2型糖尿病患者血尿酸、尿微量白蛋白水平与肱动脉血流介导的内皮依赖性血管舒张功能的关系

Relationship among serum uric acid,urinary albumin excretion rate and brachial arterial flow mediated vasodilatation function in patients with type 2 diabetes mellitus

目的探讨血尿酸(UA)、尿微量白蛋白(MA)水平与2型糖尿病患者肱动脉血流介导的内皮依赖性血管舒张功能(FMD)的关系。方法 2型糖尿病患者104例,根据尿白蛋白排泄率(UAER)不同分成2组:A组63例为UAER 20～200μg/min,B组41例为UAER>200μg/min;根据血尿酸水平高低分为C组64例和D组40例。分别记录各组血UA、病程、三酰甘油(TG)、空腹血糖(FBG)、糖化血红蛋白(HbA_(1c))、胆固醇(TC)、高密度脂蛋白—胆固醇(HDL-C)、低密度脂蛋白—胆固醇(LDL-C)、尿白蛋白排泄率(UAER)、FMD的变化,比较血UA、尿MA水平及FMD三者之间的相关性。结果 A组、C组病程、UA、FBG、UAER较B组、D组显著升高,但FMD水平下降(P均<0.05)。多元回归分析显示病程、UA、UAER与FMD呈负相关(r分别为-0.305、-0.314、-0.285,P均<0.05),UA与UAER呈正相关(r=0.241,P<0.05)。结论糖尿病患者内皮功能障碍与病程、血UA、UREA水平密切相关,血UA、UREA水平可用于早期预测糖尿病内皮功能障碍。

Objective To investigate the relationship among serum uric acid（UA）,urinary microalbumin（MA） and brachial arterial flow mediated vasodilatation（FMD） function in patients with type 2 diabetes mellitus.Methods One hundred and four type 2 diabetic patients were divided into two groups according to the UAER,group A with UAER between 20 and 200μg/min（n = 63） and group B with UAER200μg/min（n =41）;the patients were also classified into hyperuricemia group（group C,n=64） and normal blood UA group（group D,n = 40）.The disease course,UA,fasting blood glucose （FBG）,HbA_（1c）,triglyceride（TG）,total cholesterol（TC）,low density lipoprotein（LDL-C）,high density lipoproteins（HDLC）, UAER and FMD were determined and compared among these groups.The relationship of UAER and hyperuricemia with FMD was analyzed.Results The disease course,UA,FBG and UAER levels in groups A and C were significantly higher than those in groups B and D（all P0.05）,while FMD was decreased（P0.05）.The brachial arterial FMD was independently correlated to the disease course,UA and UAER（r=-0.305,-0.314,-0.285,respectively,all P0.05）,and a significant positive correlation was noted between UA and UAER（r =0.241,P0.05）.Conclusion Endothelial dysfunction in type 2 diabetic patients was significantly correlated to the disease course,UA and UAER levels,which was helpful to evaluate and predict endothelial dysfunction in type 2 diabetic patients.