2型糖尿病患者高尿酸血症的临床特征及血尿酸与代谢综合征组分数目的关系

目的分析2型糖尿病（T2DM）高尿酸血症的临床及生化特征，并探讨血尿酸（UA）与代谢综合征（MS）组分数目的关系。方法采用横断面研究方法，将547例T2DM患者按UA分为高尿酸血症组和正常尿酸组；按具有代谢综合征组分的数目不同分为4组（MS1，MS2,MS3及MS4），分析临床资料。结果T2DM并高尿酸血症组的体重指数（BMI）、收缩压（SBP）、舒张压（DBP）、空腹血糖（FPG）、肌酐（Cr）、甘油三酯（TG）、总胆固醇（TC）、糖化血红蛋白（HbAlc）明显高于正常尿酸组（P〈0．05，P〈0．01），高密度脂蛋白胆固醇（HDL-C）明显低于正常尿酸组（P〈0．05），低密度脂蛋白胆固醇（LDL-C）2组间差异无统计学意义（P〉0．05）；MS1—4组间UA、BMI、SBP、DBP、Cr、TG、TC、LDL—C、HDL-C差别均有统计学意义（P均〈0．05），年龄、FPG差别无统计学意义；UA与性别、TG、HbAlc、HDL-C、Cr有线性回归关系（P〈0．05，P〈0．01），其中与HbAlc、HDL-C负相关，TG对UA影响最大。结论随着代谢综合征组分数目的增加，T2DM患者UA增加，异常TG对UA影响最大，因此UA水平升高是代谢综合征的危险因素。

Characteristic of hyperuricemia in patients with type 2 diabetes and association between serum uric acid level and components of the metabolic syndrome

Objective To evaluate the clinical and biochemical characteristics of type 2 diabetics with hyperuricemia and to investi-gate the association between serum uric acid and the number of metabolic syndrome components. Method In the cross-sectional study of 547 type 2 diabetics, we recorded body mass index (BMI), systolic blood pressure(SBP), diastolic blood pressure (DBP), and collected blood samples to measure serum uric acid (UA), fasting plasma glucose (FPG), glycosylated hemoglobin (HbAlc), creatinine (Cr) and blood lipid profile, including tfiglyceride (TG), total cholesterol (TC), low-density cholesterol LDL-C) and high-density cholesterol (HDL-C). Results Compared with the normal UA group, the diabetic patients in the high UA group had significantly increased levels of BMI, SBP, DBP, FPG, Cr, TG, TC and HbA1c (P <0.05, P <0.01, P <0.05, P <0.01, P <0.01), and decreased level of HDL-C(P < 0.05). There was no significant difference in the level of LDL-C between the two groups (P > 0.05). According to their possession of 1, 2, 3 or 4 components of metabolic syndrome, 547 cases were divided into four groups (MSI, MS2,MS3 and MS4). There were significant difference in the levels of UA, BMI, SBP, DBP, Cr, TG, TC, LDL-C and HDL-C among MSI, MS2, MS3 and MS4 (All P < 0.05). Multiple regression analysis showed that UA concentration was positively correlated with sex, TG and Cr (Beta:0. 088,0. 350, 0. 124; P < 0.05, P <0.01, P <0.01) and negatively correlated with HDL-C and HbA1 c(Beta: -0.107, -0.124 ; P <0.01, P <0.01). The con-centration of UA was strongly correlated with serum TG. Conclusions Serum UA level in type 2 diabetics was significantly elevated as the number of metabolic components increased. Abnormal TG had great influence on serum UA. Hyperuricemia was considered to be a dangerous factor of the metabolic syndrome.