血尿酸/肌酐比值与2型糖尿病患者颈动脉斑块稳定性因素的相关性研究

Correlation between serum uric acid to creatinine ratio and stability factors of carotid plaque in type 2 diabetes patients

目的探讨血尿酸/肌酐比值(SUA/Cr)与2型糖尿病(T2DM)患者颈动脉斑块稳定性的相关性,开发一种新的评估量表,用于临床快速评估T2DM患者颈动脉斑块的稳定性。方法收集2015年1月至2022年2月T2DM合并颈动脉斑块的住院患者518例,收集患者的一般资料及临床检验等指标,完善颈动脉超声检查。根据超声特征将患者分为斑块稳定组(262例)和易损斑块组(256例)。计量资料两组间比较采用独立样本t检验、Mann Whitney U检验。计数资料两组间比较采用χ^(2)检验。二元Logistic回归分析颈动脉斑块不稳定的独立危险因素。将独立危险因素绘制受试者工作特征(ROC)曲线,并计算曲线下面积(AUC)。对易损斑块组的患者,进行颈动脉斑块数目和颈动脉斑块回声评分,分析SUA/Cr与颈动脉斑块稳定性的相关性。在二元Logistic回归模型中,将所有独立危险因素按照OR值来评分,建立评价量表。结果易损斑块组的SUA/Cr明显高于斑块稳定组,差异有统计学意义(P<0.01),斑块不稳定的风险随SUA/Cr的增加而增加(OR=3.121,95%CI 2.376~4.099,P<0.01)。ROC曲线示SUA/Cr临界值为4.899,AUC为0.783。所有数据经评价量表检验,≥6分为最佳截断值。结论在T2DM患者中,SUA/Cr与颈动脉斑块的稳定性相关,SUA/Cr可用于指示颈动脉斑块不稳定性的风险。新的评分量表是预测颈动脉斑块稳定性的可靠指标。

Objective To explore the correlation between the serum uric acid to creatinine ratio(SUA/Cr)and the stability of carotid plaque in patients with type 2 diabetes(T2DM),and to develop a new evaluation scale for rapid clinical evaluation of the stability of carotid plaque in patients with T2DM.Methods 518 inpatients with T2DM and carotid plaque from January 2015 to February 2022 were collected.Collect general information and clinical testing indicators of patients,while improving carotid artery ultrasound examination.According to the ultrasonic characteristics,the patients were divided into plaque stable group(262 cases)and plaque unstable group(256 cases).The measurement data between the two groups were compared by independent sample t test and Mann-Whitney U test.The counting data were compared between the two groups χ^(2) Inspection.The independent risk factors of carotid plaque instability were analyzed by binary logistic regression.Draw the ROC curve for independent risk factors,and calculate the area under the curve(AUC).For patients with plaque instability,carotid plaque number score and carotid plaque echo score were performed respectively to analyze the correlation between UA/Cr and carotid plaque stability.Finally,in the binary logistic regression model,all independent risk factors are scored according to the OR value to establish an evaluation scale.Results SUA/Cr in the plaque unstable group was significantly higher than that in the plaque stable group(P<0.01).The risk of plaque instability increased with the increase of SUA/Cr(OR=3.121,95%CI 2.376~4.099,P<0.01).The ROC curve shows that the critical value of SUA/Cr is 4.899 and AUC is 0.783.All data were tested by the evaluation scale,and≥6 points was the best cut-off value.Conclusions In T2DM patients,SUA/Cr is related to the stability of carotid plaque,and SUA/Cr can be used to indicate the risk of carotid plaque instability.The new scoring standard is a reliable index to predict the stability of carotid plaque.