中国全科医学 ›› 2022, Vol. 25 ›› Issue (15): 1850-1856.DOI: 10.12114/j.issn.1007-9572.2022.02.028

• 论著 • 上一篇    下一篇

内脏脂肪指数在甲状腺功能正常人群血尿酸/血肌酐比值与代谢综合征发生风险间的中介效应研究

刘焕欣1, 孟翠巧1, 聂倩1, 于春红1, 邢煜铃2, 王忠丽1, 刘承浩1, 马慧娟3,4,*()   

  1. 1. 050051 河北省石家庄市,河北省人民医院体检中心
    2. 050017 河北省石家庄市,河北医科大学研究生学院
    3. 050051 河北省石家庄市,河北省人民医院代谢病重点实验室
    4. 050051 河北省石家庄市,河北省人民医院内分泌科
  • 收稿日期:2021-11-26 修回日期:2022-02-13 出版日期:2022-03-17 发布日期:2022-04-07
  • 通讯作者: 马慧娟
  • 刘焕欣,孟翠巧,聂倩,等.内脏脂肪指数在甲状腺功能正常人群血尿酸/血肌酐比值与代谢综合征发生风险间的中介效应研究[J].中国全科医学,2022,25(15):1850-1856.[www.chinagp.net]
    作者贡献:刘焕欣、马慧娟提出研究思路,对文章整体负责,监督管理;刘焕欣、孟翠巧、聂倩、于春红进行指标数据收集;邢煜铃进行数据处理;刘焕欣、孟翠巧进行论文撰写,并绘制图表;马慧娟进行论文的修订;王忠丽、刘承浩负责文章的质量控制及审校。
  • 基金资助:
    河北省医学科学研究重点课题计划(20211202)

Mediating Effect Analysis of Visceral Adiposity Index on Serum Uric Acid to Creatinine Ratio and Metabolic Syndrome in People with Normal Thyroid Function

Huanxin LIU1, Cuiqiao MENG1, Qian NIE1, Chunhong YU1, Yuling XING2, Zhongli WANG1, Chenghao LIU1, Huijuan MA3,4,*()   

  1. 1. Health Examination Center, Hebei General Hospital, Shijiazhuang 050051, China
    2. Graduate School, Hebei Medical University, Shijiazhuang 050017, China
    3. Hebei Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang 050051, China
    4. Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050051, China
  • Received:2021-11-26 Revised:2022-02-13 Published:2022-03-17 Online:2022-04-07
  • Contact: Huijuan MA
  • About author:
    LIU H X, MENG C Q, NIE Q, et al. Mediating effect analysis of visceral adiposity index on serum uric acid to creatinine ratio and metabolic syndrome in people with normal thyroid function[J]. Chinese General Practice, 2022, 25 (15) : 1850-1856.

摘要: 背景 我国代谢综合征(MS)患病率逐年升高,血尿酸(SUA)水平与MS的发生密切相关,由于SUA受肾功能影响,采用标化SUA〔SUA/血肌酐比值(SUA/Scr)〕可更好地预测MS。内脏脂肪指数(VAI)是衡量内脏脂肪蓄积程度的重要指标,可更直接地预测MS的发生风险。但目前在甲状腺功能正常人群中,关于VAI是否介导SUA/ Scr与MS关联的研究较少。 目的 探讨VAI在甲状腺功能正常人群中SUA/Scr与MS发生风险间的中介效应。 方法 选取2020年1月至2021年6月于河北省人民医院体检中心进行年度体检的10 042例体检人群。收集研究对象的基本信息,并进行体格检查和生化检测,计算SUA/Scr和VAI。采用中华医学会糖尿病学分会制定的标准诊断MS。将研究对象分别按照SUA/Scr水平四分位数和VAI四分位数,各分为4组:Q1~Q4组和V1~V4组。采用Pearson相关分析探究SUA/Scr与VAI的相关性;多因素Logistic回归分析探讨SUA/Scr和VAI对MS发生的影响;采用bootstrap方法分析VAI是否介导SUA/Scr与MS之间的关联。 结果 10 042例研究对象中,MS患者1 833例(18.25%),非MS患者8 209例(81.75%)。Pearson相关分析结果显示,SUA/Scr与VAI呈正相关(P<0.05)。多因素Logistic回归分析结果显示,与Q1组相比,Q2组〔OR=1.310,95%CI(1.039,1.651)〕、Q3组〔OR=1.372,95%CI(1.089,1.729)〕、Q4组〔OR=1.744,95%CI(1.381,2.203)〕人群发生MS的风险增加(P<0.05);与V1组相比,V3组〔OR=6.721,95%CI(4.600,9.819)〕、V4组〔OR=33.327,95%CI(21.509,51.640)〕人群MS的发病风险增加(P<0.01)。中介效应分析表明,SUA/Scr对MS发病率具有直接影响〔β=0.154,95%CI(0.104,0.205)〕,并且VAI部分介导了SUA/Scr对MS发病率的影响〔β=0.183,95%CI(0.156,0.213)〕,中介效应占总效应的54.25%。 结论 甲状腺功能正常人群SUA/Scr和VAI是MS发生风险的预测指标,VAI部分介导了SUA/Scr对MS发病率的影响。

关键词: 代谢综合征, 内脏脂肪指数, 血尿酸, 血肌酐, 甲状腺功能, 中介效应

Abstract:

Background

The yearly prevalence of metabolic syndrome (MS) is increasing in China. Although the level of serum uric acid (SUA) is closely related to MS, due to the influence of renal function on SUA, standardized SUA 〔SUA/serum creatinine ratio (SUA/Scr) 〕 may be a better predictor for MS. Visceral adiposity index (VAI) , as an important indicator for estimating visceral fat accumulation, could be used to predict MS more directly. However, few studies have explored whether VAI mediates the association between SUA/Scr ratio and MS in euthyroid population.

Objective

To explore the mediating effect of VAI on SUA/Scr ratio and MS in people with normal thyroid function.

Methods

A total of 10 042 annual health examinees were selected from the Health Examination Center, Hebei General Hospital from January 2020 to June 2021. The basic demographic information, physical examination and biochemical parameters, as well as calculated SUA/Scr ratio and VAI were collected. MS was diagnosed according to the criteria recommended by Chinese Diabetes Society. The risk of MS was analyzed by quartiles of SUA/Scr ratio (Q1-Q4 quartiles) , and VAI (V1-V4 quartiles) , respectively. Pearson correlation analysis was used to explore the association between SUA/Scr ratio and VAI. Multivariate Logistic regression analysis was used to explore the association of SUA/Scr ratio and VAI with MS. Bootstrap was used to explore whether VAI mediated the association between SUA/Scr ratio and MS.

Results

Of the 10 042 participants, 1 833 (18.25%) had MS and 8 209 (81.75%) did not. Pearson correlation analysis showed that SUA/Scr ratio was positively associated with VAI (P<0.05) . Multivariate Logistic regression analysis indicated that compared with Q1 group, the risk of MS significantly increased in Q2 group〔OR=1.310, 95%CI (1.039, 1.651) 〕, Q3 group〔OR=1.372, 95%CI (1.089, 1.729) 〕, and Q4 group〔OR=1.744, 95%CI (1.381, 2.203) 〕 (P<0.05) . Compared with V1 group, the risk of MS notably increased in V3 group〔OR=6.721, 95%CI (4.600, 9.819) 〕 and V4 group〔OR=33.327, 95%CI (21.509, 51.640) 〕 (P<0.01) . Mediating effect analysis indicated that SUA/Scr ratio significantly, directly influenced MS prevalence〔β=0.154, 95%CI (0.104, 0.205) 〕, and VAI partly mediated the indirect effect of SUA/Scr ratio on MS prevalence〔β=0.183, 95%CI (0.156, 0.213) 〕, and the mediating effect accounted for 54.25% of the total effects.

Conclusion

Both SUA/Scr ratio and VAI were predictors of MS, and VAI partly mediated the indirect effect of SUA/Scr ratio on MS prevalence in population with normal thyroid function.

Key words: Metabolic syndrome, Visceral adiposity index, Serum uric acid, Serum creatinine, Thyroid function, Mediating effect