老年糖尿病患者血尿酸与颈动脉粥样硬化关系的分析

The Analyses between Uric Acid and Carotid Atherosclerosis in the Elderly Patients with Diabetes

摘要: 目的：研究老年糖尿病患者血尿酸与颈动脉粥样硬化之间的关系。方法：选择高原老年2型糖尿病患者60例按照伴或不伴颈动脉粥样硬化分成2组，与30例老年非糖尿病患者对照进行回顾性分析，检测空腹血糖(FBG)、血浆总胆固醇(TCH)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbAlc)、尿酸(UA)、颈动脉彩超，并且进行多元逐步回归分析。结果：1) 糖尿病组血尿酸水平显著高于对照组，且糖尿病伴颈动脉粥样硬化(CA)组血尿酸水平显著高于糖尿病无CA组。2) UA与LDL-C、TG、TCH、年龄呈正相关(P小于0.05)。3) 以CA作为因变量，以UA及其他观察指标作为自变量行多元逐步logistic回归分析显示，病程、年龄、LDL-C、UA均是CA独立相关因素。结论：高尿酸血症是老年2型糖尿病患者发生颈动脉粥样硬化的独立危险因素。提示在老年糖尿病的临床治疗中应重视对血尿酸的治疗。

Abstract: Objective: To study the relationship between uric acid and carotid atherosclerosis in elderly diabetic patients. Methods: Sixty elderly patients with type 2 diabetes at high altitude with or without carotid atherosclerosis were divided into two groups, and compared with 30 elderly patients without diabetes, a retrospective analysis was conducted. Fasting blood glucose (FBG), plasma total cholesterol (TCH), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), glycosylated hemoglobin (HbAlc), uric acid (UA), carotid artery color Doppler ultrasonography were detected, and multiple stepwise regression analysis was performed. Results: 1) The uric acid level in diabetic group was significantly higher than that in control group, and the uric acid level in diabetic group with carotid atherosclerosis (CA) was significantly higher than that in diabetic group without CA. 2) UA was positively correlated with LDL-C, TG, TCH and age (P < 0.05). 3) Multivariate stepwise logistic regression analysis with CA as the dependent variable and UA and other observation indicators as independent variables showed that the course of disease, age, LDL-C, UA were all independent related factors of CA. Conclusion: Hyperuricemia is an independent risk factor for carotid atherosclerosis in elderly patients with type 2 diabetes. It is suggested that attention should be paid to the treatment of uric acid in elderly diabetic patients.