血清高尿酸水平与住院糖尿病患者白蛋白尿短期进展的关系研究

Relationship between high serum uric acid level and short-term progression of albuminuria in hospitalized diabetic patients

目的·探讨2型糖尿病(type2 diabetes mellitus,T2DM)患者白蛋白尿短期进展的相关危险因素。方法·采用回顾性队列研究设计,连续收集2010年4月—2015年4月210例符合入选标准的T2DM住院患者,其中男性102例,女性108例。分别收集患者2次住院(分别作为基线和随访资料)的一般资料、生化检测结果和用药情况。通过多因素Logistic回归分析探讨患者基线白蛋白尿以及白蛋白尿短期进展的潜在危险因素。结果·基线资料中,大量白蛋白尿组(≥300mg/24h)血清尿酸水平显著高于无白蛋白尿组(<30mg/24h)(P=0.002)。207例患者(剔除3例数据有缺失的样本)第2次住院时,有51例白蛋白尿有进展(24.6%),156例无进展(75.4%)。白蛋白尿进展组血清尿酸水平显著高于白蛋白尿非进展组(P=0.009)。多因素Logistic回归分析结果显示,血清尿酸水平是T2DM患者白蛋白尿短期进展的独立危险因素(OR=1.349,95%CI1.014~1.793,P=0.040)。结论·T2DM患者中,血清高尿酸水平可能是T2DM患者白蛋白尿短期进展的独立危险因素,对高尿酸进行早期干预可能会延缓糖尿病肾病的发展。

Objective · To explore the risk factors associated with short-term progression of albuminuria in the patients with type 2 diabetes mellitus (T2DM). Methods · The retrospective cohort study design was performed to consecutively recruit 210 hospitalized T2DM patients who met the inclusion criteria, including 102 males and 108 females from April 2010 to April 2015. The data of the patients twice in hospital (as baseline and follow-up information, respectively), including general data, biochemical examinations and medication were collected. Multivariate Logistic analysis was used to explore the potential risk factors for baseline albuminuria and short-term progression of albuminuria. Results · Serum uric acid levels were significantly higher in the patients with macroalbuminuria (≥ 300 mg/24 h) than those in the patients without albuminuria (< 30 mg/24 h) at baseline (P=0.002). Among the 207 patients (excluding 3 samples with missing data) during the second hospitalization, 51 patients (24.6%) had progress in albuminuria and 156 patients (75.4%) had none. Serum uric acid levels were significantly higher in the progression group than those in the non-progression group (P=0.009). Multivariate Logistic regression analysis showed that high serum uric acid level was an independent risk factor for progression of albuminuria in T2DM patients (OR=1.349, 95%CI 1.014-1.793, P=0.040). Conclusion · The high serum uric acid level may be an independent risk factor for short-term progression of albuminuria, and early intervention with hyperuricemia might delay the progression of diabetic kidney disease in T2DM patients.