2型糖尿病患者血清铁蛋白水平与血尿酸的关系

Relationship between serum ferritin level and serum uric acid in patients with type 2 diabetic mellitus

目的探究2型糖尿病(T2DM)患者血清铁蛋白(SF)水平与血尿酸(SUA)的关系,为临床上T2DM合并高尿酸血症(HUA)患者的诊治提供新的分子标志物。方法选取2021年8月至2022年9月于兰州大学第一医院内分泌科住院治疗的T2DM患者351例,根据SF的四分位数水平将其分为4组:Q1组(SF<76.2 ng/mL,87例)、Q2组(SF为76.2~138.9 ng/mL,88例)、Q3组(SF为139.0~240.9 ng/mL,87例)、Q4组(SF≥241.0 ng/mL,89例),比较不同SF水平组患者SUA水平、HUA患病率的差异。根据是否合并HUA将T2DM患者分为HUA组(54例)和非HUA组(297例),比较两组之间SF水平及高铁蛋白血症患病率的差异。采用Pearson相关、Spearman秩相关及多元线性回归模型分析T2DM患者SF与SUA之间的相关性,采用二元logistic回归模型分析T2DM患者HUA发生的影响因素。结果T2DM患者Q4组SUA水平[(344.54±105.94)μmol/L]高于Q1组[(308.34±79.60)μmol/L,P<0.05],不同SF水平组间HUA患病率差异无统计学意义(P>0.05)。HUA组SF水平[174.50(105.40,295.25)ng/mL]高于非HUA组[129.00(69.55,226.00)ng/mL],差异有统计学意义(P<0.05);HUA组患者高铁蛋白血症的患病率(18.52%,10/54)与非HUA组(17.17%,51/297)比较差异无统计学意义(P>0.05)。相关性分析提示SUA与SF呈正相关(rs=0.110,P=0.040)。多元线性回归分析提示T2DM患者SF与SUA呈独立正相关(P<0.05)。二元logistic回归分析提示T2DM患者SF与HUA呈独立正相关(OR=1.003,P=0.023)。结论T2DM患者SF水平与SUA密切相关,SF是T2DM患者HUA发生的独立影响因素。

Objective To investigate the relationship between serum ferritin(SF)level and serum uric acid(SUA)in patients with type 2 diabetes mellitus(T2DM),so as to provide new molecular markers for diagnosis and treatment of T2DM patients with hyperuricemia(HUA).Methods A total of 351 T2DM patients who were hospitalized in Department of Endocrinology,First Hospital of Lanzhou University from Aug.2021 to Sep.2022 were enrolled and assigned to 4 groups according to the quartile level of SF:Q1 group(SF<76.2 ng/mL,n=87),Q2 group(SF 76.2-138.9 ng/mL,n=88),Q3 group(SF 139.0-240.9 ng/mL,n=87),and Q4 group(SF≥241.0 ng/mL,n=89);and the SUA levels and the prevalences of HUA in different SF level groups were compared.In addition,T2DM patients were assigned to HUA group(n=54)and non-HUA group(n=297)to compare the SF levels and prevalences of hyperferritinemia.Pearson correlation,Spearman rank correlation,and multiple linear regression were used to analyze the correlation between SF and SUA in T2DM patients.The influencing factors of HUA in T2DM patients were analyzed by binary logistic regression.Results The level of SUA in the Q4 group([344.54±105.94]μmol/L)was significantly higher than that in the Q1 group([308.34±79.60]μmol/L,P<0.05).There was no significant difference in the prevalences of HUA between groups with different SF levels(P>0.05).The SF level in the HUA group(174.50[105.40,295.25]ng/mL)was significantly higher than that in the non-HUA group(129.00[69.55,226.00]ng/mL,P<0.05),and the prevalence of hyperferritinemia was higher in the HUA group(18.52%,10/54)than in the non-HUA group(17.17%,51/297),but the difference was not statistically significant(P>0.05).Correlation analyses indicated that SUA was positively correlated with SF(rs=0.110,P=0.040).Multiple linear regression analysis indicated an independent positive correlation between SF and SUA in T2DM patients(P<0.05).Binary logistic regression analysis showed an independent positive correlation between SF and HUA in patients with T2DM(odds ratio=1.003,P=0.023).Conclusion SF level is closely related to SUA in T2DM patients,and SF is an independent factor of HUA in T2DM patients.