2型糖尿病患者血尿酸水平与肾损害及血浆致动脉硬化指数的相关性

Relationship of blood uric acid with renal damage and atherogenic index of plasma in patients with type 2 diabetes mellitus

目的研究2型糖尿病患者高尿酸血症与肾损害及血浆致动脉硬化指数的相关性。方法纳入217例2型糖尿病患者,根据血尿酸水平分为高尿酸组(男性尿酸浓度≥420μmol/L或女性≥360μmol/L)和正常尿酸组(男性尿酸浓度<420μmol/L或女性<360μmol/L)。测定两组患者的空腹血糖、糖化血红蛋白、血脂、血尿素氮、血肌酐、尿微量白蛋白及胱抑素C浓度。计算血浆动脉硬化指数及肾小球滤过率。应用SPSS13.0统计软件进行分析。结果 2型糖尿病伴高尿酸血症患者的血肌酐、微量蛋白尿及胱抑素C水平明显高于血尿酸正常的2型糖尿病患者,而肾小球滤过率明显低于尿酸正常患者,组间差异具有统计学意义(P<0.05)。高尿酸血症组甘油三酯水平及血浆致动脉硬化指数高于尿酸正常组,差异具有统计学意义(P<0.05)。2型糖尿病患者血尿酸水平随血浆致动脉硬化指数四分位数的增加而逐渐升高,组间比较差异具有统计学意义(F=8.57,P=0.000);2型糖尿病患者空腹血糖水平随血浆致动脉硬化指数四分位数增加而逐渐升高,但差异无统计学意义(F=1.93,P=0.125)。2型糖尿病患者血浆致动脉硬化指数与血尿酸水平及空腹血糖水平呈正相关(P<0.001)。结论2型糖尿病合并高尿酸血症会造成不同程度的肾脏损害;血浆致动脉硬化指数有助于识别此类患者罹患动脉硬化的风险。

Objective To explore the relationship of hyperuricemia（ HUA） with renal damage and atherogenic index of plasma（ AIP）in patients with type 2 diabetes mellitus. Methods Totally 217 patients with type 2 diabetes mellitus were divided into two groups according to the concentration of blood uric acid： high uric acid group（ male≥420 μmol/L or female≥360 μmol/L） and normal uric acid group（ NUA）（ male420 μmol/L or female 360 μmol/L）. The concentrations of fasting plasma glucose,glycosylated hemoglobin,blood lipid,blood urea nitrogen（ BUN）,serum creatinine（ Scr）,microalbuminuria（ MAU） and cystatin C（ Cys-C） were recorded. All the results were dynamically monitored by automatic biochemical analyzer. Atherogenic index of plasma was calculated by the formula（ AIP = lg TG/HDL-C）. Estimated glomerular filtration rate（ e GFR） was calculated by the Cockroff-Gault formula. All the data were analyzed by SPSS software. Results（1）The concentrations of Scr,MAU and Cys-C were higher in HUA group than in NUA group（ P〈0. 05）,and the level of e GFR was significantly lower in HUA group than in NUA group（ P〈0. 05）.（2）The concentration of triglyceride（ TG） and the level of AIP was significantly higher in HUA group than in NUA group（ P〈0. 05）.（3）The concentration of blood uric acid elevated with the increase of the quartile of AIP（ F = 8. 57,P = 0. 000）,and the concentration of fasting plasma glucose increased with the increase of the quartile of AIP（ F = 1. 93,P = 0.125）.（4）The AIP was correlated with the plasma uric acid and fasting plasma glucose（ P〈0. 001）. Conclusion Type 2 diabetes mellitus patients with HUA have more serious renal damage. Dynamic observation on AIP might be helpful to identify the risk of developing atherosclerosis in type 2 diabetes mellitus patients with HUA.