Zhongguo quanke yixue (May 2022)
Mediating Effect Analysis of Visceral Adiposity Index on Serum Uric Acid to Creatinine Ratio and Metabolic Syndrome in People with Normal Thyroid Function
Abstract
Background The yearly prevalence of metabolic syndrome (MS) is increasing in China. Although the level of serum uric acid (SUA) is closely related to MS, due to the influence of renal function on SUA, standardized SUA 〔SUA/serum creatinine ratio (SUA/Scr) 〕 may be a better predictor for MS. Visceral adiposity index (VAI) , as an important indicator for estimating visceral fat accumulation, could be used to predict MS more directly. However, few studies have explored whether VAI mediates the association between SUA/Scr ratio and MS in euthyroid population. Objective To explore the mediating effect of VAI on SUA/Scr ratio and MS in people with normal thyroid function. Methods A total of 10 042 annual health examinees were selected from the Health Examination Center, Hebei General Hospital from January 2020 to June 2021. The basic demographic information, physical examination and biochemical parameters, as well as calculated SUA/Scr ratio and VAI were collected. MS was diagnosed according to the criteria recommended by Chinese Diabetes Society. The risk of MS was analyzed by quartiles of SUA/Scr ratio (Q1-Q4 quartiles) , and VAI (V1-V4 quartiles) , respectively. Pearson correlation analysis was used to explore the association between SUA/Scr ratio and VAI. Multivariate Logistic regression analysis was used to explore the association of SUA/Scr ratio and VAI with MS. Bootstrap was used to explore whether VAI mediated the association between SUA/Scr ratio and MS. Results Of the 10 042 participants, 1 833 (18.25%) had MS and 8 209 (81.75%) did not. Pearson correlation analysis showed that SUA/Scr ratio was positively associated with VAI (P<0.05) . Multivariate Logistic regression analysis indicated that compared with Q1 group, the risk of MS significantly increased in Q2 group〔OR=1.310, 95%CI (1.039, 1.651) 〕, Q3 group〔OR=1.372, 95%CI (1.089, 1.729) 〕, and Q4 group〔OR=1.744, 95%CI (1.381, 2.203) 〕 (P<0.05) . Compared with V1 group, the risk of MS notably increased in V3 group〔OR=6.721, 95%CI (4.600, 9.819) 〕 and V4 group〔OR=33.327, 95%CI (21.509, 51.640) 〕 (P<0.01) . Mediating effect analysis indicated that SUA/Scr ratio significantly, directly influenced MS prevalence〔β=0.154, 95%CI (0.104, 0.205) 〕, and VAI partly mediated the indirect effect of SUA/Scr ratio on MS prevalence〔β=0.183, 95%CI (0.156, 0.213) 〕, and the mediating effect accounted for 54.25% of the total effects. Conclusion Both SUA/Scr ratio and VAI were predictors of MS, and VAI partly mediated the indirect effect of SUA/Scr ratio on MS prevalence in population with normal thyroid function.
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