Association of the uric acid to albumin ratio with early glycemic disturbances beyond conventional OGTT criteria
摘要
Conventional interpretation of the oral glucose tolerance test (OGTT) relies on fasting and 2-hour plasma glucose values and may not fully reflect early disturbances in glucose metabolism. Intermediate OGTT time points, particularly 1-hour and peak glucose levels, have been associated with early alterations in insulin sensitivity and β-cell function. The uric acid-to-albumin ratio (UAR) has been proposed as a composite metabolic marker; however, its relationship with OGTT-derived glycemic dynamics remains unclear.
MethodsIn this retrospective observational study, 1,097 adults undergoing a standard 75-g OGTT were included. Glycemic status was classified according to ADA criteria. Intermediate hyperglycemia was primarily defined as a 60-minute plasma glucose ≥ 155 mg/dL, based on previously reported risk-associated thresholds. UAR was calculated from serum uric acid and albumin levels. Associations between UAR and glycemic parameters were evaluated using correlation analyses and multivariable logistic regression models adjusted for age, sex, BMI, renal function, and lipid parameters. Multivariable analyses were performed in a complete-case subset of participants with available covariate data (n = 378).
ResultsIndividuals with intermediate hyperglycemia (60-minute glucose ≥ 155 mg/dL) had higher UAR levels compared with those without such abnormalities (p < 0.001). UAR showed significant correlations with OGTT-derived parameters, including glucose excursion, time to peak glucose, and OGTT area under the curve. In multivariable analyses, UAR was not independently associated with prediabetes (p = 0.228), but remained independently associated with 60-minute glucose ≥ 155 mg/dL (OR 1.13 per 0.1-unit increase, 95% CI 1.03–1.24; p = 0.006). Discriminative performance for prediabetes was modest (AUC = 0.62).
ConclusionsUAR is associated with intermediate glycemic abnormalities during OGTT in this cohort. While not a standalone diagnostic marker, it may provide complementary metabolic information in relation to early OGTT-derived disturbances. Further prospective studies are required to clarify its potential role in early dysglycemia.