糖尿病肾病血尿酸与血脂及肌酐清除率的关系

目的 通过检测2型糖尿病(T2DM)患者血尿酸(SUA)、血脂、血肌酐(SCr)等水平,探讨高尿酸血症与相关影响因素及糖尿病肾病发生、发展的关系.方法 根据尿微量白蛋白(mAlb)/肌酐(Cr)水平将102例T2DM患者分为三个亚组:正常白蛋白尿组30例(尿mAlb/Cr＜30μg/mg)、微量白蛋白尿组41例(30μg/mg≤尿mAlb/Cr＜300μg/mg)及临床白蛋白尿组31例(尿mAlb/Cr≥300μg/ms),测定SUA、SCr、糖化血红蛋白(HbA1c)、空腹胰岛索(FINS)、三酰甘油(TG)等指标,计算肌酐清除率(CCr),并与40例对照者(对照组)比较.结果 临床白蛋白尿组SUA水平为(369.3±181.2)μmol/L,显著高于对照组、正常白蛋白尿组、微量白蛋白尿组的(248.6±109.4)、(228.7±104.8)、(296.5±121.4)μmol/L(P＜0.01或＜0.05),且SUA随mAlb/Cr的增加而增加.SUA与SCr、TG呈正相关r=0.369、0.525,P＜0.01),与CCr呈负相关r=-0.389,P＜0.01);多元线性逐步回归分析显示TG与SUA呈正相关(P＜0.05),CCr与SUA呈负相关(P＜0.05),SCr与SUA无相关性.结论 TG和CCr是SUA的独立相关因素,CCr与SUA相关性较SCr更好,高尿酸血症可能参与了T2DM患者糖尿病肾病的发生、发展过程,应尽早干预治疗.

Relationship among serum uric acid,lipid and creatinine clearance rate of type 2 diabetes mellitus

Objective To detect the levels of serum uric acid(SUA),lipid and creatinine(SCr) of type 2 diabetes mellitus(T2DM),and discuss the correlation between them and diabetic nephropathy(DN).Methods One hundred and two cases of T2DM patients were selected and divided into three groups based on the level of urine microalbumin(mAlb)/creatinine(Cr):30 cases of N-UAlb group(urine mAlb/Cr＜30μg/mg),41 cases of M-UAlb group(30μg/mg≤urine mAlb/Cr＜300μg/mg)and 31 cases of C-UAlb group(urine mAlb/Cr≥300 μg/mg),detected the SUA,SCr,HbA1c,fasting insulin(FINS),triglyeride(TG)and calculated the creatinine clearance rate(CCr).Selected 40 healthy subjects as control group.Results The SUA level in C-UAlb group[(369.3±181.2)μmol/L]was significantly higher than the other groups [(248.6±109.4)μmol/L in control group;(228.7±104.8)μmol/L in N-UAlb group;(296.5±121.4)μmol/L in M-UAIb group](P＜0.01 or＜0.05),and increased with increment of urine mAlb/Cr.In the whole study population,the Pearson correlation coefficient of SCr,CCr,TG and SUA were 0.369,-0.389.0.525,respectively(P＜0.01).Multiple regression analysis showed that SUA levels in T2DM patients were positively correlated with TG(P＜0.05),and were negatively correlated with CCr(P＜0.05).Conclusions TG and CCr are independent risk factors of SUA.CCr correlates with SUA better than SCr.Diabetic hyperuricemia might affect the process of occurrence and development of DN.There is need for prevention and treatment.