血尿酸与2型糖尿病胰岛素抵抗及血管并发症的关系

Relationship between serum uric acid and insulin resistance and vascular complications of type 2 diabetes

目的:评价高尿酸血症对2型糖尿病胰岛素抵抗及血管并发症的影响,并探讨其可能的发生机制。方法:68例2型糖尿病患者,根据血尿酸水平分成尿酸正常(NUA)组(42例)和高尿酸(HUA)组(26例),分析两组病人的胰岛素抵抗指数和大血管、微血管病变发生率的差异。结果:(1)HUA组体重指数(BM I)、甘油三酯(TG)、血压(BP)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、腰臀比值(WHR)、胰岛素抵抗指数(HOMA-IR)均高于NUA组(均P<0.05),而高密度脂蛋白胆固醇(HDL-C)则低于NUA组(P<0.05)。(2)HUA组冠心病、脑血管病、视网膜病变、肾脏病变、颈动脉斑块和下肢动脉斑块的发生率均高于NUA组(均P<0.05)。结论:高尿酸血症与肥胖、血脂异常、胰岛素抵抗明显相关,并可导致大血管及微血管并发症的发生。

Ojective To evaluate the effect of hyperuricemia on insulin resistance and vascular complications of type 2 diabetes and to analyze the possible mechanism. Methods 68 cases with type 2 diabetes were divided into two groups ： normal serum uric acid （ n = 42 ） and hyperuricemia （ n = 26 ）. The insulin resistance index and macrovascular and microvascular complications were detected. Results （ 1 ） Hyperuricemia group showed higher body mass index （ BMI）, blood pressure （ BP ）, TG, TC, LDL, waist-hip ratio （ WHR ） , hemeostasis model assessment-insulin resistance （ HOMA- IR） ratio and lower serun HDL- C than the group with normal serum uric acid （ all P 〈 0.05 ）. （ 2 ） Higher morbidities due to macrovascular and microvascular complications were found in the group with hyperuricemia than in the group with normal serum uric acid （ all P 〈 0.05 ）. Conclusions Hyperuricemia is associated with obesity and dyslipidmia and insulin resistance, resulting in macrovascular and microvascular complications.