内脏脂肪面积不同的2型糖尿病患者中 维生素D与高尿酸血症的研究进展

Research Progress on Vitamin D and Hyperuricemia in Type 2 Diabetic Patients with Different Visceral Fat Areas

摘要: 本综述系统梳理不同内脏脂肪面积(Visceral Fat Area, VFA)的2型糖尿病(Type 2 Diabetes Mellitus, T2DM)患者中维生素D (Vitamin D, VD)与高尿酸血症(Hyperuricemia, HUA)的相关性研究进展。现有证据表明，2型糖尿病患者维生素D缺乏与高尿酸血症发生率升高密切相关，而内脏脂肪堆积可能通过炎症反应、胰岛素抵抗等机制介导二者关联。内脏脂肪面积正常的患者中，维生素D水平与血尿酸呈弱负相关，补充维生素D对血尿酸的调节作用有限；内脏脂肪过量患者中，二者负相关性显著增强，维生素D缺乏可能通过加重脂肪组织炎症、抑制尿酸排泄，协同增加高尿酸血症发病风险。未来需开展更多分层干预研究，明确不同内脏脂肪负荷下维生素D补充对2型糖尿病患者尿酸代谢的影响，为精准防治提供依据。

Abstract: This review systematically summarizes the research progress on the correlation between vitamin D (VD) and hyperuricemia (HUA) in patients with type 2 diabetes mellitus (T2DM) with different visceral fat areas (VFAs). Current evidence indicates that vitamin D deficiency is closely associated with an increased incidence of hyperuricemia in patients with type 2 diabetes mellitus, and visceral fat accumulation may mediate the relationship between the two through mechanisms such as inflammatory response and insulin resistance. In patients with normal visceral fat area, serum vitamin D level shows a weak negative correlation with serum uric acid, and vitamin D supplementation has a limited regulatory effect on serum uric acid. In patients with excessive visceral fat, the negative correlation is significantly enhanced. Vitamin D deficiency may synergistically increase the risk of hyperuricemia by exacerbating adipose tissue inflammation and inhibiting uric acid excretion. Further stratified intervention studies are needed to clarify the effects of vitamin D supplementation on uric acid metabolism in type 2 diabetes mellitus patients with different visceral fat burdens, so as to provide evidence for precise prevention and treatment.