2型糖尿病高血尿酸与糖尿病肾病的相关性研究

The relationship between hyperuricemia and diabetic nephropathy in type 2 diabetes patients

目的评估2型糖尿病患者血尿酸、肾小球滤过率及尿蛋白排泄率水平,探讨2型糖尿病的高血尿酸水平与糖尿病肾病的关系。方法根据血尿酸浓度将503例2型糖尿病患者分为高尿酸组和正常尿酸组,分别检测两组血压、人体测量学指标、糖化血红蛋白、血脂、血尿酸、血肌酐及尿蛋白排泄率等指标,计算肾小球滤过率,比较两组患者一般临床资料、肾小球滤过率及尿蛋白排泄率水平。结果高尿酸组中的无蛋白尿患者、微量白蛋白尿患者、大量白蛋白尿患者的肾小球滤过率均较正常组降低(P<0.05),差异有统计学意义。高尿酸组中大量蛋白尿的患病率明显高于正常组(P<0.05),而两组间微量蛋白尿的患病率比较差异无统计学意义。结论 2型糖尿病患者高血尿酸与糖尿病肾病相关,血尿酸可更直观地预测肾小球滤过率下降水平。

Objective To evaluate glomerular filtration rate and urinary protein excretion rate in type 2 diabetes patients with hyperuricemia to investigate the relationship between elevated uric acid and diabetic nephropathy.Methods 503 type 2 diabetes patients were divided into the high uric acid group and the normal uric acid group by the concentration of serum uric acid.We detected blood pressure,anthropometric indexes,glaciated hemoglobin,lipids,serum uric acid,serum creatinine and urinary protein excretion rate,calculated glomerular filtration rate with a simplified diet kidney disease formula and compared the data.Results The prevalence of macroalbuminuria in the high uric acid group is significantly higher than the normal uric acid group（P0.05）.Compared with the normal group,patients without proteinuria,with microalbuminuria or macroalbuminuria in the high uric acid group have decreased glomerular filtration rate（P0.05）.Conclusion In patients with type 2 diabetes,high uric acid will play a key role in the progression of diabetic nephropathy as an independent risk factor,will predict a decline in glomerular filtration rate as early as possible.