初诊2型糖尿病合并代谢综合征患者血清尿酸水平与血液流变学相关性分析

目的探讨初诊2型糖尿病(T2DM)合并代谢综合征(MetS)患者血清尿酸(UA)水平和血液流变学指标的关系。方法检测并比较91例单纯T2DM患者、122例T2DM合并MetS患者及256例健康者(对照组)体质量指数、血压、血糖、血脂、UA及血液流变学等指标检测结果。结果单纯T2DM患者和T2DM合并MetS患者体质量指数、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、UA、糖化清蛋白水平均高于健康者(P<0.05),患者组间总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、UA、糖化清蛋白比较差异亦有统计学意义(P<0.05)。患者组间红细胞刚性指数、红细胞变形指数、血液黏度、血液还原黏度、微循环滞留时间、血栓形成系数等血液流变学指标比较差异有统计学意义(P<0.05)。各研究组间高尿酸血症患病率比较差异有统计学意义(P<0.01)。控制了年龄、性别、体质量指数、总胆固醇、三酰甘油等水平后,UA水平与血细胞比容、红细胞聚集指数、红细胞刚性指数、血液黏度、血液还原黏度、微循环滞留时间、血栓形成系数等血液流变学指标存在正相关。结论合并MetS的T2DM患者较单纯T2DM患者存在更明显的血液流变学改变和更高的UA水平,且UA水平与血液流变学指标关系密切。初诊T2DM患者除应控制血糖、血压、血脂及体质量外,更应控制UA水平及改善血液流变性,从而阻止或延缓病情的发生与发展。

Relationship between serum uric acid and hemorrheology in patients with newly diagnosed type 2 diabetes mellitus complicated metabolic syndrome

Objective To evaluate the relationship between serum uric acid （UA）and hemorrheology in pa- tients with newly diagnosed type 2 diabetes mellitus （T2DM）complicated metabolic syndrome （MetS）. Methods 91 patients with T2DM, 122 patients complicated with T2DM and MetS, and 256 healthy subjects were enrolled and measured for body mass index （BMI）, total cholesterol （TC）, triglycerol（TG）, high-density lipoprotein cholesterol （HDL-C） ,low-density lipoprotein cholesterol （LDL-C）, UA, glycated serum protein （GSP） and hemorrheology. Re- sults The differences of BMI, TC, TG, HI）L-C, LDL-C, UA, GSP and hemorrheology indicators between patients with T2I）M and healthy subjects were significant （P〈O. 05）. Of patients with T2DM, those complicated with MetS had significantly higher TC, TG, HDL-C, LI）L-C, UA, GSP and hemorrheology indicators （P〈0.05）. The prevalence rate of hyperuricemia in patients with T2DM complicated MetS was significant elevated （P（0.05）. After adjustment of age, sex, smoking, BMI, TC, TG, the partial correlation analysis showed that the UA level was significantly positive related to the levels of hematocrit, erythrocyte aggregation index, blood viscosity, blood reduced viscosity, microcircu- lation retention time and thrombosis index. Conclusion Patients complicated with MetS and T2I）M might have re- markable overweight, dyslipidemia,hyperuricemia and hypercoagulabale, and more attention should be paid to drop u- ric acid and blood viscosity, excepting the treatment of blood glucose, blood pressure and blood fat, to prevent or delay the genesis and development of diseases.