女性2型糖尿病患者血尿酸水平与胰岛β细胞功能的相关性研究

Correlation of serum uric acid and islet beta cell functions in female type 2 diabetics

目的 研究女性2型糖尿病患者血尿酸水平与胰岛β细胞功能的相关性.方法 2007年1月至2008年12月在上海中山医院内分泌科住院533例女性2型糖尿病患者为研究对象,测定人体参数、相关生化指标及精氨酸刺激的胰岛β细胞一相胰岛素分泌功能（AIR）和一相C肽分泌功能（ACPR）.其中262例患者行75 g口服葡萄糖耐量试验并计算胰岛素曲线下面积（AUC）和C肽AUC.以血尿酸＞360 μmol/L为高尿酸血症.结果 高尿酸组（86例）与正常尿酸组（447例）的血尿酸水平分别为（430±8）和（248 ±3） μmol/L.高尿酸组的AIR、ACPR、AUC及C肽AUC均高于正常尿酸组（均P＜0.01）.单因素相关分析发现血尿酸水平分别与AIR（r=0.194,P＜0.01）、ACPR（r=0.146,P＜0.01）、胰岛素AUC（r=0.307,P＜0.01）及C肽AUC（r=0.420,P＜0.01）呈正相关.按AIR三分位分组的血尿酸水平分别为（260±7）、（264±8）、（302±7）μmoL/L；按ACPR三分位分组的血尿酸水平分别为（263±8）、（271±7）、（296±7） μmol/L;按胰岛素AUC 三分位分组的血尿酸水平分别为（241±10）、（279±10）、（301±8）μmol/L；按C肽AUCe三分位分组的血尿酸水平分别为（229±8）、（265±9）、（326±10） μmol/L,差异均有统计学意义（均P＜0.01）.多元线性回归分析显示在校正了多个相关危险因素后,血尿酸水平分别与AIR（β=0.002,95％ CI：0.0010 -0.0030,P＜0.01）、ACPR（ββ =0.001,95％ CI：0.0002—0.0020,P=0.02）、胰岛素AUC（ β=0.002,95％ CI：0.0004～0.0030,P＜0.01）及C肽AUC（β=0.003,95％ CI：0.0020～0.0030,P＜0.01）独立相关.结论 血尿酸水平可能是预测女性2型糖尿病患者胰岛β细胞功能的独立危险因素.

Objective To examine the correlation of serum uric acid and islet beta cell functions in female type 2 diabetics.Methods A total of 533 female type 2 diabetics were recruited. And their clinicobiochemical parameters were measured.The levels of acute insulin response （AIR） and acute Cpoptide response （ACPR） were measured by a stimulation of arginine.Among them,262 patients received the examinations of OGTT （oral glucose tolerance test）,area under the curve of insulin （AUC-insulin） and C peptide （AUC-C peptide）.Serum uric acid 〉 360 μmol/L was defined as hyperuricemia.Results The serum uric acid levels of the hyperuricemia and control groups were （430 ＋ 8） and （ 248 ＋ 3 ） μmol/Lrespectively.The AIR,ACPR,AUC-insulin and AUC-C peptide levels were significantly higher in the hyperuricemia group than those in the control group （P 〈 0.01 ）.There was a significant positive correlation between serum uric acid and AIR,ACPR,AUC-insulin and AUC-C peptide （r =0.194,P 〈 0.01; r =0.146,P 〈 0.01 ; r =0.307,P 〈 0.01 and r =0.420,P 〈 0.01 ）.The serum levels of uric acid were significantly different between tertile groups of AIR （260 ＋_ 7 ）,（264 ＋ 8 ）,（ 302 ＋ 7 ） μmol/L,ACPR （（263_＋8）,（ 271 ＋7）,（296＋7） μmo]/L）,AUC-insulin （（241 ＋10）,（279 ＋10）,（301 ＋8） μmol/L）and AUC-C peptide （ （ 229 ＋ 8 ）,（ 265 ± 9 ）,（ 326 ± 10 ） μmol/L,P 〈 0.01 ）.Multivariate linear regression demonstrated that the serum level of uric acid were associated with AIR （β =0.002,95% CI0.0010 - 0.0030,P 〈 0.01 ）,ACPR （ α =0.001,95% CI 0.0002 - 0.0020,P =0.02 ）,AUC-insulin （ β =0.002,95 % CI 0.0004 - 0.0030,P 〈 0.01 ） and AUC-C peptide （ α =0.003,95 % CI 0.0020 -0.0030,P 〈 0.01 ） after an adjustment of related risk factors.Conclusion The serum level of uric acid is significantly correlated with AIR,ACPR,AUC-insulin and AUC-C peptide in female type 2 diabetics.And it may be an independent risk factor of predicting islet beta cell functions in female type 2 diabetics.