尿酸与2型糖尿病代谢紊乱及危险因素分析

Association of elevated uric acid with metabolic disorders and analysis of the risk factors of hyperuricemia in type 2 diabetes mellitus

目的探讨2型糖尿病（T2DM）尿酸升高与代谢紊乱的关系及其危险因素。方法收集159例T2DM住院患者[年龄40~80岁,SCr水平51~159μmol/L（0.6~1.8 mg/dl）]临床实验室资料,明确高尿酸血症（HUA）与T2DM代谢紊乱的关系及其危险因素。结果 159例患者中HUA患者40例,占25.2%;单因素分析发现男性、体质指数（BMI）≥25 kg/m2、高血压、血肌酐（SCr）≥110μmol/L、血尿素氮（BUN）≥7.0 mmol/L、尿微量白蛋白（U-MA）≥11.2 mg/L、血甘油三酯（TG）≥1.70 mmol/L、血高密度脂蛋白（HDL）〈1.04 mmol/L、血低密度脂蛋白（LDL）≥3.37 mmol/L等因素影响HUA的发生（P〈0.05）;Logistic回归分析提示SCr、BMI、TG水平是影响T2DM发生HUA的独立危险因素;各主要危险因素在T2DM中均有较高的发生率;T2DM合并HUA患者冠心病、颈动脉粥样硬化、脑梗死、糖尿病肾病、糖尿病视网膜病变发生率明显增高（P〈0.05）。结论 T2DM尿酸升高与多种危险因素有关,HUA与T2DM代谢紊乱及并发症密切关联。

Objective To explore the association of elevated serum uric acid with metabolic disorders and the risk factors of hyperuricemia in type 2 diabetes mellitus（T2DM）.Methods The clinical and laboratory data of 159 T2DM patients aged 40-80 years with a Scr level of 51-159 μmol/L（0.6-1.8 mg/dl） were analyzed to explore the association of hyperuricemia（HUA） with metabolic disorders and identify the risk factors of HUA.Results Forty out of 159 T2DM patients（25.2%） were found to have HUA.Univariate analysis showed that male gender,a body mass index ≥25 kg/m2,hypertension,serum creatinine ≥110 μmol/L,blood urea nitrogen ≥7.0 mmol/L,microalbuminuria ≥11.2 mg/L,triglyceride ≥1.70 mmol/L,high-density lipoprotein 1.04 mmol/L,low density lipoprotein ≥3.37 mmol/L were all risk factors of HUA（P0.05） in T2DM.Binary logistic regression analysis identified serum creatinine,body mass index and triglyceride as independent risk factors of HUA in T2DM.The main risk factors related to HUA had high incidences in T2DM.Patients with HUA had a significantly higher incidences of coronary artery disease,carotid atherosclerosis,cerebral infarction,diabetic nephropathy and diabetic retinopathy than those with normal uric acid level（P0.05）.Conclusion Several risk factors contribute to the occurrence of elevated serum uric acid in T2DM,and metabolic disorders and complications are also closely associated with HUA.