肥胖及糖尿病前期并发高尿酸血症患者血清内皮/炎性因子表达水平相关性

Correlation between obesity and prediabetes complicated with hyperuricemia and serum endothelial/inflammatory factor expression levels

目的分析糖尿病前期并发高尿酸血症患者超体质量或肥胖、血尿酸(SUA)与血清内皮/炎性因子之间的关系。方法选取2019年5月—2021年4月在昆明医科大学附属延安医院全科医学科/老年病科诊治老年高尿酸血症(HUA)患者180例,按糖代谢水平分为空腹血糖受损(IFG)组72例和糖耐量异常(IGT)组108例,每组再按照体质量指数分为肥胖亚组、超体质量亚组和体质量正常亚组。检测并比较患者血清vWF、ET-1、NO、IL-1β、IL-6水平。Pearson直线相关检验分析血清内皮/炎性因子与临床病理特征相关性,Logistic回归分析血清内皮/炎性因子对肥胖及糖尿病前期合并高尿酸血症的影响因素。结果与IFG组比较,IGT组血清NO水平降低,vWF、ET-1、IL-1β、IL-6水平升高,差异均有统计学意义(t=7.016、16.646、16.405、11.856、3.036,P均<0.001);IFG组及IGT组的各亚组间血清NO随BMI的增加而下降,vWF、ET-1、IL-1β、IL-6水平随BMI增加而上升,差异均有统计学意义(IFG组:F=5.897、12.359、7.324、6.654、35.210,P均<0.001;IGT组:F=4.332、18.965、15.674、4.859、59.687,P均<0.001);Pearson直线相关检验结果提示,血清vWF、ET-1、IL-1β、IL-6与BMI呈正相关(r=0.52、0.55、0.54、0.52,P<0.05),NO与BMI呈负相关(r=-0.44,P<0.05);Logistic回归分析结果提示,血清vWF、ET-1、IL-1β、IL-6升高为肥胖及糖尿病前期合并高尿酸血症的危险因素,血清NO升高为其保护因素[OR(95%CI)=3.435(1.792~6.585)、3.245(1.767~5.957)、3.401(1.813~6.380)、3.522(1.809~6.858)、0.191(0.079~0.459)]。结论肥胖及IGT合并高尿酸血症老年患者血清vWF、ET-1、IL-1β、IL-6水平升高,NO水平降低,且是肥胖及糖尿病前期并发高尿酸血症的影响因素。

Objective To analyze the relationship between overweight or obesity,serum uric acid(SUA)and serum endothelial/inflammatory factors in patients with prediabetes complicated with hyperuricemia.Methods A total of 180 elderly patients with hyperuricemia(HUA)were selected from the Department of General Medicine/Department of Geriatrics,Yan'an Hospital Affiliated to Kunming Medical University from May 2019 to April 2021.According to the level of glucose metabolism,72 cases were divided into impaired fasting glucose(IFG)group and 108 cases of impaired glucose tolerance(IGT)group.Each group was further divided into obese subgroup,overweight subgroup and normal weight subgroup according to body mass index.The serum levels of vWF,ET-1,NO,IL-1βand IL-6 were detected and compared.The correlation between serum endothelial/inflammatory factors and clinicopathological characteristics was analyzed by Pearson linear correlation test,and the influencing factors of serum endothelial/inflammatory factors on obesity and prediabetes complicated with hyperuricemia were analyzed by Logistic regression.Results Compared with the IFG group,the serum NO level in the IGT group decreased,while the levels of vWF,ET-1,IL-1β,and IL 6 increased,and the differences were statistically significant(t=7.016,16.646,16.405,11.856,3.036,all P<0.001).In the IFG group and the IGT group,serum NO decreased with the increase of BMI,and the levels of vWF,ET-1,IL-1β,and IL-6 increased with the increase of BMI,and the differences were statistically significant(IFG group:F=5.897,12.359,7.324,6.654,35.210,all P<0.001.IGT group:F=4.332,18.965,15.674,4.859,59.687,all P<0.001).The results of Pearson linear correlation test showed that serum vWF,ET-1,IL-1β,and IL-6 were positively correlated with BMI(r=0.52,0.55,0.54,0.52,P<0.05),and NO was negatively correlated with BMI(r=-0.44,P<0.05).Logistic regression analysis showed that elevated serum vWF,ET-1,IL-1β,and IL-6 were risk factors for obesity and prediabetes complicated with hyperuricemia,and elevated serum NO was a protective factor[OR(95%CI)=3.435(1.792-6.585),3.245(1.767-5.957),3.401(1.813-6.380),3.522(1.809-6.858),0.191(0.079-0.459)].Conclusion Serum levels of vWF,ET-1,IL-1β,and IL 6 in obese and IGT patients with hyperuricemia were increased,while NO levels were decreased,and these were the influencing factors of obesity and prediabetes complicated with hyperuricemia.