检测晨尿尿酸/肌酐对2型糖尿病患者高尿酸血症分型诊断的意义

Significance of morning urinary uric acid/creatinine ratio for the classification of hyperuricemia in patients with type 2 diabetes mellitus

目的在合并T2DM的高尿酸血症(HUA)患者中,建立晨尿尿酸/肌酐(UUA/Cr)用于HUA分型诊断的界点,指导降尿酸药物的选择。方法选取2017年1~6月于我院内分泌科住院、肾功能正常且合并T2DM的HUA患者119例,分析晨UUA/Cr与24hUUA及尿酸清除率(Cua)的相关性,确定晨UUA/Cr用于HUA分型的诊断界点。结果在合并T2DM的HUA患者中,尿酸生成过多型患者BMI、FC-P、晨UUA/Cr、24hUUA、Cua高于尿酸排泄不良型患者(P<0.05)。晨UUA/Cr与Cua呈正相关(r=0.262,P=0.004),与24h UUA无相关性(r=0.158,P=0.44),晨UUA/Cr用于HUA分型诊断的界点为0.4266,敏感性和特异性分别为91.5%和48.6%。结论晨UUA/Cr可作为评价合并T2DM的HUA患者尿酸排泄的有效指标。

Objective To establish the cut-off point of morning urinary uric acid/creatinine ratio（UUA/Cr）for the classification of hyperuricemia（HUA）in patients with type 2 diabetes（T2DM）and to guide the selection of uric acid-lowering drugs. Methods 119 HUA patients with T2DM and normal renal function,who were hospitalized in endocrinology department of Peking University People＇s Hospital from January 2017 to June 2017,were included in this study.The relationship between morning UUA/Cr and 24 hUUA or uric acid clearance rate（Cua）were analyzed.The cut-off point of morning UUA/Cr for the classification of HUA was determined by ROC curve. Results In HUA patients with T2DM,BMI,fasting C-peptide,morning UUA/Cr,24 hUUA and Cua were significantly higher in overproduction type than those in underexcretion type（P〈0.05）.There was positive correlation between morning UUA/Cr and Cua（r=0.262,P=0.004）.There was no correlation between morning UUA/Cr and 24 hUUA（r=0.158,P=0.44）.The cut-off point of morning UUA/Cr for the classification of HUA was 0.4266,the value of sensitivity and specificity were 91.5% and 48.6%,respectively. Conclusions Morning UUA/Cr can be an effective predictor of the uric acid excretion in HUA patients with T2DM.