血尿酸对2型糖尿病血管并发症的影响及相关因子分析

目的评价高尿酸血症对2型糖尿病（T2DM）血管并发症的影响，并探讨其可能的作用机制。方法对586例T2DM患者，根据血尿酸水平分成尿酸正常（NUA）组和高尿酸（HUA）组，分析两组病人的大血管和微血管病变发病率的差别，测定两组病人的C-RP、TNF、IL-1、IL-2、IL-6、IL-8及PAI-1并进行分析。结果（1）HUA组的BMI、TG、BP、TC、LDL-C、WHR均高于NUA组（P〈0．05），而HDL-C则低于NUA组（P〈0．05）。（2）HUA组的冠心病、脑血管病、视网膜病变、肾脏病变、颈动脉斑块和下肢动脉斑块的发病率均高于NUA组（P均〈0．05）。（3）HUA组的CRP、TNF、IL-6、IL-8及PAI-1也高于NUA组（P均〈0．05）。结论（1）HUA血症与肥胖、血脂异常明显相关。（2）HUA血症可能通过炎性相关因子引起血管内膜增厚和斑块形成，导致大血管及微血管并发症的发生。

The effect of hyperuricemia on vascular complications of type 2 diabetes and the related-factors analysis

Objective To evaluate the effect of hyperuricemia on vascular complications of type 2 diabetes and analysis of the possible mechanism. Methods 586 cases with T2DM were divided into two groups: normal serum uric acid (n=397) and hyperuricemia (n=189).The morbidity of macrovascular and microvascular complications and the serum levels of CRP,TNF,IL-1,IL-2,IL-6,IL-8 and PAI-1 were detected. Results (1)Hyperuricemia group showed higher BMI, blood pressure, TG,TC,LDL,WHR ratio and lower serum HDL-C than the group with normal uric acid (all P<0.05).(2)Group with hyperuricemia showed higher morbidities of macrovascular and microvascular complications than the group with normal uric acid (all P<0.05).(3) Group with hyperuricemia had higher levels of CRP,TNF,IL-6,IL-8,PAI-1 (all P<0.05). Conclusions (1) Hyperuricemia is associated with obesity and dyslipidemia.(2) Hyperuricemia may cause atherosclerosis by inflammation of vascular endothelium, resulting macrovascular and microvascular complications.