2型糖尿病绝经期妇女高尿酸血症与早期慢性肾脏病的关系

Relationship Between Hyperuricemia and Early-stage Chronic Kidney Disease in Menopausal Women with Type 2 Diabetes Mellitus

目的探讨2型糖尿病绝经期妇女高尿酸血症与早期慢性肾脏疾病(chronic kidney disease,CKD)的关系。方法选取96名绝经期2型糖尿病患者,根据肾小球滤过率(estimating glomerular filtration rate,eGFR)水平分为正常对照组(eGFR≥90 ml/min·1.73 m^(-2))与早期肾损害组(eGFR60~89 ml/min·1.73 m^(-2))。检测体质量指数(body mass index,BMI)、内脏脂肪面积(visceral fat area,VFA)、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、24h尿微量白蛋白;空腹抽取静脉血,检测总胆固醇(total cholesterol,TC)、甘油三脂(triglyceride,TG)、高密度脂蛋白-胆固醇(high-density lipoprotein-cholesterol,HDL-C)、低密度脂蛋白-胆固醇(low-density lipoprotein-cholesterol,LDL-C)、C反应蛋白(C-reactive protein,CRP)、同型半胱氨酸(homocysteine,Hcy)、尿酸(uric acid,UA)、糖化血红蛋白(glycated hemoglobin,HbA1c)等指标。采用独立样本t检验比较两组间各项指标的差异,运用多元线性回归分析UA与eGFR的关系。结果与正常对照组相比,早期肾损害组UA、Hcy水平明显升高,组间比较差异具有统计学意义(P<0.05);调整年龄后,行偏相关分析显示,eGFR与UA、Hcy均呈负相关(P=0.01);多元回归分析显示,UA升高是eGFR的独立危险因素(β=-0.317,P=0.003)。结论 2型糖尿病绝经期女性UA、Hcy升高是早期CKD的独立危险因素。

Objective To investigate the relationship between hyperuricemia and early-stage chronic kidney disease(CKD)in menopausal women with type 2 diabetes mellitus.Methods A total of 96 menopausal women with type 2 diabetes mellitus were enrolled.According to the estimated glomerular filtration rate(eGFR),the subjects were divided into normal control group(eGFR≥90 ml/min·1.73 m^(-2))and early-stage kidney disease group(eGFR60-89 ml/min·1.73 m^(-2)).Body mass index(BMI),visceral fat area(VFA),systolic blood pressure(SBP),diastolic blood pressure(DBP),24-hour urine microalbumin were detected.Fasting venous blood samples were taken for total cholesterol(TC),triglyceride(TG),high-density lipoprotein-cholesterol(HDL-C),low-density lipoprotein-cholesterol(LDL-C),C-reactive protein(CRP),homocysteine(Hcy),blood uric acid(UA),glycated hemoglobin(HbA1 c),and other indicators.An independent sample t test was used to compare the differences between two groups.The relationship between UA and eGFR was analyzed by multiple linear regression.Results Compared with the normal control group,the UA and Hcy levels of the earlystage kidney disease group increased significantly(P<0.5).Adjusted age,partial correlation analysis showed that eGFR was negatively correlated with UA and Hcy(P=0.01).Multiple regression analysis showed that elevated UA was an independent risk factor for eGFR(β=-0.317,P=0.003).Conclusion Elevated UA and Hcy in menopausal women with type 2 diabetes mellitus are independent risk factors for early-stage chronic kidney disease.