Association Analysis of Serum Uric Acid and Insulin Resistance in Patients with Recurrent Spontaneous Abortion
Objective:To investigate the association between serum uric acid(UA)levels and insulin resistance(IR)in patients with recurrent spontaneous abortion(RSA).Methods:Using a cross-sectional design,771 pa-tients with RSA who attended the outpatient clinic of the Second Hospital of Lanzhou University from September 1,2019 to February 28,2022 were selected and classified into a hyperuricemia group(HUA)and a non-HUA group.The clinical characteristics of the two groups were compared.Univariate and multivariate Logistic regres-sion were used to analyze the influencing factors of the occurrence of IR in patients with RSA,as well asthe corre-lation between serum UA levels and IR.Related indicators were analyzed by stratified and interaction tests.Re-sults:①There were statistically significant differences(P＜0.05)in the proportion of residence,BMI,triglycerides(TG),total cholesterol(TC),and high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),aspartate aminotransferase(AST),alanine aminotransferase(ALT),and related glycemic indices.②Univariate Logistic regression analysis showed that BMI,HDL-C,TG,ALT,LDL-C,and UA levels were related fac-tors affecting the occurrence of IR(P＜0.05).③Multifactorial Logistic regression analysis showed that after ad-justing for all confounders(Model 2),the risk of IR increased by 4％with each 10 μmol/L increase in serum UA in patients with RSA(OR 1.04,95％Cl 1.02-1.07).Sensitivity analysis showed that in model 2,the risk of IR was significantly increased in the medium and high UA groups compared to the low UA group(OR＞1,P＜0.05).The results obtained from the continuous variable of serum UA were consistent with the P-value of the trend test after grouping.④Stratified analysis showed that in RSA patients with age≥30 years,BMI≥24 kg/m2,high school edu-cation or less,living in a rural area,Han ethnicity,the number of abortions≥4,higher TG and ALT values,and low-er LDL-C values and HDL-C values,the association between HUA with IR was stronger.No interaction was ob-served in the subgroups(P＞0.05).Conclusions:The risk of IR increases with increasing UA levels in patients with RSA,and HUA contributes to the development of IR,especially in special populations(age≥30 years,BMI≥24 kg/m2,rural residence,number of miscarriages≥4,elevated TG and ALT,and lowered LDL-C and HDL-C).
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