老年2型糖尿病患者高尿酸血症的相关因素分析

目的 了解老年糖尿病患者发生高尿酸血症的情况及其临床特点,并探讨老年人高尿酸血症的相关因素.方法 收集近5年在内分泌科住院60岁以上已诊断为2型糖尿病者,进行全面体格检查,统一方法测量血压,空腹静脉抽血检查血糖、尿素氮、血肌酐、血尿酸、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、糖化血红蛋白等.测定24 h尿蛋白定量.纳入资料完整的454例,根据尿酸水平不同将患者分为高尿酸组82例（18.1％）和非高尿酸组372例进行分析.结果 （1）高尿酸血症组年龄、体质指数、三酰甘油、24h尿蛋白定量等均高于非高尿酸组,糖尿病病程、肾小球滤过率低于非高尿酸组；（2）高尿酸血症与年龄（r =0.115,P＜0.001）、体质指数（r=0.159,P＜0.001）、三酰甘油（r=0.179,P＜0.001）、24 h尿蛋白定量（r=0.168,P＜0.001）呈正相关,与糖尿病病程（r=-0.136,P＜0.001）、肾小球滤过率（r=-0.274,P＜0.001）呈负相关；男性高尿酸血症者多于女性；（3）多元逐步回归分析显示：性别、体质指数、三酰甘油、24h尿蛋白定量、肾小球滤过率是高尿酸血症的独立危险因素.结论 老年2型糖尿病患者的高尿酸血症患病率18.1％.应控制体质量、降低三酰甘油、关注肾小球滤过率受损,积极防治老年2型糖尿病患者的高尿酸血症.

Relevant factors of hyperuricemia in elderly patients with type 2 diabetes

Objective To explore the prevalence and clinical features of hyperuricemia among the Chinese patients diagnosed with type 2 diabetes aged over 60 and to analyze the relationship between hyperuricemia and relevant risk factors.Methods A total of 454 patients diagnosed with type 2 diabetes aged over 60 were studied.Data of physical examination,resting blood pressure,fasting plasma glucose （FPG）,blood urea nitrogen （BUN）,serum creatinine （SCr）,serum uric acid （SUA）,total cholesterol （TC）,triglyeride （TG）,high density liporotein cholesterol （HDL-C）,low density liporotein cholesterol （LDL-C）,glycosylated hemoglobin A1 c （HbA1 c） and 24 hours urinary albumin excreation （24 h-UAE） were collected.The prevalence of hyperuricernia and the risk factors associated with hyperuricemia were investigated.Results In this study hyperuricemia occurred in 18.1% （82/454） patients.（1） Age,body mass index （BMI）,serum triglyceride and 24 hours urinary albumin excreation （24 h-UAE） were significantly higher and diabetic course,estimated glomerular filtration rate （eGFR） significantly lower in hyperuricemia patients than those non-hyperuricemia subjects.（2） Hyperuricemia was positively correlated with age,BMI,serum triglyceride and 24 h-UAE （r =0.115,r =0.159,r =0.179,r =0.168,respectively,all P 〈 0.001） and negatively correlated with diabetic course and eGFR （r =-0.136,r =-0.274,respectively,both P 〈 0.001）.Hyperuricemia was more common in males than in females.（3） Multiple stepwise regression analysis revealed that gender,BMI,serum triglyceride,24 h-UAE and eGFR were independent risk factors for hyperuricemia.Conclusions Hyperuricemia is common in elderly patients with type 2 diabetes and gender,BMI,serum triglyceride,24 h-UAE and eGFR are independent risk factors for hyperuricemia.