中老年Ⅱ型糖尿病患者血尿酸水平与血糖血脂的关系

A study on the associations of serum uric acid with blood glucose and lipids in middle and aged diabetic patients

研究了６５例非胰岛素依赖型糖尿病患者和４２例非糖尿病对照者的血尿酸水平与血糖血脂的关系。结果表明：①非糖尿病对照高尿酸血症者（血清尿酸≥４２０μｍｏｌ／Ｌ）较血尿酸正常者体重指数和血清甘油三酯明显升高，前者舒张压≥１２ｋＰａ者高达６７％，而后者仅为３７％。②糖尿病患者血尿酸水平（２４４．８９±９９．６０μｍｏｌ／Ｌ）较非糖尿病对照者（３６９．５±１１３．１μｍｏｌ／Ｌ）明显降低（Ｐ＜０．００１），糖尿病高脂血症者与血脂正常者血尿酸水平无差异，糖尿病患者血尿酸与血糖呈负相关（ｒ＝－０．２４６，Ｐ＜０．０５）。提示：①非糖尿病对照者高尿酸血症作为冠心病的危险因素可能与并存的肥胖、血脂及血压异常有关。②糖尿病患者血尿酸水平降低可能与高血糖的利尿作用使尿酸的排泄增加有关，高尿酸血症本身可能不是长期糖尿病患者动脉硬化的高危因素。

The associations of serum uric acid with blood glucose and lipids in 65 non-insulin dependent diabetic patients and 42 non-diabetic controls were studied.The results showed:①Non-diabetic controls with hyperuricemia(serum uric acid≥420μmol/L)had markedly higher body mass indexes and levels of serum triglyceride than those with normal serum uric acid.The incidences of diastolic blood pressure≥12kPa were 67%in the former and 37% in the latter.②The serum uric acid level was lower in diabetic patients(244.89±99.60 μmol/L) than in non-diabetic controfs(369.50±113.10μmol/L,P<0.001),but there was no difference between diabetic patients with hyperlipidemia and those with normal lipids.A negative correlation between serum uric acid and blood glucose was found in diabetics(r=-0. 246,P<0.05).It suggests that hyperuricemia taken as a risk factor for coronary heart disease may be related to obesity, abnormality of lipids and blood pressure. The decreased serum uric acid level in diabetics may be related to diuretic effect of hyperglycemia which increased the excretion of uric acid.Hyperuricemia might not be a riskfactor in overt diabetic atherosclerosis.