2型糖尿病患者血尿酸与糖尿病视网膜病变相关性研究

Association analysis between serum uric acid levels and diabetic retinopathy among patients with type 2 diabetes mellitus

目的 探讨T2DM患者血尿酸(SUA)与DR的相关性。方法 选取2010年1月至2020年1月于大连市中心医院内分泌科住院治疗的T2DM患者1344例。根据基线SUA四分位间距分为Q1、Q2、Q3及Q4组。Cox回归分析DR进展的影响因素,受试者工作特征(ROC)曲线分析SUA对DR进展的预测价值。结果 中位随访时间4.75年,228(16.9%)例患者出现DR进展。Cox回归分析结果显示,Q3、Q4组DR进展风险比分别为Q1组的1.462、1.928倍(P<0.05),DM病程、SBP、HbA1c是DR进展的危险因素。分层分析结果显示,SUA与DR进展风险不受DM病程、SBP和HbA1c影响。SUA预测DR进展的ROC曲线下面积为0.725,最佳临界值为295.5μmol/L。结论 T2DM患者SUA是DR进展的独立危险因素,检测SUA对预测DR进展有一定价值。

Objective To investigate the association between serum uric acid(SUA)levels and diabetic retinopathy(DR)among patients with type 2 diabetes mellitus(T2DM).Methods A total of1344 inpatients with T2DM in the Department of Endocrinology in Dalian Central Hospital form January2010 to January 2020 were retrospectively analyzed. According to the baseline SUA quartiles,the patients were divided into 4 groups. Cox proportional risk regression analysis were used to analyze the influencing factors of DR progression. ROC curve was used to analyze the predictive value of SUA for DR progression.Results The median follow-up time was 4. 75 years. 228(16. 9%)patients progressed to DR stage. Cox analysis showed that the risk ratio of DR progression in Q3 and Q4 SUA group was 1. 462 times and 1. 928times higher than that in Q1 SUA group(P<0. 05). Meanwhile,duration of diabetes,systolic blood pressure and Hb A1c were the risk factors for DR progression. Stratified analysis showed that SUA and the risk of DR progression were not affected by duration of diabetes,systolic blood pressure and Hb A1c. The area under ROC of SUA in prediction of DR progression was 0. 725,with the optimal cut off point 295. 5 μmol/L.Conclusion SUA is an independent factor associated with the progression of DR. Detection of SUA level has a certain value in predicting the progression of DR.