血尿酸及促甲状腺激素水平对2型糖尿病患者颈动脉粥样斑块形成的影响

Effects of serum uric acid and thyroid stimulating hormone levels on the formation of carotid atherosclerotic plaques in type 2 diabetes mellitus

目的探讨血尿酸及促甲状腺激素水平对2型糖尿病患者颈动脉粥样斑块形成的影响。方法回顾性分析2016年1月至2019年1月在南京市栖霞区医院住院的389例2型糖尿病患者的临床资料,根据颈部血管B超检查结果分为有颈动脉粥样斑块者203例(有斑块组)和无颈动脉粥样斑块者186例(无斑块组),比较两组患者性别、年龄、病程、高血压、血脂、C反应蛋白(CRP)、脂肪肝、糖化血红蛋白、促甲状腺激素(TSH)、血尿酸(UA)等临床资料。采用多因素Logistic回归分析法分析影响2型糖尿病患者颈动脉粥样斑块形成的危险因素。结果单因素分析结果显示,有斑块组患者的血尿酸、促甲状腺激素、C反应蛋白、病程及高血压发生率分别为(328.08±97.72)μmmol/L、2.51 (1.63,3.59)μIU/L、1.1 (0.40,2.60) mg/L、10 (5.0,14.0)年、64.53%,明显高于无斑块组的(307.94±87.63)μmmol/L、2.22 (1.34,3.06)μIU/L、0.8 (0.16,1.86) mg/L、5.0 (3.0,10.0)年、37.10%,差异均有统计学意义(P<0.05);但两组患者在性别、年龄、胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、甘油三酯(TG)、糖化血红蛋白及有无合并脂肪肝方面比较差异均无统计学意义(P>0.05);多因素Logistic回归分析结果显示,病程长、高血压及TSH升高是2型糖尿病患者颈动脉粥样斑块形成的危险因素(P<0.05)。结论控制或延缓2型糖尿病慢性并发症颈动脉粥样斑块的形成,需积极控制高尿酸及高促甲状腺激素水平。

Objective To investigate the effects of serum uric acid and thyroid stimulating hormone levels on the formation of carotid atherosclerotic plaques in type 2 diabetes mellitus.Methods The clinical data of 389 patients with type 2 diabetes mellitus who were hospitalized in Qixia District Hospital of Nanjing city from January 2016 to January 2019 were retrospectively analyzed.According to the results of B-ultrasonography,there were 203 patients with carotid atherosclerotic plaque(with plaque group)and 186 patients without carotid atherosclerosis plaque group(without plaque group).The gender,age,course of disease,hypertension,blood lipids,C-reactive protein(CRP),fatty liver,hemoglobin A1c,thyroid stimulating hormone(TSH),serum uric acid(UA)were compared between the two groups.Logistic regression analysis was used to analyze the risk factors for the formation of carotid atherosclerotic plaque in patients with type 2 diabetes mellitus.Results Univariate analysis showed that there were statistically differences in the levels of serum uric acid with(328.08±97.72)μmmol/L vs(307.94±87.63)μmmol/L,thyrotropic hormone with 2.51(1.63,3.59)uIU/L vs 2.22(1.34,3.06)uIU/L,C-reactive protein with 1.1(0.40,2.60)mg/L vs 0.8(0.16,1.86)mg/L,course of disease with 10(5.0,14.0)years vs 5.0(3.0,10.0)years,incidence hypertension(64.53%vs 37.10%)between the two groups(all P<0.05).There were no statistical differences between the two groups in gender,age,cholesterol,HDL,LDL,triglyceride,hemoglobin A1c and presence of fatty liver(all P>0.05).Logistic regression analysis showed that long course,hypertension and elevated TSH were risk factors for the formation of carotid atherosclerotic plaque in patients with type 2 diabetes mellitus(all P<0.05).Conclusion High uric acid and high thyroid stimulating hormone levels should be actively controlled to control or delay the formation of carotid atherosclerotic plaque in type 2 diabetes mellitus.