ZHANG Xuan-e,GU Lei,ZHANG Xiao-yan,et al.Associations of lipid accumulation product, visceral adiposity index with serum uric acid levels in middle-aged and elderly people[J].同济大学学报（医学版）,2020,41(2):185-191. [点击复制]
(Dept. of Endocrinology, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, China)
ObjectiveTo investigate the association of serum uric acid(SUA）with lipid accu-mulation product(LAP）and visceral fat index(VAI)，and to evaluate the effectiveness of LAP and VAI in predicting hyperuricemia(HUA). MethodsTotal 868 middle-aged and elderly residents from Shanghai Yangpu community were recruited in this cross-section study. The subjects were divided into quartile groups according to serum uric acid level. The difference of body mass index(BMI), waist circumference(WC), hip circumference(HC), waist to hip ratio(WHR), systolic blood pressure(SBP), diastolic blood pressure(DBP), fasting plasma glucose(FPG), 2-h postprandial glucose(2hPG), fasting insulin(FINS), 2-h postprandial insulin(2hINS), total cholesterol(TC), high-density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), triglycerides(TG), serum creatinine(Cr), HOMA insulin resistance index(HOMA-IR), HOMA insulin sensitivity index(HOMA-ISI), LAP and VAI were compared in these 4 groups. Multivariate Logistic regression analysis was used to screen the variables closely related to hyperuricemia(HUA). The diagnostic value for HUA was evaluated by receiver operating character curve(ROC）analysis. ResultsWith the elevation of quartile levels of serum uric acid, the HOMA-IR increased(P<0.05), HOMA-ISI declined(P<0.001), LAP and VAI also increased gradually(all P<0.01). Serum uric acid level showed a significant positive correlation with body weight, BMI, WC, HC, WHR, DBP, SBP, FINS, 2hINS, HOMA-IR, TG, Cr, LAP and VAI, and a significant negative correlation with TC, HDL-C and HOMA-ISI(all P<0.05). After adjusting for gender, age, smoking, drinking, blood pressure, blood glucose, insulin, blood lipid, creatinine and other potential confounder，the risks of HUA in 3rd and 4th quantile of LAP group were increased relative to 1st quantile group(OR=3.164, 95%CI：1.62-6.18 and OR=4.131, 95%CI：1.913-8.921，respectively)；and the risk of HUA in 3rd and 4th quantile of VAI group were increased relative to 1st quantile group(OR=2.22, 95%CI：1.197-4.115 and OR=3.955, 95%CI：2.159-7.245，respectively). The area under the ROC curve(AUC）of LAP and VAI in prediction of hyperuricemia were 0.673（95%CI：0.630-0.716, P<0.001）and 0.645(95%CI：0.599-0.691, P<0.001）respectively. The combination of VAI, LAP with HOMA-IR can better identify the risk of hyperuricemia in female population. ConclusionLAP and VAI are closely related to serum uric acid level. They are independent risk factors of HUA and may predict the occurrence of HUA.