2型糖尿病大血管并发症与高尿酸血症、胰岛素抵抗的关系

目的探讨高尿酸血症、胰岛素抵抗与2型糖尿病大血管并发症的关系。方法将142例2型糖尿病患者分成高尿酸血症组（70例）和正常血尿酸组（72例）。分别测定两组患者的血尿酸、空腹血糖、空腹胰岛素、糖化血红蛋白、血脂、体重指数及胰岛素抵抗指数，进行分析比较。观察他们的大血管并发症情况。结果糖尿病大血管并发症的发病率与高尿酸血症、胰岛素抵抗呈正相关；高尿酸组患者的冠心病、高血压及脑卒中的患病率高于对照组（P〈0．05），颈动脉粥样硬化的发生率明显高于对照组（P〈0．01）；胰岛素抵抗指数、体重指数及甘油三酯水平亦高于血尿酸正常组。结论高尿酸血症加重了2型糖尿病的代谢紊乱及胰岛素抵抗，胰岛素抵抗促进了糖尿病大血管并发症的发生发展。

Relationship of hyperuricemia,insulin resistance and macro - vascular complication of type 2 diabetes mellitus

Objective To explore the relationship between hyperuricemia, insulin resistance and macro - vascular complication of type 2 diabetes mellitus. Methods One hundred and forty - two cases were divided into two groups according to their uric acid levels. There were hyperuricemia group（n =70） and normal uric acid group（n =72）. Their UA, FBG, HbAlc, CHO, LDL - C,TG,BMI and HOMA -IR were mearsured and analyzed. We observed serious degree and incidence of macro - vessels complication. Results There was a positive relation between hyperuricemia, insulin resistance and the incidence of macro - vessels complication of type 2 diabetes mellitus. The incidence of CHD, HT and STROKE in hyperuricemia group was higher than the compared group（ P 〈0.05）. The occurrence of AS in hyperuricemia group was higher than the compared group（ P 〈0.01）. HOMA -IR,BMI and TG were also higher. Conclusions Hyperuricemia makes metabolic disorder and insulin resistance of type 2 diabetes mellitus heavier, insulin resistance makes the macro -vascular complication of type 2 diabetes mellitus occur and develop.