Insulin resistance surrogate markers and risk of hyperuricemia among patients with and without coronary artery disease: a cross-sectional study

Zeinab Ghorbani; Seyedeh Nooshan Mirmohammadali; Nargeskhatoon Shoaibinobarian; Sara K Rosenkranz; Samira Arami; Azita Hekmatdoost; Marjan Mahdavi-Roshan

doi:10.3389/fnut.2023.1048675

Insulin resistance surrogate markers and risk of hyperuricemia among patients with and without coronary artery disease: a cross-sectional study

Front Nutr. 2023 Aug 21:10:1048675. doi: 10.3389/fnut.2023.1048675. eCollection 2023.

Authors

Zeinab Ghorbani^{1

2}, Seyedeh Nooshan Mirmohammadali³, Nargeskhatoon Shoaibinobarian⁴, Sara K Rosenkranz⁵, Samira Arami², Azita Hekmatdoost^{6

7}, Marjan Mahdavi-Roshan^{1

2}

Affiliations

¹ Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
² Department of Clinical Nutrition, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
³ Department of Food, Nutrition, Dietetics and Health, Kansas State University, Manhattan, KS, United States.
⁴ Department of Nutrition, School of Medical Sciences and Technologies, Islamic Azad University, Science and Research Branch, Tehran, Iran.
⁵ Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, Las Vegas, NV, United States.
⁶ Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁷ Department of Clinical Nutrition and Dietetics, National Nutrition and Food Technology Research Institute, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

Background: Although emerging evidence emphasizes the associations between both insulin resistance and hyperuricemia with coronary artery disease (CAD) risk, no definite relationship has yet been established. In this respect, time-efficient and affordable methods to estimate insulin resistance (IR) status, and to predict risk of hyperuricemia, are needed. Thus, the goal of this investigation was to examine the associations between IR, as assessed by novel surrogate markers [triglyceride-glucose (TyG) and TyG-body mass index (TyG-BMI)], and risk of hyperuricemia in patients with and without diagnosed CAD.

Methods: This cross-sectional study used data from the medical records of 1,170 patients who were referred to the cardiology outpatient clinic. Medical records, anthropometrics, and serum analytes were determined at the initial visit. Hyperuricemia was defined as serum uric acid ≥ 5.6 mg/dL. IR was estimated through surrogate markers (TyG and TyG-BMI). Multiple regression analysis was performed to assess the relationship between these indices and odds of hyperuricemia among patients with and without CAD.

Results: Overall, 814 angiographically-confirmed CAD cases (mean age (SD) = 52 (8)yrs) were compared with 356 patients without CAD (mean age (SD) = 48 (8)yr). There were positive associations between TyG and TyG-BMI indices and odds of hyperuricemia in CAD patients after controlling for confounders (adjusted odds ratio (aOR) = 1.60; 95%CI: 1.02-2.51; p-value = 0.036; and aOR = 1.83; 95%CI: 1.24-2.70; p-value = 0.002, third tertiles for TYG and TYG-BMI, respectively).

Conclusion: The present findings suggest that higher levels of the IR surrogate markers, TyG and TyG-BMI, are associated with higher odds of hyperuricemia in patients with CAD. However, given the cross-sectional design of this study, the sensitivity and specificity of these novel markers could not be determined for confirming the diagnosis of IR and hyperuricemia, further studies are needed to determine such outcomes and to confirm the current findings.

Keywords: coronary artery disease (CAD); hyperuricemia; insulin resistance; insulin sensitivity; triglyceride.