血清尿酸与2型糖尿病早期肾脏损害的相关性观察

Relationship between hyperuricemia and early diabetic nephropathy in patients with type 2 diabetes

目的探讨血清尿酸(SUA)水平与T2DM患者早期肾脏损害的相关性。方法选取2015年1月至2017年1月于我院内分泌科就诊的148例T2DM患者,根据SUA水平分为高尿酸组82例,正常尿酸组66例,比较两组BMI、FPG、HbA_1c、FIns、胰岛素抵抗指数(HOMA-IR)、血脂、尿白蛋白/肌酐比值(UACR)的差异。结果高尿酸组TC、FIns、HOMA-IR、UACR高于正常尿酸组[(2.68±0.86)vs(1.72±0.72)mmol/L、(16.13±6.64)vs(10.66±5.49)mIU/L、(7.11±1.25)vs(4.83±1.08)、(32.1±6.3)vs(15.2±5.8)mg/g,P<0.05]。Spearman相关性分析显示,SUA与TC、FIns、HOMA-IR、UACR呈正相关(r=0.321、0.253、0.244、0.314,P<0.05)。进一步采用偏相关分析,校正年龄、病程、BMI、生化指标等影响后,SUA与UACR仍呈正相关(r=0.322,P<0.05)。结论高尿酸血症与T2DM患者早期肾脏损害密切相关,临床上应引起足够重视。

Objective To investigate the relationship between hyperuricemia and early diabetic nephropathy in patients with type 2 diabetes （T2DM）. Methods A total of 148 patients with T2DM were recruited in this study from Jan 2015 to Jan 2017 in our hospital and divided into two group., the high uric acid group （n=82）, and the normal uric acid group （n=66）. The body mass index （BMI）, fasting plasma glucose （FPG）, glycosylated hemoglobin （HbA1c）, fasting insulin （Fins）, insulin resistance index （HOMA-IR）, lipid levels and morning urine albumin-to- creatinine ratio （UACR） were calculated and compared between the two groups. Results The TC, Fins, HOMA-IR, UACR in high uric acid group were （2.68±0. 86） mmol/L, （16.13±6.64） mIU/L, （7.11±1.25）, （32.1±6.3） mg/g, which were higher than in normal uric acid group[（1.72 ± 0. 72） mmol/L, （10. 66 ± 5.49） mIU/L, （4. 83± 1.08）, （15.2±5.8） mg/g] （P〈0. 05）. Spearman correlation analysis showed that the lvel of serum uric acid was positively correlated with TC, Fins, HOMA-IR, and UACR（r= 0. 321, 0. 253, 0. 244, 0. 314 respectively; P〈0. 05）. After adjusting age, sex, duration, BMI, and biochemical indexes, the level of serum uric acid was also positively correlated with UACR （r=0. 322, P〈0.05）. Conclusion The level of serum uric acid is closely correlated with early diabetic nephropathy in patients with T2DM.