2型糖尿病患者血尿酸与蛋白尿的关系

Relationship between serum uric acids and albuminuria in patients with type 2 diabetes mellitus

目的探讨2型糖尿病(T2DM)患者血尿酸(SUA)与蛋白尿的关系。方法选择2016年5月至2017年9月安徽省立医院住院的T2DM患者791例,根据血尿酸(SUA)水平将患者分为正常尿酸(NUA)组656例和高尿酸(HUA)组135例,通过单因素分析比较两组患者尿白蛋白/肌酐(UACR)的差异;通过Pearson相关分析,比较UACR与其他生化指标的相关性,并将有统计学意义的指标纳入logistic回归分析中,了解SUA对蛋白尿发生的相对危险度。结果 (1)HUA组患者UACR高于NUA组[(225.53±870.90)mg/g vs(576.58±1 213.86)mg/g],差异有统计学意义(P<0.05);(2)Pearson相关分析显示,UACR与SUA呈正相关(P<0.05);Logistic回归分析显示,血尿酸水平每增加1 mg/d L,发生蛋白尿的相对危险度为1.096(P=0.005)。结论 T2DM患者中,血尿酸水平升高可引起UACR升高,是蛋白尿发生的危险因素,在糖尿病的治疗中需监测血尿酸水平。

Objective To investigate the relationship between serum levels of uric acids（ SUA） and diabetic kidney diseases（ DKD） in those patients with type 2 diabetes mellitus（ T2 DM）. Methods From May 2016 to Sep 2017,791 cases of patients with T2 DM（ 400 males and 391 females） admitted in our hospital were collected,and then divided into two groups according to their SUA levels： the NUA group with normal uric acids（ 656 cases） and the HUA group with hyperuricemia（ 135 cases）. Univariate analysis was conducted to compare the difference of urinary albumin/creatinine ratio（ UACR） between the two groups. Meanwhile,Pearson correlation analysis was performed to identify the correlation between UACR and other biochemical indexes,and certain statistically significant indexes were further included in Logistic regression analysis for calculation of relative risk of SUA to proteinuria development. Results The UACR value in the HUA group was significantly higher than that in the NUA group [（ 225. 53 ± 870. 90） mg/g vs（ 576. 58 ± 1213. 86） mg/g; P〈0. 05].Pearson correlation analysis showed that the UACR value was positively correlated to the SUA level（ P〈0. 05）,and Logistic regression analysis indicated that the relative risk of proteinuria was 1. 096 for each 1 mg/d L increase in the SUA level（ P = 0. 005）. Conclusion For the T2 DM patients,elevated SUA level which causing secondary UACR increase could be identified as a risk factor for proteinuria development,and monitoring of SUA level would be necessary in the treatment of diabetes.