血脂正常的空腹血糖受损人群尿酸水平与颈动脉粥样硬化的关系

Relationship between uric acid level and carotid atherosclerosis in patients with impaired fasting glucose plus normal serum lipids

目的探讨血脂正常的空腹血糖受损(IFG)人群血清尿酸(UA)水平与颈动脉粥样硬化(CAS)斑块及硬化程度的关系。方法选282例2006年1月至2008年12月在我院体检中心体检的血脂正常的IFG人群,进行颈动脉彩色超声检查,测量其左右颈动脉内-中膜厚度(IMT)。根据测量结果分为CAS斑块组(n=96)和无斑块组(n=186)。结果 CAS斑块组血浆UA浓度明显高于无CAS斑块组(P<0.05)。CAS斑块组高UA血症发生率较无CAS斑块组显著增高(P<0.05)。CAS程度:0级、1级与3级组,0、1与4级血UA水平比较,差异有统计学意义(P<0.05)。相关分析显示颈动脉斑块形成与年龄、UA、IL-6、TN F-α、纤维蛋白原呈正相关,与HDL-C呈显著负相关。多因素Logistic回归分析显示,校正了其他影响因素后UA增高与颈动脉斑块程度仍相关(P<0.05)。结论血脂正常的IFG人群中颈动脉粥样硬化斑块形成与UA水平升高有关。

Objective To investigate the correlation between uric acid （UA）level and carotid atherosclerosis （CAS） in patients with impaired fasting glucose（IFG） and normal serum lipids profile （NSL）. Methods 282 cases with IFG and NSL received the colour Doppler ultrasonograpb examination for the intima-media thickness （IMT） of bilateral carotid arteries. Patients were divided into two groups： with and without CAS （n=96 and 186 respectively）. The degrees of CAS were divided into 0-4 levels. The levels of UA, hs-CRP,IL-6,TNF-a, and fibrinogen were detected. Results Group with CAS versus without CASshowed higher level of UA[491（422 594） vs 273（214-385）/,mol/L,P〈0.05] and higher prevalence of hyperuricacidemia[72.9M （70/96） vs 15.6M （29/186）, P〈 0. 01]. The UA levels were gradually increased along with the increments of severity of CAS. The positive correlation of CAS generation with age, UA, IL-6, TNF-a and fibrinogen, and negative correlation with HDL-C （all P〈0.05） were found. After correction of influencing factors, serum UA was still correlated with CAS（P〈0.05）. Conclusions The formation of CAS plaque may be closely associated with the increased level of plasma uric acid in patients with impaired fasting glucose and normal serum lipids.