2型糖尿病合并高尿酸血症患者微血管病变研究

Study on microvascular disease in patients with type 2 diabetes mellitus complicated with hyperuricemia

目的 探讨2型糖尿病(T2DM)合并高尿酸血症(HUA)患者微血管病变发生情况及其影响因素。方法 选取102例T2DM合并HUA患者作为研究对象,根据是否发生微血管病变分为微血管病变组59例与非微血管病变组43例,比较2组患者一般资料、血压、糖脂代谢指标和肾功能指标等,并采用多因素Logistic回归分析探讨T2DM合并HUA患者发生微血管病变的影响因素。结果 微血管病变组的年龄、体质量指数、腰臀比(WHR)、合并高血压病者占比和收缩压(SBP)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、血尿酸(SUA)水平均高于非微血管病变组,糖尿病病程长于非微血管病变组,估算肾小球滤过率(eGFR)低于非微血管病变组,差异有统计学意义(P<0.05);2组患者性别构成、吸烟史、饮酒史、舒张压(DBP)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、血尿素氮(BUN)和血肌酐(Scr)比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析显示,WHR、高血压病、糖尿病病程、SBP、HbA1c、SUA和LDL-C均为T2DM合并HUA患者发生微血管病变的独立影响因素(P<0.05)。结论 T2DM合并HUA患者发生微血管病变的风险较高,WHR、高血压病、糖尿病病程、SBP和HbA1c、SUA、LDL-C水平均是其影响因素。

Objective To investigate the occurrence of microvascular lesions in patients with type 2 diabetes mellitus(T2 DM) complicated with hyperuricemia(HUA), and its influencing factors. Methods A total of 102 patients with T2 DM and HUA were selected as study objects, and were divided into microvascular disease group(n=59) and non-microvascular disease group(n=43) according to whether they occurred microvascular disease or not. The general data, blood pressure, glucose and lipid metabolism indexes and renal function indexes were compared between the two groups. Multivariate Logistic regression analysis was used to explore the influencing factors of microvascular disease in T2 DM patients complicated with HUA. Results Age, body mass index(BMI), waist-to-hip ratio(WHR), systolic blood pressure(SBP), fasting blood glucose(FBG), serum glycated hemoglobin(HbA1 c), triglyceride(TG), low-density lipoprotein cholesterol(LDL-C) and blood uric acid(SUA) levels in the microvascular disease group were significantly higher than those in the non-microvascular disease group, duration of diabetes was longer than that of the non-microvascular disease group, and the estimated glomerular filtration rate(eGFR) was significantly lower than that in the non-microvascular disease group(P<0.05). There were no significant differences in gender composition, smoking history, drinking history, diastolic blood pressure(DBP), total cholesterol(TC),high density lipoprotein cholesterol( HDL-C),blood urea nitrogen( BUN) and serum creatinine( Scr)between the two groups( P > 0. 05). Logistic regression analysis showed that WHR,hypertension,duration of diabetes,SBP,HbA1c,SUA and LDL-C were independent risk factors for microvascular disease in T2DM patients with HUA( P < 0. 05). Conclusion T2DM patients with HUA have higher risk of microvascular disease,and WHR,hypertension,disease duration,SBP and levels of Hb A1c,SUA and LDL-C are all risk factors for microvascular disease.