Association between three non-insulin-based indexes of insulin resistance and hyperuricemia
- 7 Downloads
The association between hyperuricemia and insulin resistance (IR) has been demonstrated by many studies, but the traditional IR indexes are too impractical to be used in clinical practice for the recognition of the IR state in individuals with hyperuricemia. Therefore, we aimed to further investigate the association between hyperuricemia and three non-insulin-based IR indexes in this large-scale cross-sectional study.
A total of 174,695 adults without self-reported use of antihyperuricemic agents, hypoglycemic agents, or lipid-lowering drugs were included in the current analysis. The triglyceride to high-density lipoprotein cholesterol ratio (TG/HDLc), the product of fasting triglycerides and glucose (TyG), and metabolic score for IR (METS-IR) were calculated. Then, logistic regression analyses were applied to explore their association with hyperuricemia.
The TG/HDLc, TyG, and METS-IR all had positive correlations with uric acid level. However, only TG/HDLc and TyG were significantly associated with hyperuricemia in both sexes and body mass index (BMI) classification (the ORs of the highest quartile for each were 6.751 and 1.505 in females and 6.487 and 1.646 in males, respectively). The AUC values of TG/HDLc and TyG to discriminate hyperuricemia were also statistically significant in both sexes and BMI classification (all greater than 0.7).
• In this large-scale study, we identified TG/HDLc and TyG as indicators for identification of IR in patients with hyperuricemia.
• These simple and practical IR indicators are of substantial clinical importance for implementing preventive strategies against IR-driven comorbidities of hyperuricemia.
KeywordsHyperuricemia Insulin resistance METS-IR TG/HDLc TyG index
In the preparation and implementation of this study, we get a lot of selfless help. All of our authors thank all those who have helped us.
This work was supported by the National Natural Science Foundation of China (grant number 81671595).
Compliance with ethical standards
This study was approved by the ethics committee of Hangzhou Aeronautical Sanatorium of the Chinese Air Force.
- 3.Meigs JB, Rutter MK, Sullivan LM, Fox CS, D'Agostino RB Sr, Wilson PW (2007) Impact of insulin resistance on risk of type 2 diabetes and cardiovascular disease in people with metabolic syndrome. Diabetes Care 30(5):1219–1225Google Scholar
- 4.Laakso M, Kuusisto J (2014) Insulin resistance and hyperglycaemia in cardiovascular disease development. Nat Rev Endocrinol 10(5):293–302Google Scholar
- 5.Dawson J, Wyss A (2017) Chicken or the egg? Hyperuricemia, insulin resistance, and hypertension. Hypertension. 70(4):698–699Google Scholar
- 7.Han T, Lan L, Qu R, Xu Q, Jiang R, Na L, Sun C (2017) Temporal relationship between hyperuricemia and insulin resistance and its impact on future risk of hypertension. Hypertension 70(4):703–711Google Scholar
- 8.Krishnan E, Pandya BJ, Chung L, Hariri A, Dabbous O (2012) Hyperuricemia in young adults and risk of insulin resistance, prediabetes, and diabetes: a 15-year follow-up study. Am J Epidemiol 176(2):108–116Google Scholar
- 9.Owei I, Jain N, Jones D, Umekwe N, Dagogo-Jack S (2018) Physiology of glycemic recovery and stabilization after hyperinsulinemic euglycemic clamp in healthy subjects. J Clin Endocrinol Metab 103(11):4155–4162Google Scholar
- 10.Fan J, Li HH, Huang S, Liu XZ (2019) The prevalence of obesity and metabolic abnormalities in eastern China: a cross- sectional study. Int J Diabetes Dev Ctries. https://doi.org/10.1007/s13410-019-00725-2
- 11.Li HH, Huang S, Liu XZ, Zou DJ (2019) Applying the China-PAR risk algorithm to assess 10-year atherosclerotic cardiovascular disease risk in populations receiving routine physical examinations in Eastern China. Biomed Environ Sci 32(2):87–95Google Scholar
- 13.Abbasi F, Reaven GM (2011) Comparison of two methods using plasma triglyceride concentration as a surrogate estimate of insulin action in nondiabetic subjects: triglycerides×glucose versus triglyceride/high-density lipoprotein cholesterol. Metabolism 60(12):1673–1676Google Scholar
- 14.Simental-Mendía LE, Rodríguez-Morán M, Guerrero-Romero F (2008) The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metab Syndr Relat Disord 6(4):299–304Google Scholar
- 15.Bello-Chavolla OY, Almeda-Valdes P, Gomez-Velasco D, Viveros-Ruiz T, Cruz-Bautista I, Romo-Romo A, Sánchez-Lázaro D, Meza-Oviedo D, Vargas-Vázquez A, Campos OA, Sevilla-González MR, Martagón AJ, Hernández LM, Mehta R, Caballeros-Barragán CR, Aguilar-Salinas CA (2018) METS-IR, a novel score to evaluate insulin sensitivity, is predictive of visceral adiposity and incident type 2 diabetes. Eur J Endocrinol 178(5):533–544Google Scholar
- 16.Sattui SE, Singh JA, Gaffo AL (2014) Comorbidities in patients with crystal diseases and hyperuricemia. Rheum Dis Clin N Am 40(2):251–278Google Scholar
- 19.Manley SE, Stratton IM, Clark PM, Luzio SD (2007) Comparison of 11 human insulin assays: implications for clinical investigation and research. Clin Chem 53(5):922–932Google Scholar
- 20.Shulman GI (2014) Ectopic fat in insulin resistance, dyslipidemia, and cardiometabolic disease. N Engl J Med 371(12):1131–1141Google Scholar
- 22.Zhou M, Zhu L, Cui X, Feng L, Zhao X, He S, Ping F, Li W, Li Y (2016) The triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio as a predictor of insulin resistance but not of β cell function in a Chinese population with different glucose tolerance status. Lipids Health Dis 15:104PubMedCentralGoogle Scholar
- 24.Matsuura F, Yamashita S, Nakamura T, Nishida M, Nozaki S, Funahashi T, Matsuzawa Y (1998) Effect of visceral fat accumulation on uric acid metabolism in male obese subjects: visceral fat obesity is linked more closely to overproduction of uric acid than subcutaneous fat obesity. Metabolism 47(8):929–933Google Scholar
- 25.Rodacka A, Strumillo J, Serafin E, Puchala M (2014) Effect of resveratrol and tiron on the inactivation of glyceraldehyde-3- phosphate dehydrogenase induced by superoxide anion radical. Curr Med Chem 21(8):1061–1069Google Scholar
- 27.Mazidi M, Kengne AP, Katsiki N, Mikhailidis DP, Banach M (2018) Lipid accumulation product and triglycerides/glucose index are useful predictors of insulin resistance. J Diabetes Complicat 32(3):266–270Google Scholar
- 28.Wang B, Zhang M, Liu Y, Sun X, Zhang L, Wang C, Li L, Ren Y, Han C, Zhao Y, Zhou J, Pang C, Yin L, Feng T, Zhao J, Hu D (2018) Utility of three novel insulin resistance-related lipid indices for predicting type 2 diabetes mellitus among people with normal fasting glucose in rural China. J Diabetes 10(8):641–652Google Scholar
- 29.Nan H, Dong Y, Gao W, Tuomilehto J, Qiao Q (2007) Diabetes associated with a low serum uric acid level in a general Chinese population. Diabetes Res Clin Pract 76(1):68–74Google Scholar
- 30.Li H, Zha X, Zhu Y, Liu M, Guo R, Wen Y (2016) An invert U-shaped curve: relationship between fasting plasma glucose and serum uric acid concentration in a large health check-up population in China. Medicine (Baltimore) 95(16):e3456Google Scholar
- 31.Facchini F, Chen YD, Hollenbeck CB, Reaven GM (1991) Relationship between resistance to insulin-mediated glucose uptake, urinary uric acid clearance, and plasma uric acid concentration. JAMA 266(21):3008–3011Google Scholar
- 32.Erdberg A, Boner G, van Dyk DJ, Carel R (1992) Urine uric acid excretion in patients with insulin-dependent diabetes mellitus. Nephron 60(2):134–137Google Scholar
- 33.Yu X, Wang L, Zhang W, Ming J, Jia A, Xu S, Li Q, Ji Q (2018) Fasting triglycerides and glucose index is more suitable for the identification of metabolically unhealthy individuals in the Chinese adult population: a nationwide study. J Diabetes Investig. https://doi.org/10.1111/jdi.12975
- 35.Liu XZ, Li HH, Huang S, Zhao DB (2019) Association between hyperuricemia and nontraditional adiposity indices. Clin Rheumatol 38(4):1055–1062Google Scholar
- 36.Takir M, Kostek O, Ozkok A, Elcioglu OC, Bakan A, Erek A, Mutlu HH, Telci O, Semerci A, Odabas AR, Afsar B, Smits G, ALanaspa M, Sharma S, Johnson RJ, Kanbay M (2015) Lowering uric acid with allopurinol improves insulin resistance and systemic inflammation in asymptomatic hyperuricemia. J Investig Med 63(8):924–929Google Scholar
- 37.Qu LH, Jiang H, Chen JH (2017) Effect of uric acid-lowering therapy on blood pressure: systematic review and meta-analysis. Ann Med 49(2):142–156Google Scholar