尿酸与2型糖尿病肾病的相关性研究

Study on the Relationship between Uric Acid and Type 2 Diabetes Nephropathy

摘要: 目的：分析2型糖尿病患者血清尿酸与糖尿病肾病的相关性。方法：选取2019-10至2022-10就诊于海南医学院第二附属医院内分泌科的糖尿病患者为研究对象，根据微量白蛋白/肌酐(UACR)，将患者分为非 DKD组(UACR < 30 mg/g)和DKD组(UACR ≥ 30 mg/g)；受试者均检测空腹血糖、谷丙转氨酶、谷草转氨酶、尿酸、尿素氮、肌酐等生化指标，并结合临床资料进行分析。结果：1) 与NDKD组相比，DKD组收缩压、病程、甘油三酯、尿素氮、肌酐、微量白蛋白、微量白蛋白/肌酐、尿酸水平均升高(p < 0.05)，差异有统计学意义。DKD组高密度脂蛋白低于NDKD组。2) 多因素Logistic回归分析表明：SBP、病程、尿酸是2型糖尿病患者发生DKD的独立危险因素(p < 0.05)。3) ROC分析结果表明：当约登指数为0.313时，SUA的临界值是428.5 μmol/L，SUA诊断DKD的敏感性是51.30%，特异性是80.00%。结论：1) 在2型糖尿病患者中，SUA、收缩压、病程是DKD发生的独立危险因素。2) 当SUA > 428.5 μmol/L时，发生DKD的风险将增加。

Abstract: Objective: To analyze the correlation between serum uric acid and diabetes nephropathy in pa-tients with type 2 diabetes. Methods: From October 2019 to October 2022, diabetes patients in the Department of Endocrinology of the Second Affiliated Hospital of Hainan Medical University were selected as the study subjects. According to the trace white egg/creatinine (UACR), divide the pa-tients into non-DKD group (UACR < 30 mg/g) and DKD group (UACR ≥ 30 mg/g); Fasting blood glu-cose, glutamic pyruvic transaminase, glutamic oxaloacetic transaminase, uric acid, urea nitrogen, creatinine and other biochemical indicators were detected by the subjects, and analyzed in combi-nation with clinical data. Results: 1) Compared with NDKD group, the systolic blood pressure, course of disease, triglyceride, urea nitrogen, creatinine, microalbumin, microalbumin/creatinine and uric acid levels in DKD group were significantly higher (p < 0.05). HDL in DKD group was lower than that in NDKD group. 2) Multivariate logistic regression analysis shows that SBP, course of disease and uric acid are independent risk factors for DKD in type 2 diabetes patients (P < 0.05). 3) ROC analysis results show that when the Yodon index was 0.313, the critical value of SUA was 428.5 μmol/L, the sensitivity of SUA in diagnosing DKD was 51.30%, and the specificity was 80.00%. Conclusion: 1) In patients with type 2 diabetes, SUA, systolic blood pressure, and course of disease are independent risk factors for DKD. 2) When SUA > 428.5 μmol/L, the risk of DKD will increase.