2型糖尿病患者血尿酸水平与Framingham十年冠心病发生风险的关系研究

目的探讨2型糖尿病(T2DM)患者血尿酸(UA)水平与Framingham十年冠心病发生风险的关系。 方法回顾性分析2015年8月至2017年12月于上海交通大学医学院附属第九人民医院北院内分泌科住院的T2DM患者904例。比较T2DM患者男性与女性的血UA水平及Framingham十年冠心病发生风险；按照血UA水平四分位数分为4组，比较分析各组Framingham十年冠心病发生风险及其他各指标水平；分别对其进行Framingham风险评分后分为十年冠心病发生风险低危组、中危组、高危组，比较分析各组血UA水平及其他各指标水平；采用Logistic回归分析Framingham十年冠心病发生风险的危险因素。 结果T2DM男性患者的血UA水平340.00(287.00，393.00)μmol/L]和Framingham十年冠心病发生风险20(13，31)%]高于女性患者305.00(255.00，365.50)μmol/L，15(10，20)%]，两组比较均差异有统计学意义(Z＝－6.22，－7.01；均P<0.01)。根据血UA四分位数分为4组，组1至组4 Framingham十年冠心病发生风险分别为15(8, 20)%、16(10, 20)%、20(13, 25)%、20(13, 31)%，血UA水平较高组Framingham十年冠心病风险明显升高(P<0.05)；Framingham十年冠心病风险较高组血UA水平明显升高(P<0.05)。Logistic回归分析表明血UA是Framingham十年冠心病风险的独立相关因素(P＝0.022，OR＝1.003，95%CI：1.000~1.006)。 结论T2DM患者中，血UA是Framingham十年冠心病风险的独立相关因素，并且血UA水平与T2DM患者Framingham十年冠心病风险程度独立相关。

Relationship between serum uric acid level and Framingham 10-year risk of coronary heart disease in patients with type 2 diabetes mellitus

ObjectiveTo investigate the relationship and significance of serum uric acid (UA) level and the Framingham 10-year risk of coronary heart disease in patients with type 2 diabetes mellitus (T2DM). Methods904 patients with T2DM who were admitted to the Department of Endocrinology, Ninth People′s Hospital (North Hospital) , Shanghai Jiaotong University School of Medicine, from August 2015 to December 2017 were chosen, the serum UA levels and Framingham 10-year risk of coronary heart disease between men and women with T2DM were compared. Patients were divided into 4 groups based on quantiles of serum UA level, Framingham 10-year risk of coronary heart disease, and other indicators were compared. T2DM patients were divided into low-risk group, medium-risk group and high-risk group based on their Framingham risk scores for 10-year coronary heart disease, and serum UA levels and other indicators in each group were compared and analyzed. The risk factors for coronary heart disease in the Framingham 10-year were investigated using Logistic regression. ResultsMen with T2DM had higher serum UA levels 340.00(287.00, 393.00)μmol/L] and a higher Framingham 10-year coronary heart disease risk 20(13, 31)%] than women 305.00(255.00, 365.50)μmol/L, 15(10, 20)%], and the differences were statistically significant (Z=-6.22, -7.01, all P<0.01). Based on serum UA level quartiles, Framingham 10-year coronary heart disease risk was 15(8, 20)%, 16(10, 20) %, 20(13, 25) %, and 20(13, 31)% from group 1 to group 4, respectively. Patients with higher serum UA levels had a significantly higher 10-year risk of coronary heart disease (P<0.05). Patients in the higher Framingham 10-year risk groups had significantly higher serum UA levels (P<0.05). According to a Logistic regression analysis, serum UA level was an independent factor in the Framingham 10-year risk of coronary heart disease (P=0.022, OR=1.003, 95%CI: 1.000-1.006). ConclusionSerum UA level is an independent factor in Framingham 10-year risk of coronary heart disease in patients with T2DM, at the same time, serum UA level is positively associated with the Framingham 10-year risk degree of coronary heart disease in T2DM.