2型糖尿病患者血清尿酸水平与颈动脉粥样硬化斑块及10年心血管疾病风险分析

Relationship among blood uric acid level,carotid atherosclerotic plaque and 10-y cardiovascular disease risks in patients with type 2 diabetes mellitus

目的血清尿酸(UA)与许多心血管危险因素相关,但其作为心血管病的独立危险因素仍存在争议。本研究探讨2型糖尿病(T2DM)患者血清尿酸水平与颈动脉粥样硬化斑块(CAP)以及10年心血管疾病风险之间的关系。方法选择2020年1月至2021年12月于西安交通大学第一附属医院健康医学科T2DM患者6667例,按照尿酸水平男性>420µmol/L,女性>360µmol/L定义为高尿酸血症,分为高尿酸血症组(1217例)和无高尿酸血症组(5450例)。µ采用单因素和多因素Logistic回归分析血清尿酸水平与CAP以及国人缺血性心血管病(ICVD)10年发病风险之间的相关性。结果T2DM患者的高尿酸血症组的CAP发生率(39.3%)显著高于无高尿酸血症组(34.6%,P<0.001),高尿酸血症组的ICVD 10年发病风险(8.08%)显著高于无高尿酸血症组(7.02%,P<0.001)。高尿酸血症组的年龄、体质指数(BMI)、收缩压(SBP)、舒张压(DBP)、肌酐(Cr)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)水平均升高,高密度脂蛋白胆固醇(HDL-C)水平降低,差异具有统计学意义(P<0.05)。多因素Logistic回归显示尿酸水平(OR=1.001,95%CI:1.000~1.002,P=0.010)与颈动脉粥样硬化有关,尿酸水平(OR=1.001,95%CI:1.001~1.003,P=0.030)与心血管发病风险相关。结论在T2DM患者中,血尿酸水平与颈动脉粥样硬化斑块发生和10年心血管疾病风险相关,高尿酸血症可能促进T2DM患者心血管疾病的发生。

Objective To discuss the relationship among level of blood uric acid(BUA)level,carotid atherosclerotic plaque(CAP)and risks of 10-y cardiovascular disease in patients with type 2 diabetes mellitus(T2DM).Methods T2DM patients(n=6667)were chosen from Department of Health Medicine in the First Affiliated Hospital of Xi`an Jiaotong University from Jan.2020 to Dec.2021.According to BUA level>420 umol/L in males and BUA>360 umol/L in females as hyperuricemia,the patients were divided into hyperuricemia group(n=1217)and non-hyperuricemia group(n=5450).The correlation among BUA level,CAP and risks of Chinese 10-y ischemic cardiovascular disease(ICVD)was analyzed by using single-factor and multi-factor Logistic regression analysis.Results The incidence of CAP was 39.3%in hyperuricemia group and 34.6%in non-hyperuricemia group(P<0.001).The risks of 10-y ICVD was 8.08%in hyperuricemia group and 7.02%in non-hyperuricemia group(P<0.001).Age and levels of body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),creatinine(Cr),total cholesterol(TC),low-density lipoprotein-cholesterol(LDL-C)and triglyceride(TG)increased,and level of high-density lipoprotein-cholesterol(HDL-C)decreased in hyperuricemia group compared with non-hyperuricemia group(P<0.05).The results of multi-factor Logistic regression analysis showed that BUA level was correlated to carotid atherosclerosis(OR=1.001,95%CI:1.000~1.002,P=0.010)and risks of cardiovascular diseases(OR=1.001,95%CI:1.001~1.003,P=0.03).Conclusion The level of BUA is correlated to CAP and risks of 10-y cardiovascular diseases,and hyperuricemia may contribute to cardiovascular disease development in T2DM patients.