摘要目的:探究正常糖代谢人群血尿酸（SUA）水平与胰岛素原（PI）的关系，评估SUA对早期胰岛β细胞功能的影响。方法:收集2018年4至12月于海南省海口市和万宁市经75 g口服葡萄糖耐量试验确认的999例糖代谢正常的成年人，其中男337例，女662例，平均年龄（44.45±12.97）岁。所有受试者均接受问卷调查，并检测SUA、空腹血糖、空腹胰岛素等生化指标。采用空腹PI（FPI）、FPI/胰岛素比值（FPI/I）评估胰岛β细胞功能，稳态模型评估胰岛素抵抗指数（HOMA-IR）评估胰岛素抵抗程度。将受试者根据SUA水平四分位分为4组：组1（SUA<283 μmol/L，246例），组2（283 μmol/L≤SUA<336 μmol/L，249例），组3（336 μmol/L≤SUA<400 μmol/L，253例）和组4（SUA≥400 μmol/L，251例），各组间临床指标的差异采用方差分析和秩和检验进行比较。运用多重线性回归模型分析SUA对胰岛β细胞功能指标的影响。结果:共有190例被诊断为高尿酸血症，其中男性159例，女性31例。高尿酸水平组（组4）FPI、FPI/I明显高于低尿酸水平组（组1）［13.43（13.34）和9.26（7.96）pmol/L；0.25（0.20）和0.19（0.20），均 P<0.01］。校正年龄、性别、体质指数、腰围、空腹血糖、空腹胰岛素、HOMA-IR等干扰因素后，多重线性回归分析显示，SUA仍与FPI水平呈正相关（ β=0.013， P<0.01）。SUA每升高100 μmol/L，总体受试者FPI平均升高1.3 pmol/L。性别分层后，无论男女亚组在校正各类混杂因素后，SUA仍与FPI呈正相关（男性 β=0.014， P<0.05；女性 β=0.010， P<0.01），而和FPI/I无明显相关性（ P>0.05）。 结论:糖代谢正常人群SUA和FPI呈线性正相关，应及早关注高尿酸血症患者早期胰岛β细胞功能变化。

abstractsObjective:To investigate the relationship between serum uric acid (SUA)levels and proinsulin (PI) in subjects with normal glucose metabolism.Methods:A total of 999 adults with normal glucose metabolism confirmed by 75 g oral glucose tolerance test in Haikou City and Wanning City of Hainan Province from April to December 2018 were collected, including 337 males and 662 females with an average age of (44.45±12.97) years. All subjects received questionnaire survey, and their SUA, fasting blood glucose level, fasting insulin level and other laboratory parameters were detected. Fasting PI (FPI) and FPI to insulin ratio (FPI/I) were used to evaluate islet β cell function, and homeostasis model assessment of insulin resistance (HOMA-IR) was used to assess insulin resistance level. According to SUA quartiles, the subjects were divided into four groups: group 1 (SUA<283 μmol/L, n=246), group 2 (283 μmol/L≤SUA<336 μmol/L, n=249), group 3 (336 μmol/L≤SUA<400 μmol/L, n=253) and group 4 (SUA≥400 μmol/L, n=251). The clinical indexes between different groups were compared with analysis of variance and rank sum test. Additionally, multiple linear regression analysis was performed to investigate the effect of SUA on islet β cell function. Results:A total of 190 people were diagnosed with hyperuricemia, including 159 males and 31 females. Theβ cell function indexes in patients with higher SUA level (group 4), including FPI and FPI/I, were higher than those in patients with lower SUA level (group 1) [13.43 (13.34) vs 9.26 (7.96) pmol/L; 0.25 (0.20) vs 0.19 (0.20), both P<0.01]. Multiple linear regression analysis showed that the plasma SUA level was linearly related to FPI level even after adjusting for age, gender, body mass index, waist circumference, fasting plasma glucose, fasting insulin and HOMA-IR ( β=0.013, P<0.01). For every 100 μmol/L increase in SUA, FPI increased by 1.3 pmol/L on average in all subjects. However, when analyzed in gender-specific subgroups, the SUA level was still linearly correlated with FPI but not with FPI/I after adjustment for potential confounding factors (male β=0.014, P<0.05; female β=0.010, P<0.01). Conclusion:There is a positive linear correlation between SUA and FPI in patients with normal glucose metabolism. We should pay attention to the early changes of islet β cell function in hyperuricemia patients