【摘要】 目的 探讨青年人群中空腹三酰甘油葡萄糖(TyG)指数与高尿酸血症(Hyperuricemia, HUA)的相关性。方法 收集2004、2009及2014年开展的山东沿海地区居民HUA和痛风流行病学调查中年龄18～40岁的5 203例调查对象的相关资料，依据研究对象血尿酸水平的不同分为HUA组和尿酸正常组，比较两组研究对象的基本临床资料；根据研究对象的TyG指数进行四分位数法分组，分别为Q1～Q4组，比较4组研究对象的血尿酸水平和HUA患病率的差异。进一步根据性别将研究对象分为男性组和女性组，每一组再按照TyG指数水平以四分位数法分为Q1～Q4亚组，比较每组中4个亚组间血尿酸水平和HUA患病率的差异。根据研究对象的糖代谢状态分为血糖正常组、糖尿病前期组及糖尿病组，每一组再按照血清中尿酸水平分为HUA亚组和尿酸正常亚组，比较每组中两个亚组间的TyG指数水平差异。最后，分析TyG指数与HUA的相关性。结果 HUA组的TyG指数显著高于尿酸正常组(t=19.038,P<0.05);Q1、Q2、Q3、Q4组的平均血尿酸水平呈依次增高趋势(F=312.832,P<0.01),各组两两比较差异均有显著性(P<0.05)。Q1、Q2、Q3、Q4组HUA的患病率呈线性增高趋势(χ~2=343.314,P<0.01)。将研究人群按照糖代谢状态分组后，在血糖正常组、糖尿病前期组及糖尿病组中分别以TyG指数为自变量，以HUA为因变量行Logistic回归分析显示，在血糖正常的人群中，TyG指数是HUA的独立危险因素(P<0.01)。校正年龄、性别、BMI等混杂因素后，TyG指数每增加一个单位，HUA的患病风险增加42.2%(P=0.01)。将TyG指数进行四分位数法分组后，Q4组HUA的患病风险是Q1组的1.869倍(P=0.002)。在血糖正常人群中，TyG指数预测HUA的ROC曲线下面积为0.719(95%CI=0.694～0.743),阈值TyG指数为8.426。结论 在血糖正常的青年人群中，TyG指数与HUA独立相关，对HUA有一定预测价值。更多还原

【Abstract】 Objective To investigate the association between fasting triglycerides-glucose(TyG) index and hyperuricemia(HUA) in young adults. Methods Related data were collected from 5 203 subjects, aged 18—40 years, who participated in the epidemiological survey of HUA and gout among residents in the coastal regions of Shandong Province of China in 2004, 2009, and 2014. The respondents were divided into HUA group and normal uric acid group according to the level of serum uric acid, and basic clinical data were compared between the two groups. The subjects were divided into Q1-Q4 groups according to the quartiles of TyG index, and the level of serum uric acid and the prevalence rate of HUA were compared between groups. The subjects were divided into male group and female group according to sex, and each group was further divided into Q1-Q4 subgroups according to the quartiles of TyG index. The level of serum uric acid and the prevalence rate of HUA were compared between the 4 subgroups. The subjects were divided into normal blood glucose group, prediabetes group, and diabetes group according to the status of glucose metabolism, and each group was further divided into HUA subgroup and normal uric acid subgroup according to the level of serum uric acid. TyG index was compared between the two subgroups. Finally, the association between TyG index and HUA was analyzed. Results The HUA group had a significantly higher TyG index than the normal uric acid group(t=19.038,P<0.05), and the mean level of serum uric acid showed a trend of increase from Q1 group to Q4 group(F=312.832,P<0.01), with a signi-ficant difference between any two groups(P<0.05). The prevalence rate of HUA showed a linear increasing trend in Q1, Q2, Q3, and Q4 groups(χ~2=343.314,P<0.01). After the subjects were divided into groups according to the status of glucose metabolism, a logistic regression analysis was performed in the normal blood glucose group, the prediabetes group, and the diabetes group, with TyG index as the independent variable and HUA as the dependent variable, and the results showed that TyG index was an independent risk factor for HUA in the normal blood glucose group(P<0.01). After adjustment for related confounding factors including age, sex, and body mass index, the risk of HUA was increased by 42.2% for every unit of increase in TyG index(P=0.01). After the subjects were divided into groups according to the quartiles of TyG index, the risk of HUA in Q4 group was 1.869 times than in Q1 group(P=0.002). In the population with normal blood glucose, TyG index had an area under the ROC curve of 0.719(95% confidence interval: 0.694-0.743) in predicting HUA, at the optimal cut-off value of 8.426. Conclusion TyG index is independently related to HUA in the young population with normal blood glucose, and it has a certain predictive value for HUA.更多还原