科，第一医学中心内分泌科，北京 100853
  • 出版日期:2023-09-20 发布日期:2023-09-28

Value of C-peptide-based insulin resistance index for evaluating correlation between insulin resistance and serum uric acid level in individuals undergoing health examination

FANG Fusheng,WANG Ning, LIU Xingyu,WANGWei, SUN Jing, LI Hong, SUN Banruo, GU Zhaoyan, FU Xiaomin, YAN Shuangtong   

  1. Department of Health Care, Department of Health Management, Department of Endocrinology, Second Medical Center of Chinese PLA General Hospital, Beijing 100853, China; Department of Endocrinology, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
  • Online:2023-09-20 Published:2023-09-28

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摘要： 目的 探讨基于C肽的胰岛素抵抗指数在评估健康体检人群胰岛素抵抗与血尿酸（Ua）水平关联中的作用。方法 回顾性收集2017年1月~2021年12月在解放军总医院第二医学中心进行健康体检的资料46 017例，根据Ua水平分为两组：Ua≤420 μmol/L和Ua>420 μmol/L，比较两组胰岛素抵抗指数（HOMA2-IR）、基于C肽的胰岛素抵抗指数（HOMA2 IR-CP）水平的差异，采用Pearson相关分析、线性回归分析HOMA2-IR、HOMA2 IR-CP与Ua的相关性，分层交互分析不同亚组间HOMA2-IR、HOMA2IR-CP与Ua的关联是否存在差异，利用ROC曲线评价HOMA2-IR、HOMA2 IR-CP对Ua升高的预测能力。结果 Ua≤420 μmol/L组HOMA2-IR、HOMA2 IR-CP水平均显著低于Ua>420 μmol/L（P<0.001）。单因素Pearson相关分析显示HOMA2-IR与Ua（r=0.262，P<0.001）弱相关，HOMA2 IR-CP与Ua（r=0.409，P<0.001）中等强度相关。多因素线性回归分析提示在调整相关混淆因素后HOMA2-IR（R2=0.445，P<0.001）或HOMA2 IR-CP（R2=0.461，P<0.001）均是Ua水平的影响因素。分层交互分析发现不同性别、年龄、糖代谢亚组间胰岛素抵抗指数与Ua的关联均存在差异（P<0.001）。ROC曲线显示HOMA2-IR、HOMA2 IR-CP预测Ua升高的曲线下面积分别为0.662、0.722。结论 HOMA2 IR-CP更为准确地评估胰岛素抵抗与血尿酸水平关联。

关键词: 胰岛素抵抗；血尿酸；血清胰岛素；血清C肽；2型糖尿病

Abstract: Objective To investigate the value of C-peptide-based insulin resistance index in evaluating the correlation between insulin resistance and serum uric acid (Ua) level in subjects undergoing health examination. Methods The data of 46 017 subjects undergoing health examination were retrospectively collected from the Second Medical Center of PLA General Hospital from January, 2017 to December, 2021. The subjects were divided into Ua≤420 μmol/L group and Ua>420 μmol/L group for comparison of HOMA insulin resistance index (HOMA2-IR) and HOMA insulin resistance-C peptide (HOMA2 IR-CP). The correlations of HOMA2-IR and HOMA2 IR-CP with Ua level were analyzed using Pearson correlation analysis and linear regression analysis. Hierarchical interaction analysis was conducted to assess the differences in the association between insulin resistance index and Ua level in different subgroups. The ROC curve was used to evaluate the predictive ability of insulin resistance index for an increased Ua level. Results The levels of HOMA2-IR and HOMA2 IR- CP were significantly lower in Ua≤420 μmol/L group than in Ua>420 μmol/L group. Univariate Pearson correlation analysis showed a weak correlation of HOMA2- IR with Ua (r=0.262, P<0.001) and moderate correlation of HOMA2 IR-CP with Ua (r=0.409, P<0.001). Multivariate linear regression analysis, after adjustment for confounding factors, demonstrated that HOMA2-IR (R2=0.445, P<0.001) and HOMA2 IR-CP (R2=0.461, P<0.001) were both factors affecting Ua level. Hierarchical interaction analysis showed that the association of insulin resistance index with Ua level varied significantly with gender, age, and glucose metabolism (P<0.001). ROC curve showed that the areas under the curve predicted an increased Ua level by HOMA2- IR and HOMA2 IR-CP were 0.662 and 0.722, respectively. Conclusions HOMA2 IR-CP is a more accurate indicator for assessing the correlation between insulin resistance and Ua level.

Key words: insulin resistance; serum uric acid; serum insulin; serum C-peptide; type 2 diabetes