2型糖尿病患者血尿酸与大血管病变的相关性

目的探讨2型糖尿病患者高尿酸血症与大血管病变及其影响因素的相关性。方法选择2型糖尿病患者472例,根据血尿酸水平分为高尿酸血症组(男性≥416.4μmol/L,女性≥356.9μmol/L)和正常血尿酸组。分析两组患者大血管病变及影响因素的关系。结果高尿酸血症组的AB I值、高密度脂蛋白胆固醇(HDL-C)低于尿酸正常组;而体质量指数(BM I)、三酰甘油(TG)、尿素氮(BUN)、肌酐(C r)、尿微量白蛋白(MAU)均高于尿酸正常组(P<0.05)。高尿酸血症组高血压病、冠心病的发病率高于尿酸正常组,差异有统计学意义(P<0.01)。多元线性回归分析显示,尿酸与病程(r=0.118)、BM I(r=0.204)、BUN(r=0.298)、C r(r=0.145)、糖化血红蛋白(r=0.107)、LDL-C(r=0.168)均呈正相关(P<0.05)。结论 2型糖尿病患者高尿酸血症与下肢动脉硬化密切相关,预防糖尿病的大血管并发症除控制血糖、血压、血脂、体质量等危险因素外,还应控制血尿酸水平。

Association of Uric Acid with Arteriosclerotic Diseases in Type 2 Diabetes Mellitus

Objective To observe the association of uric acid with arteriosclerotic diseases and contributing factors in type 2 diabetes mellitus(T2DM).Methods A total of 472 patients with T2DM,at an average age of 63.1±13.0years,were divided into two groups:high uric acid(HUA)group and normal uric acid(NUA)group based on the serum level of uric acid,i.e.,UA>416.4 μmol/L(men)and ≥356.9 μmol/L(women).ABI in all patients were measured by using an ES-1000SPM Doppler blood stream detector.Results The levels of ABI and high-density lipoprotein cholesterol in T2DM with HUA0.94±0.21mmHg and 1.28±0.47mmol/L,were significantly lower than those in T2DM with NUA,0.99±0.17mmHg and 1.13±0.3mmol/L,(all P<0.05),respectively.Patients with HUA had a higher body mass index,higher triglyceride,higher urea nitrogen,higher creatinine,and microalbuminuria than patients with NUA(all P<0.05).The multiple linear regression with UA as a dependent variable showed that UA was positively correlated with disease duration,BMI,urea nitrogen,creatinine,glycosylated hemoglobin,and low density lipoprotein cholesterol(r=0.118,0.204,0.298,0.145,0.107 and 0.168,respectively,all P<0.05).Conclusion Hyperuricacidemia in T2DM patients was closely associated with the atherosclerosis of lower limbs,which should be corrected along with the control of blood glucose,blood pressure,body mass index,and other risk factors for the prevention of macrovascular complications.