2型糖尿病患者血尿酸水平与发生动脉粥样硬化性心血管疾病事件风险的影响研究

Effect of serum uric acid level on the risk of ASCVD in patients with type 2 diabetes mellitus

目的探讨T2DM患者血尿酸(SUA)水平对10年内发生动脉粥样硬化性心血管疾病(ASCVD)事件风险的影响,预测并寻找降低T2DM患者发生ASCVD的治疗新靶点。方法选取2019年1~6月于天津市人民医院内分泌科住院的18~84岁T2DM患者514例,按照SUA水平分为SUA≤300μmol/L组、300420μmol/L组,应用China-PAR模型评估10年内发生ASCVD风险。结果所有患者中合并高尿酸血症患者112例,患病率为21.8%(男11.3%、女10.5%)。随SUA水平升高,10年内发生ASCVD风险为绝经前女性先升后降再升高,在360420μmol/L组10年内发生ASCVD风险是SUA≤300μmol/L组的1.060倍(95%CI 1.032~1.088,P<0.05)。结论控制T2DM患者高水平SUA有利于降低其10年内ASCVD发病率。绝经前女性SUA水平控制在360~420μmol/L可降低ASCVD发生风险。

Objective To investigate the effect of serum uric acid level on the risk of arteriosclerotic cardiovascular disease(ASCVD)in patients with type 2 diabetes mellitus(T2DM)within 10 years,and to predict and find new therapeutic targets to reduce the incidence of ASCVD in type 2 diabetic patients.Methods A total of 514 hospitalized patients with T2DM aged 18 to 84 years old were enrolled in this study from the Department of endocrinology in Tianjin People’s Hospital from January 2019 to June 2019.All the patients were divided into four groups according to their SUA levels:SUA≤300μmol/L,300420μmol/L group.The risk of ASCVD within 10years was assessed by China‐PAR model.Results A total of 112 patients had hyperuricemia,and the prevalence rate was 21.8%(11.3% male,10.5% female).With the increase of SUA level,the risk of ASCVD within 10 years increased first,then decreased and then increased in premenopausal women,decreased in 360420μmol/L group than in SUA≤300μmol/L group(95%CI 1.032~1.088,P<0.05).Conclusion Controlling the high level of SUA in T2DM patients may be beneficial to reduce the incidence rate of ASCVD events in 10 years.SUA levels in the range of 360 to 420μmol/L in premenopausal women can reduce the risk of ASCVD.