2型糖尿病患者血尿酸水平与周围神经病变的相关性

Correlation between serum uric acid levels and diabetic peripheral neuropathy in patients with type 2 diabetic mellitus

目的分析2型糖尿病(T2DM)患者血尿酸(SUA)水平与糖尿病周围神经病变(DPN)的关系。方法对60例T2DM患者进行糖化血红蛋白(HbA1c)、空腹C肽、血压、血脂、血尿酸、血肌酐等测定,并计算体重指数(BMI)、胰岛素抵抗指数(HOMA-IR),同时进行糖尿病周围神经病变体征的筛查和神经传导速度检查,分析SUA水平与DPN的相关性。结果将患者分别根据有或无DPN进行分组,DPN组SUA水平显著高于N-DPN组[(369.74±87.92)μmol/L、(336.26±64.47)μmol/L,P<0.05]。将患者分别按SUA是否正常分为N-SUA组和H-SUA组,不同SUA水平组的运动/感觉神经振幅和传导速度差异有统计学意义(P<0.05)。SUA水平与运动/感觉神经幅值及CV值呈负相关(P<0.05)。Logistic多元回归分析显示,糖尿病病程、SUA水平、高胆固醇(TC)水平与DPN的发生明显相关(P<0.05)。结论SUA水平与DPN之间存在显著相关性。SUA升高可能是预测DPN在T2DM患者中发生的重要指标。

Objective To investigate the relationship between the levels of serum uric acid(SUA)and diabetic peripheral neuropathy(DPN)in patients with type 2 diabetic mellitus(T2DM).Methods A total of 60 patients with T2DM(31males and 29 females)were enrolled in the study.The levels of fasting blood glucose,blood pressure,fasting c-peptide,glycosylated hemoglobin(HbA1c),blood lipids,SUA,creatinine,body mass index(BMI),insulin resistance index(HOMA-IR)were detected.Moreover the signs of diabetic peripheral neuropathy and the nerve conduction velocity were measured.The correlation between the levels of SUA and DPN was analyzed.Results The levels of SUA in DPN group were significanfly higher than those in non-DPN group[(369.74±87.92)μmol/L vs(336.26±64.47)μmol/L,P<0.05].The patients were divided into N-SUA group and H-SUA group according to whether SUA was normal or not,there were significant differences in motor/sensory nerve amplitude and conduction velocity(CV)parameters between N-SUA group and H-SUA group(P<0.05).Moreover the levels of SUA were negatively correlated with the motor/sensory nerve amplitude and CV value(P<0.05).The Logistic multiple regression analysis showed that the duration of T2DM,the levels of SUA and total cholesterol(TC)were significantly associated with the pathogenesis of DPN(P<0.05).Conclusion There is a significant correlation between SUA levels and the pathogenesis of DPN,and the increase of SUA levels may be the valuable indexes to predict the occurrence of DPN in patients with T2DM.