目的 探讨高尿酸血症对对空腹血糖受损前期合并肥胖患者炎症因子、代谢指标及血管损伤的影响。方法 选取昆明医科大学附属延安医院2019年1月至2023年6月老年高尿酸血症（HUA）患者180例,依据空腹血糖测定结果分为正常空腹血糖组、早期空腹血糖受损组（pre-IFG）组、空腹血糖受损（IFG）组,每组60例,每个组别根据体质量指数（BMI）再分为正常体重亚组,超重亚组和肥胖亚组,测定炎症因子、胰岛素抵抗（HOMA-IR）、代谢指标、血管内皮功能及IMT等指标后进行对比。采用Pearson相关性分析法检验尿酸与炎症因子、HOMA-IR、血管内皮功能、IMT的相关性,构建多元Logistic回归分析模型检验其危险因素。结果 正常空腹血糖组、pre-IFG组、IFG组的炎症因子、HOMA-IR、代谢指标、血管内皮功能、IMT比较差异有统计学意义（P<0.05）;正常空腹血糖组、pre-IFG组、IFG组内正常体重亚组、超重亚组、肥胖亚组的炎症因子[C反应蛋白（CRP）、白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）]、HOMA-IR、代谢指标[总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）]、血管内皮功能[一氧化氮（NO）、内皮素-1（ET-1）、肱动脉血管内径（D0）]以及IMT比较,差异均有统计学意义（P<0.05）;Pearson相关性分析结果显示,BMI与IMT相关（P<0.05）;多元Logistic回归分析结果显示,NO为IMT的保护性因素（P<0.05）,CRP、ET-1、IL-1β、IL-6、HOMA-IR为IMT的危险因素（P<0.05）。结论 HUA可加剧糖代谢异常合并肥胖患者的炎症反应,导致代谢指标恶化,并增加血管损伤的风险,在临床实践中应重视HUA的管理,以降低患者的心血管疾病风险。

Objective To investigate the influence of hyperuricemia on inflammatory factors, metabolic indexes and vascular injury in patients with pre impaired fasting blood glucose complicated with obesity. Methods A total of 180 elderly patients with hyperuricemia (HUA) from Yan 'an Hospital Affiliated to Kunming Medical University from January 2019 to June 2023 were selected and divided into normal fasting blood glucose group, early impaired fasting blood glucose group (pre-IFG) and impaired fasting blood glucose group (IFG) according to the fasting blood glucose test results. Each group had 60 cases in each group, and each group was further divided into normal weight subgroup, overweight subgroup and obesity subgroup based on body mass index (BMI). Inflammatory factors, insulin resistance (HOMA-IR), metabolic indicators, vascular endothelial function and IMT were measured. Pearson correlation analysis was used to examine the correlation between uric acid and inflammatory factors, HOMA-IR, vascular endothelial function, and IMT, and a multiple Logistic regression analysis model was constructed to examine its risk factors. Results There were statistically significant differences in inflammatory factors, HOMA-IR, metabolic indicators, vascular endothelial function and IMT among normal FPG group, pre-IFG group and IFG group (P<0.05). Inflammatory factors [C-reactive protein (CRP), interleukin-1β (IL-1 β), interleukin-6 (IL-6)], HOMA-IR, metabolic indicators [total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C)], vascular endothelial function [nitric oxide (NO), endothelin-1 (ET-1), brachial artery diameter (D0)] and IMT revealed statistical differences among normal weight subgroup, overweight subgroup and obesity subgroup in normal FPG group, pre-IFG group and IFG group (P<0.05). Pearson correlation analysis results showed that BMI was correlated with IMT (P<0.05). Multiple Logistic regression analysis showed that NO was a protective factor for IMT (P<0.05), while CRP, ET-1, IL-1 β, IL-6 and HOMA-IR are risk factors for IMT (P<0.05). Conclusions HUA can aggravate the inflammatory response of patients with abnormal glucose metabolism and obesity, lead to the deterioration conditions of metabolic indicators, and increase the risk of vascular injury. In clinical practice, it is necessary to pay attention to the management of HUA to reduce the risk of cardiovascular disease in patients.