2型糖尿病合并高血尿酸血症相关危险因素分析

Analysis of the risk factors in type 2 diabetics with hyperuricaemia

目的:探讨2型糖尿病的血尿酸水平与性别、年龄、血脂、血压、血糖等指标及与合并冠心病(CHD)、脑卒中、糖尿病肾病等糖尿病并发症的关系。方法:选取我院2010年5月～2012年5月2年间收治的2型糖尿病601例,根据患者血尿酸结果分为A组:高尿酸血症(HUA)组即男性和绝经后女性血尿酸>420μmol/L、绝经前女性>350μmol/L,B组:非高尿酸血症组(NUA),男性及绝经后女性血尿酸≤420μmol/L,绝经前女性≤350μmol/L;对两组病程、年龄、血糖、血脂、血压、体质量指数(BMI)、血肌酐(SCr)、24 h微量白蛋白尿(24 h UMA)、空腹胰岛素(FINS)及临床资料等进行回顾性分析。结果:①A组的糖尿病肾病、糖尿病视网膜病变(DR)、糖尿病周围神经病变(DPN)、脑卒中、高血压、冠心病(CHD)的发病率均高于B组,P<0.05;其中A组DR、DPN、脑卒中、冠心病的发病率较B组有显著统计学差异,P<0.01。②A组的年龄、糖尿病病程、血肌酐、血甘油三酯(TG)、24 h UMA、空腹胰岛素(FINS)均高于B组,P<0.05。结论:高尿酸血症是代谢综合征组分的评价因素,也是心脑血管疾病、糖尿病肾病等2型糖尿病并发症的相关危险因素,2型糖尿病合并高尿酸血症需要重点筛查大血管及微血管并发症,临床上应予重视。

Objective： To investigate the relationship of blood uric acid level,sexes,ages,levels of blood fat,blood pressure and blood glucose in type 2 diabetes mellitus（T2DM） and the risk factors complicated with coronary heart disease（CHD）,cerebral stroke and diabetic nephropathy（DN）.Methods： 601 T2DM patients admitted to our hospital between May 2010 and Feb.2012 were allocated to group A and B by the blood uric acid levels determined.Group A included hyperuricemia（HUA）,men and postmenopausal women with uric acid ＆gt;420 μmol / L and premenopausal women with uric acid ＆gt; 350 μmol / L,whereas group B were cases of non hyperuricemia（NUA）,men and postmenopausal women with serum uric acid ≤ 420 μmol / L and premenopausal women with serum uric acid ≤350 μmol / L.The two groups were retrospectively analyzed regarding the disease duration,ages,levels of blood lipids and blood pressure,body mass index（BMI）,serum creatinine（SCr）,urinary microalbumin in 24 h（24 h UMA） and fasting insulin（FINS） as well as related clinical data.Results： ①Group A had a higher incidence rates of DN,diabetic retinopathy（DR）,diabetic peripheral neuropathy（DPN）,stroke,hypertension,CHD than that of group B（P ＆lt; 0.05）,in which the rates of DR DPN,cerebral stroke and CHD were significantly different from group B（P ＆lt; 0.01）;②The indicators in group A were higher than those of group B concerning the ages,duration of diabetes,SCr,serum triglyceride（TG）,24 h UMA and FINS（P ＆lt;0.05）.Conclusion： Hyperuricemia is not only the evaluation factors for metabolic syndrome components but the risk factors for estimation of cardiovascular and cerebrovascular diseases as well as DN complicated in type 2 diabetics.T2DM associated with hyperuricemia is of clinical attention to make necessary screening the potential complications in large blood vessels and capillaries.