2型糖尿病患者血清尿酸水平与尿酸排泄分数的相关性

目的：分析2型糖尿病（T2DM）患者血清尿酸（SUA）水平与肾脏尿酸排泄分数（FEur）的关系及影响因素。方法：收集430例T2DM患者的临床资料，按其SUA水平分为低、中、高3组；根据相关生化指标计算尿酸清除率（Cur）、FEur和胰岛素抵抗指数（HOMA—IR）。结果：高尿酸血症（HUA）者占12．6％；SUA水平越高，男性所占比例越大；SUA水平随体重指数（BMI）、甘油三酯（TG）和空腹胰岛素（FINS）水平的升高而升高。而高密度脂蛋白胆固醇（HDL—C）、空腹血糖（FPG）和糖基化血红蛋白（HbAlc）则相反：24h尿尿酸（UUA）定量随SUA水平的升高而升高，Cur和FEur则随SUA水平的升高而降低；相关分析显示：FEur与肌酐清除率（Ccr）、BMI和SUA呈负相关，与HbAlc和HOMA—IR呈正相关。结论：T2DM患者尿酸代谢紊乱存在低尿酸血症和HUA两种形式；FEur可更全面、真实的反映肾脏处理尿酸的状况。对易合并肾损害的T2DM患者而言，关注其FEur、避免高尿酸尿对肾脏的损害更具意义。

The relationship between the level of serum uric acid and fractional excretion of uric acid in patients with type 2 diabetes

Objective： To evaluate the relationship between the level of serum uric acid（SUA） and fractional excretion of uric acid （FEur）and their influencing factors in patients with type two diabetes（T2DM）. Methods： Clinical data of 430 patients with T2DM were collected. According to the level of SUA, patients were divided into three groups; clearance of uric acid（Cur）,FEur and insulin resistance index（HOMA-IR） were calculated in accordance with the relevant biochemical indicators. Results： The prevalence of hyperuricemia（HUA） was 12.6 %. Patients with higher SUA levels were more male; patients with higher SUA levels had bigger body mass indexs （BMI）,higher triglycerides （TG） and higher fast insulin levels（FINS）,but lower high-density lipoproteins cholesterol （HDL-C）,lower fast serum glucose（FPG） and lower glycosylated hemoglobin （HbA1c）levels. The higher level of SUA, the higher 24 hours urinary uric acid （UUA）, but the smaller Cur and smaller FEur. The correlation analysis showed that FEur was negatively correlated with creatinine clearance rate （Ccr）,BMI and SUA, positively correlated with HbAle and HOMA-IR. Conclusion： There are two different forms of uric acid metabolism disorder in patients with T2DM： hypouricemia and HUA; FEur can evaluate the excretion of uric acid in kidney fully and truly. For patients with T2DM who combine kidney of kidney induced by damages easily, we should be concerned about their FEur in order to avoid the injuries hyperuricuria.