基于FGF21 水平分析绝经女性高尿酸血症 与胰岛素抵抗的相关性

Correlation between hyperuricemia and insulin resistance in postmenopausal women based on FGF21 level

摘要:

目的 通过测定绝经高尿酸血症患者血清成纤维细胞生长因子21（FGF21）和胰岛素抵抗指数 （HOMA-IR）的变化，探讨FGF21、胰岛素抵抗（IR）与血清尿酸（SUA）的相关性。方法 选取2017 年 12 月—2019 年8 月于锦州医科大学附属第一医院就诊的无症状高尿酸血症绝经患者76 例作为高尿酸血症组， 并根据BMI 水平分为高BMI 组和正常BMI 组。另选取同期在该院体检的健康绝经女性80 例作为对照组。 分别检测高尿酸血症组和对照组的FGF21、血清肌酐（Scr）、SUA、HOMA-IR、FPG、空腹胰岛素（FIns）、 血脂、血压等指标。结果 高尿酸血症组BMI、Scr、SUA、TG、FGF21、FIns 及HOMA-IR 较对照组高（P <0.05）。 高BMI 组SUA、FGF21、FIns 及HOMA-IR 较正常BMI 组高（P <0.05）。经Pearson 相关性分析，FGF21 与 BMI、TG、FPG 及lnFIns 呈正相关（r =0.803、0.472、0.184 和0.747，P <0.05）。ln（HOMA-IR）与BMI、 TG、FPG 及lnFIns 呈正相关（r =0.616、0.452、0.529 和0.644，P <0.05）。FGF21 与ln（HOMA-IR）呈正 相关（r =0.752，P <0.05），SUA 与ln（HOMA-IR）呈正相关（r =0.537，P <0.05），SUA 与FGF21 呈正相关 （r =0.573，P <0.05）。FGF21 和ln（HOMA-IR）预测高尿酸血症的ROC 曲线下面积分别为0.850（95% CI ： 0.793，0.907）和0.914（95% CI ：0.868，0.960）。结论 在绝经高尿酸血症患者中HOMA-IR 水平明显上升 且伴随FGF21 水平升高。提示FGF21 水平升高与IR、高尿酸血症有密切关系，其可能参与IR 导致高尿酸血 症的病理过程，并对高尿酸血症的发生有预测作用。

Abstract:

Objective To investigate the relationship of both FGF21 and insulin resistance (IR) with serum uric acid (SUA) by measuring the changes of serum fibroblast growth factor21 (FGF21) and insulin resistance index (HOMA-IR) in postmenopausal women with hyperuricemia (HUA). Methods Totally 76 female patients with HUA were included in the HUA group and divided into high BMI group (n = 35) and normal BMI group (n = 41) according to body mass index(BMI) level. 80 healthy women were included in the control group. FGF21, SUA, HOMA-IR, fasting blood-glucose (FPG), Fasting insulin (FIns), blood lipids, blood pressure and other indicators were detected in HUA group and control group, respectively. Results BMI, Scr, SUA, TG, FGF21, FIns and HOMA-IR in HUA group were higher than those in control group. SUA, FGF21, FIns and HOMA-IR in high BMI group were higher than those in normal BMI group. FGF21 was positively correlated with BMI (r = 0.803) and TG (r = 0.472), FPG (r = 0.184), lnFIns (r = 0.747) (P < 0.05); there was a positive correlation between ln (HOMA-IR) and BMI (r = 0.616), TG (r = 0.452), FPG (r = 0.529), lnFIns (r = 0.644) (P < 0.05); there was a positive correlation between FGF21 and ln (HOMA-IR) (r = 0.752, P < 0.05), SUA and ln (HOMA-IR) (r = 0.537, P < 0.05), SUA and FGF21 (r = 0.573, P < 0.05), respectively. The area under the ROC curve of FGF21 and ln (HOMA-IR) were 0.850 and 0.914, respectively, both of which were greater than 0.5, and the difference was statistically significant (P < 0.05). Conclusion In menopausal women with HUA, IR significantly increases and is accompanied by an increase in the level of FGF21, which suggests that the level of FGF21 is associated with IR and HUA closely, and FGF21 may be involved in the pathophysiological process of HUA caused by IR and predicts the occurrence of HUA.