Association between the glucose-lipid metabolism 7-factor index and hyperuricemia in patients with type 2 diabetes: a retrospective study

Abstract

The glucose-lipid metabolism 7-factor index (GLM7) is a composite metabolic index that integrates age, body mass index, fasting blood glucose, insulin, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. However, the specific correlation between this index and hyperuricemia (HUA) in patients with type 2 diabetes (T2DM) has not been clarified to date. This study investigated the association between GLM7 and HUA, and evaluated the discriminatory performance of this index in hospitalized patients with T2DM. This retrospective cross-sectional study enrolled 959 patients with T2DM admitted to the First Affiliated Hospital of Harbin Medical University between January and December 2024. GLM7 was calculated based on routinely collected clinical and biochemical indicators. HUA was defined in accordance with established serum uric acid (SUA) criteria. Multivariable logistic regression and linear regression models were constructed respectively to analyze the associations of GLM7 with HUA and SUA. Restricted cubic spline (RCS) analysis was conducted to identify the specific pattern of the association. Receiver operating characteristic (ROC) curve analysis was applied to evaluate the discriminatory performance of GLM7. Incremental discriminatory capacity and model fitting were further compared between the conventional clinical model with and without the inclusion of GLM7. Of the 959 enrolled patients, 259 (27.0%) were diagnosed with HUA. The GLM7 level was significantly higher in patients with HUA compared with those without HUA. After multivariable adjustment, elevated GLM7 was independently associated with increased odds of HUA (OR per 1-unit increase: 1.72; 95% CI: 1.29–2.28; P  < 0.001). Compared with patients in the lowest GLM7 quartile, those in the highest quartile had significantly higher odds of HUA (OR: 2.04; 95% CI: 1.28–3.26; P  = 0.003). Elevated GLM7 was also significantly associated with increased SUA concentrations, with an adjusted increment of 37.88 μmol/L (95% CI: 28.22–47.55; P  < 0.001) per 1-unit increase in GLM7. Restricted cubic spline analysis confirmed a significant overall association between GLM7 and HUA, and no statistically significant nonlinear association was detected. GLM7 exhibited limited discriminatory performance for HUA, with an area under the ROC curve of 0.599 (95% CI: 0.559–0.640). The optimal cutoff value was 7.959, with a sensitivity of 63.3% and a specificity of 55.0%. Adding GLM7 to the conventional clinical model did not significantly improve the area under the ROC curve (0.754 vs 0.757; DeLong P  = 0.438), while model fitting was significantly improved (likelihood-ratio χ²=5.70, P  = 0.017). GLM7 is independently and positively associated with HUA and SUA levels among hospitalized patients with T2DM. Nevertheless, GLM7 exhibits limited standalone discriminatory capacity, and its addition to the conventional clinical model does not yield a significant improvement in discriminatory performance. The present findings support the role of GLM7 as a composite metabolic marker correlated with hyperuricemia in patients with T2DM, but do not validate its use as a diagnostic or screening tool.