2型糖尿病患者合并高尿酸血症的相关因素分析

Related factors of hyperuricemia in patients with type 2 diabetes mellitus

目的探讨2型糖尿病(T2DM)患者合并高尿酸血症的相关因素。方法选择2015年1月至2016年6月期间我院内二科诊治的400例2型糖尿病患者为研究对象,将61例合并高尿酸血症的患者纳入高尿酸组,余339例患者纳入正常尿酸组,测定并记录其体质量指数(BMI)、收缩压(SBP)、舒张压(DBP)水平,检测患者空腹血糖(FPG)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、血尿酸以及糖化血红蛋白(Hb A1c),估算肾小球滤过率(eGFR)、尿白蛋白排泄率(UAER),并对结果进行分析。结果高尿酸血症组患者的年龄、男性比例、DBP、TG、LDL-C及UAER明显高于正常尿酸组,eGFR明显低于正常尿酸组,差异均有统计学意义(P<0.05);多元逐步回归分析结果显示,TG、BMI、eGFR、UAER为T2DM患者合并高尿酸血症的独立危险因素(P<0.05)。结论 T2DM患者高尿酸血症的发生与肥胖、高甘油三酯血症、蛋白尿及肾功能受损有关。对于T2DM患者,要密切监测血尿酸水平,注意控制体重、血脂,保护肾功能。

Objective To investigate the related factors of hyperuricemia in patients with type 2 diabetes mellitus（T2DM）. Methods A total of 400 T2 DM patients treated from Jan. 2015 to Jun. 2016 in Department Ⅱ of Internal Medicine of our hospital were selected as the research subjects, of which 61 with hyperuricemia were assigned into high uric acid group and the remaining 339 were included into the normal uric acid group. The body mass index（BMI）, systolic blood pressure（SBP）, diastolic blood pressure（DBP）, fasting plasma glucose（FPG）, triglyceride（TG）, total cholesterol（TC）, low density lipoprotein cholesterin（LDL-C）, high density lipoprotein cholesterin（HDL-C）, serum uric acid（UA） and glycosylated hemoglobin（Hb A1c）, estimated glomerular filtration rate（eGFR）, urinary albumin excretion rate（UAER） were detected and analyzed. Results The age, proportion of men, DBP, TG, LDL-C and UAER in high uric acid group were significantly higher than those in the normal uric acid group, and eGFR was significantly lower. The differences were statistically significant（P〈0.05）. Multiple stepwise regression analysis showed that TG, BMI, eGFR, UAER were the independent risk factors of hyperuricemia in T2DM（P〈0.05）. Conclusion The incidence of hyperuricemia in patients with T2 DM is related to obesity, high triglyceride, proteinuria and impaired renal function. For T2 DM patients,we should closely monitor the level of serum uric acid, pay attention to controlling the body weight and blood lipid, and protect the patient＇s renal function.