痛风系列颗粒对原发性痛风患者胰岛素抵抗的影响

作者	单位
张明	上海中医药大学附属岳阳中西医结合医院痛风专科
王金锋	上海中医药大学附属岳阳中西医结合医院痛风专科
王一飞	上海中医药大学附属岳阳中西医结合医院痛风专科
周敏	上海中医药大学附属岳阳中西医结合医院痛风专科
李斌	上海中医药大学附属岳阳中西医结合医院痛风专科

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中文摘要:

目的探讨原发性痛风与胰岛素抵抗(insulin-resistance,IR)之间的相关性,观察痛风系列颗粒对原发性痛风患者IR的影响。方法原发性痛风患者和同期健康体检者各60例,分别检测两组人群血压(BP)、血尿酸(sUA)、空腹血糖(FPG)、空腹血胰岛素(FINS)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血瘦素(FL)、C肽(CP)、体重指数(BMI)、腰臀比(WHR)、胰岛素抵抗指数(IRI)和胰岛素敏感指数(ISI)等指标,进行Pearson相关性分析和多元逐步回归分析。将60例原发性痛风患者随机分为治疗组和对照组,每组各30例,治疗组给予虎杖痛风颗粒、茵连痛风颗粒治疗,对照组给予双氯芬酸钠双释放胶囊、苯溴马隆片治疗;并于治疗12周后评价两组患者上述指标的变化。结果原发性痛风患者sUA、FPG、TC、TG、LDL-C、FINS、CP、FL和IRI、BMI、WHR均高于健康志愿者(P<0.05),而HDL-C、ISI低于健康志愿者(P<0.05)。Pearson相关分析显示,sUA与FPG、FINS、IRI、BMI、TC、TG、LDL-C、CP、FL、收缩压(SBP)、舒张压(DBP)之间呈正相关(r分别为0.444,0.496,0.660,0.542,0.414,0.467,0.344,0.470,0.419,0.275,0.330,P<0.05),而与ISI(取对数)、HDL-C呈负相关(r分别为-0.569,-0.264,P<0.05)。以sUA为因变量进行多元逐步回归分析结果显示,sUA与IRI、TG和BMI仍呈正相关(r分别为5.758,2.849,3.425,P<0.05)。治疗12周后,治疗组在TC、TG、FINS、FPG、IRI降低幅度和HDL-C、ISI增高幅度方面优于对照组(P<0.05)。结论原发性痛风患者胰岛素敏感性降低,存在IR;痛风系列颗粒具有一定的增强胰岛素敏感性和改善IR的作用。

英文摘要:

Objective To clarify the correlation between primary gout and insulin-resistance(IR),and to observe the effect of serial Gout Granules(SGGs) on IR in patients with primary gout.Methods Pearson′s correlation analysis and multiple stepwise correlation analysis were conducted between 60 patients and 60 healthy volunteers in terms of blood pressure(BP),blood levels of uric acid(sUA),fasting plasma glucose(FPG),fasting insulin(FINS),fasting leptin(FL),triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),and C-peptide(CP),body mass index(BMI),waist-to-hip ratio(WHR),insulin resistance index(IRI) and insulin sensitivity index(ISI).Besides,the 60 primary gout patients were equally randomized into two groups,the treatment group treated with SGGs(Huzhang Gout Granule and Yinlian Gout Granule),and the control group treated with Diclofenac Sodium Dual Release Enteric-coated capsules and Benzbromarone.Above-mentioned indexes in them were assessed before and after 12 weeks of treatment.Results The levels of sUA,FPG,TC,TG,LDL-C,FINS,CP,FL,IRI,BMI,and WHR were higher while the levels of HDL-C and ISI was lower in gout patients than those in healthy controls(all P<0.05);Pearson′s correlation analysis showed that level of sUA was positively correlated with levels of FPG,FINS,IRI,BMI,TC,TG,LDL-C,CP,FL,systolic pressure and diastolic pressure(r=0.444,0.496,0.660,0.542,0.414,0.467,0.344,0.470,0.419,0.275,0.330 respectively,P<0.05),but negatively correlated with levels of ISI and HDL-C(r=-0.569,-0.264 respectively,P<0.05).Multiple stepwise correlation analysis showed that sUA was also positively correlated with IRI,TG and BMI(r=5.758,2.849,3.425 respectively,P<0.05).After 12 weeks of treatment,the lowed range of TC,TG,FINS,FPG and IRI,and the increased amplitude of HDL-C and ISI in the treatment group were superior to those in the control group respectively(P<0.05).Conclusion Patients with primary gout are low in insulin sensitivity and indicating the existence of IR.SGGs could enhance patients′ insulin sensitivity and improve IR to a certain extent.

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