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Register a new userUric Acid Relationship with Noninsulin-Based Insulin Resistance Indices in Selected Metabolic Disorders: A Systematic Critical Review
علاقة حمض اليوريك مع مؤشرات مقاومة الأنسولين الغير المعتمدة على الانسولين في والاضطرابات ذات الصلة بالأيض : مراجعة نقدية منهجية
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يمتاز حمض اليوريك بأن له دور في التسبب في العديد من الاضطرابات الأيضية بما في ذلك مقاومة الأنسولين والاضطرابات المرتبطة بها. ان الهدف من هذا التقرير هو مراجعة الأدلة المتاحة التي تكشف عن الارتباط بين حمض اليوريك ومقاومة الانسولين والاضطرابات ذات الصلة عبر مؤشرات مقاومة الانسولين المعتمدة وغير المعتمدة على الانسولين. الطريقة: تم مسح الأدلة المنشورة باستخدام Google Scholar و PubMed بإدخال مصطلحات السمنة, حمض اليوريك, مقاومة الانسولين, متلازمة التمثيل الغذائي,سكري الحمل, ومتلازمة تكيس المبايض. النتائج: أظهر حمض اليوريك علاقات إيجابية كبيرة مع مقاومة الانسولين ، بالإضافة إلى السمنة ,متلازمة الأيض الغذائي, مرض السكري,سكري الحمل, ومتلازمة تكيس المبايض. من الواضح أن حمض اليوريك له دور في الإجهاد التأكسدي ، والخلل البطاني وتحريض الالتهاب الذي قد يسبب مقاومة الانسولين والتي تعد العامل الرئيسي في تطور متلازمة الأيض الغذائي والأمراض ذات الصلة. نموذج تقييم مقاومة الأنسولين المتجانس والمعتمد على الانسولين أظهر ارتباطا إيجابيا مع حمض اليوريك.علاوة على ذلك و على وجه التحديد ، نسبة الدهون الثلاثية إلى نسبة كوليسترول البروتين الدهني عالي الكثافة ,مؤشر السمنة الحشوية ، منتج تراكم الدهون ، مؤشر الدهون الثلاثية إلى جلوكوز الصائم والتي هي مؤشرات مقاومة انسولين غير معتمدة عليه أظهرت ارتباطات إيجابية مع حمض اليوريك.كما أظهرت نسبة متلازمة الأيض الغذائي الى مقاومة الانسولين ، والتي هي مؤشر مقاومة انسولين غير معتمد على الانسولين ارتباطات متناسبة بشكل كبير مع مكونات متلازمة الأيض الغذائي وكذلك مستوى حمض اليوريك.وقد كانت نسبة حمض اليوريك إلى نسبة كوليسترول البروتين الدهني عالي الكثافة مؤشراً إحصائياً واضحاً للتنبؤ بمتلازمة الأيض الغذائي ومرض السكري.كما أظهرحمض اليوريك ارتباطا إيجابيا بفرط انسولين الدم ومقاومة الانسولين في مرض ماقبل السكري. الخلاصة: يمكن أن يكون حمض اليوريك بإيجاز علامة كيميائية حيوية ناشئة للتنبؤ بحدوث مقاومة الانسولين ومتلازمة الأيض الغذائي والاضطرابات ذات الصلة. هناك ما يبرر توجيه المزيد من الدراسات المتعلقة بفرط حمض يوريك الدم من كونها مترابطة إلى آلية
Uric acid (UA) has a role in pathogenesis of several metabolic abnormalities including insulin resistance (IR) and their related disorders. The aim of this report is to review the available evidences that reveal the association between UA, IR and related disorders via both noninsulin and insulin-based IR indices. METHODS: The published literature was surveyed using Google Scholar and PubMed entering the terms Obesity, UA, IR, Metabolic Syndrome (MetS), Gestational Diabetes (GDM), Polycystic Ovarian Syndrome (PCOS). RESULTS: UA had substantial positive relationships with IR, as well as obesity, MetS, DM, GDM, and PCOS. Evidently UA with a role in oxidative stress, endothelial dysfunction and induction of inflammation may cause IR in totality, the major factor in development of MetS and related diseases. Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), insulin based IR index, correlated positively with UA. Moreover, specifically triglyceride to high density lipoprotein cholesterol ratio (TG/HDL-C), visceral adiposity index (VAI), lipid accumulation product (LAP), triglyceride to fasting glucose (TyG) index are noninsulin-based IR indices of positive correlations with UA. MetS score for IR (MetS-IR), a non-insulin based IR index, had significantly proportional correlations with MetS components as well as UA level. UA to HDL-cholesterol ratio (UHR) was a pronounced statistical predictor of MetS and diabetes control. UA positively associated with hyperinsulinemia and IR in prediabetes. CONCLUSION: Succinctly UA can be an emerging biochemistry marker of predictive role in IR, MetS and related anomalies. More hyperuricemia related studies are warranted to be oriented from being correlational to mechanistic
References used
Ali N., Perveen R., Rahman S., Mahmood S., Rahman S., Islam S., Haque T., Sumon A.H., Kathak R.R., Molla N.H. and Islam F. Prevalence of hyperuricemia and the relationship between serum uric acid and obesity: A study on Bangladeshi adults. PLoS One. 2018; 13: e0206850.
Bandaru P. and Shankar A. Association between serum uric acid levels and diabetes mellitus. International Journal of Endocrinology. 2011;
Babikr W.G, Elhussein A.B., Abdelraheem A., Magzoub A., Mohamed H. and Alasmary M. The Correlation of Uric Acid Levels with Glycemic Control in Type II Diabetic Patients. Biomedical and Pharmacology Journal. 2016; 9:1005-8
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