Effect and predictive value of serum uric acid level and homeostasis model assessment of insulin resistance index on new-onset atrial fibrillation in patients with metabolic syndrome
- Author:
- No author available
- Journal Title:
- China Medicine
- Issue:
- 2
- DOI:
- 10.3760/j.issn.1673-4777.2023.02.007
- Key Word:
- 代谢综合征;心房颤动;血尿酸;稳态模型胰岛素抵抗指数;巢式病例对照研究
Abstract： 目的 探讨血尿酸水平和稳态模型胰岛素抵抗指数(HOMA-IR)对代谢综合征(MS)患者新发心房颤动的影响及预测价值.方法 本研究采用巢式病例对照研究设计,基于回顾性MS队列.收集2015 年1 月至2016 年12 月于黑龙江中医药大学附属第一医院就诊的MS患者,筛选基线调查起5 年内新发心房颤动的病例285 例为心房颤动组;匹配未发生心房颤动的病例570 例为对照组.收集2 组患者基线资料,分析基线资料的组间差异;通过构建Logistic回归模型并校正混杂因素,分析血尿酸水平和HOMA-IR与MS患者新发心房颤动的关系;通过受试者工作特征(ROC)曲线进行预测价值分析.结果 心房颤动组的血尿酸水平和HOMA-IR均高于对照组,差异均有统计学意义(均P<0.05);血尿酸和HOMA-IR为MS患者新发心房颤动的独立影响因子(均P<0.05).将血尿酸和HOMA-IR分别按照四分位数(Q1、Q2、Q3、Q4)分层,构建Logistic回归模型.校正全部混杂因素后,血尿酸Q2、Q3、Q4 分层新发心房颤动的风险分别为Q1 分层的1.752、3.040、4.281 倍,HOMA-IR Q3、Q4 分层新发心房颤动的风险分别为Q1 分层的 1.922、2.403 倍.血尿酸、HOMA-IR及二者联合预测MS患者新发心房颤动的 ROC曲线下面积(AUC)分别为0.757、0.714、0.828;二者联合预测新发心房颤动的AUC高于单一指标(均P<0.05).结论 在MS人群中,血尿酸水平和HOMA-IR是新发心房颤动的独立影响因子,且新发心房颤动的风险与血尿酸水平和HOMA-IR呈正相关;血尿酸水平和HOMA-IR对新发心房颤动均有良好的预测价值,且二者联合对新发心房颤动的预测价值更高.
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