FEATURES OF INSULIN RESISTANCE ASSESSMENT IN PATIENTS WITH TYPE 2 DIABETES MELLITUS WITH HYPERURICEMIA

Topicality. The link between hyperuricemia (HUA) and insulin resistance (IR) has been established in many studies, but the traditional «insulin» indices used to assess the severity of IR, although there are the most informative, sensitive and specific, have not been widely used in clinical practice. The aim of the research is to evaluate the possibility to use calculated «non-insulin» indices in clinical practice to assess IR in patients with type 2 diabetes (T2DM) with HUA. Materials and methods. We examined 395 patients with type 2 diabetes (231 women and 164 men) aged 39 to 81 years, the average — (54.6 ± 12.9) years, who received oral hypoglycemic therapy. Anthropometric indicators were determined — waist circumference (WC) and body mass index (BMI). The author determined the level of fasting blood glucose in capillary blood by glucose oxidase method, the concentration of uric acid (SUA) in the serum, the level of high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) — by colorimetric method; immunoreactive insulin — by immunochemiluminescent method. The IR severity was assessed by indices HOMA-IR, QUICKI, Caro, visceral obesity index (AVI), triglyceride-glucose index (TyG-index), TyG-BMI index, TyG-WC index, metabolic index (MI) and the ratio of TG/cholesterol-HDL (TG/HDL-C-ratio). Statistical analysis of the obtained data was performed using the software package «Statgraphics Plus for Windows 10.0». Results. Between groups of patients with T2DM on the concentration of SUA in the blood the author found significant differences in WC, BMI and TG level, which affected the calculated «non-insulin» indices: AVI (P = 0.026), TyG-index (P = 0.04), TyG-BMI-index (P = 0.001), TyG-WC index (P = 0.037) and MI (P = 0.03). A positive correlation between HOMA-IR and MI (rs = 0.44, P = 0.0006) and AVI (rs = 0.28, P = 0.01) was established;  QUICKI with MI (rs = 0.32, P = 0.012), TyG-index (rs = 0.29, P = 0.02), TyG-BMI index (rs = 0.25, P = 0.04), TyG-WC index (rs = 0.34, P = 0.004) and AVI (rs = 0.31, P = 0.01). It has been determined that the Caro index at the trend level positively correlates with the TyG-index (rs = 0.23, P = 0.065). Among the studied calculated «non-insulin» indices in patients with T2DM with the concentration of SUA in the blood are significantly associated with TyG-index (rs = 0.19; P = 0.0034), TyG-BMI index (rs = 0.43; P = 0.0001), TyG-WC index (rs = 0.44; P = 0.00001), MI (rs = -0.17; P = 0.012) and TG/HDL-C-ratio (rs = 0.15); P = 0.011). Conclusions. the author established a positive correlation between HOMA-IR and MI and AVI in patients with T2DM with SUA; QUICKI with MI, TyG-index, TyG-BMI-index, TyG-WC-index and AVI. Among the calculated «non-insulin» IR indices with the concentration of SUA in patients with T2DM are significantly associated with TyG-index, TyG-BMI-index, TyG-WC-index, MI and TyG/HS-HDL. To adequately assess the severity of IR in patients with T2DM with HUA, it is advisable to use TyG-index, TyG-BMI-index, TyG-WC-index, MI and TG/HS-HDL.