尿酸与2型糖尿病颈动脉内中膜厚度的相关性研究

Study on the Correlation of Uric Acid and Carotid Intima-Media Thickness in Type 2 Diabetes

摘要: 目的：研究2型糖尿病(T2DM)患者尿酸与颈动脉内膜中层厚度的相关性。方法：回顾性分析2018年1月至2021年12月入住海南医学院第二附属医院内分泌科的300例T2DM患者病历资料，均符合糖尿病诊断标准，按尿酸水平将患者分4组(<240 μmol/L, 240~360 μmol/L, 360~480 μmol/L, >~480 μmol/L)。比较4组的血尿酸水平与颈动脉内膜中层厚度的差异。结果：1) 本研究纳入300例2型糖尿病患者，随着尿酸水平的增高，CIMT、男性比例、病程、空胰岛素、空C肽、甘油三酯、尿素氮、肌酐、微量白蛋白、微量白蛋白/肌酐呈增高趋势(p < 0.05)。2) Spearman分析结果显示左颈动脉CIMT与尿酸分组(r = 0.146, p = 0.012)呈正相关。3) 经Logistic多因素回归分析，结果提示尿酸(OR = 1.002 95% CI 1.000, 1.004, p < 0.05)、年龄(OR = 1.08 95% CI 1.053, 1.108, p < 0.001)、肌酐(OR = 1.015 95% CI 1.002, 1.028, p < 0.05)是T2DM患者CIMT增厚的危险因素。结论：1) 2型糖尿病患者颈动脉厚度随着尿酸升高而增加。2) CIMT与尿酸呈正相关。3) 尿酸、年龄、肌酐为T2DM患者发生CIMT增厚的危险因素。4) 经ROC分析，糖尿病年龄 > 57.5岁，同时肌酐 > 66.5 μmol/L及血清尿酸 > 367.5 mmol/L，可作为预测CIMT的条件。

Abstract: Objective: To study the correlation between uric acid and carotid intima-media thickness in pa-tients with type 2 diabetes mellitus (T2DM). Methods: The medical records of 300 T2DM patients admitted to the Department of Endocrinology of the Second Affiliated Hospital of Hainan Medical University from January 2018 to December 2021 were retrospectively analyzed. All patients met the diagnostic criteria for diabetes and were divided into four groups according to the level of uric acid (<240 μmol/L, 240~360 μmol/L, 360~480 μmol/L, >~480 μmol/L). Results: 1) 300 patients with type 2 diabetes were included in this study. With the increase of uric acid level, CIMT, male ra-tio, course of disease, empty insulin, empty peptide, triglyceride, urea nitrogen, microalbumin, mi-croalbumin/muscle show an increasing trend (p < 0.05); 2) The results of Spearman analysis showed that left carotid artery CIMT was positively correlated with uric acid grouping (r = 0.146, p = 0.012); 3) Logistic regression analysis shows that uric acid (OR = 1.002 95% CI 1.000, 1.004, p < 0.05), age (OR = 1.08 95% CI 1.053, 1.108, p < 0.001) and muscle (OR = 1.015 95% CI 1.002, 1.028, p < 0.05) are risk factors for CIMT thickening in T2DM patients. Conclusion: 1) Carotid artery thick-ness in type 2 diabetes patients increases with the increase of uric acid; 2) CIMT is positively corre-lated with uric acid; 3) Uric acid, age and muscle are risk factors for CIMT thickening in T2DM pa-tients; 4) ROC analysis shows that diabetes age > 57.5 years, creatinine > 66.5 μmol/L and serum uric acid > 367.5 mmol/L could be used as conditions to predict CIMT.