2型糖尿病患者血清尿酸水平与肾脏和颈动脉粥样硬化病变的关系

Relationship between Serum Uric Acid Levels and Renal and Carotid Atherosclerotic Lesions in Patients with Type 2 Diabetes Mellitus

摘要: 目的：评估2型糖尿病患者血清尿酸水平与尿白蛋白排泄程度以及颈动脉粥样硬化标志物之间的关系。方法：研究对象为1980例2型糖尿病患者。根据尿酸水平，将患者分为正常尿酸组(n = 1670)和高尿酸组(n = 310)。比较两组患者基线及临床特征。评估研究对象血清尿酸水平与尿白蛋白排泄程度以及主要心血管风险因素的关系，包括年龄、血脂和HbA1c等；此外，还评估血清尿酸水平与颈动脉内膜中层厚度(IMT)和颈动脉斑块(CAP)之间的关系。结果：与正常尿酸组相比，高尿酸组患者糖尿病病程、甘油三酯、尿酸、肾脏病变率、心血管疾病发生率、IMT及CAP发生率较高，而低密度脂蛋白、高密度脂蛋白和总胆固醇水平较低(所有P < 0.05)。血清尿酸水平与尿白蛋白排泄量的对数呈正相关(r = 0.305, P < 0.001)。血尿酸水平与IMT呈正相关(r = 0.236, P = 0.008)；血清尿酸水平和CAP也呈正相关(r = 0.138, P = 0.021)。多元回归分析表明，血清尿酸浓度、糖尿病病程、HbA1c和甘油三酯是尿白蛋白排泄对数的独立影响因素(所有P < 0.05)。结论：2型糖尿病患者血清尿酸水平增高与肾脏和颈动脉粥样硬化病变具有正相关。

Abstract: Objective: To evaluate the relationship between serum uric acid concentration, urinary albumin excretion and carotid atherosclerosis markers in type 2 diabetes patients. Methods: The subjects were 1980 patients with type 2 diabetes. According to uric acid levels, patients were divided into normal uric acid group (n = 1670) and high uric acid group (n = 310). Compare baseline and clinical characteristics between two groups of patients. Evaluate the relationship between serum uric acid levels and urinary albumin excretion, as well as major cardiovascular risk factors, including age, blood lipids, and HbA1c, among the study subjects. In addition, the relationship between serum uric acid levels and carotid intima-media thickness (IMT) and carotid plaque (CAP) was also evaluated. Results: Compared with the normal uric acid group, the hyper uric acid group had significantly higher duration of diabetes, triglyceride, uric acid, renal lesion rate, incidence of vascular disease, IMT and CAP, and significantly lower levels of low-density lipoprotein, high-density lipoprotein and total cholesterol (all P < 0.05). The serum uric acid level was positively correlated with the logarithm of urinary albumin excretion (r = 0.305, P < 0.001). The serum uric acid level was positively correlated with IMT (r = 0.236, P = 0.008). The serum uric acid level was also positively correlated with CAP (r = 0.138, P = 0.021). Multiple regression analysis showed that the serum uric acid concentration, the course of diabetes, HbA1c and triglycerides were independent influencing factors of the logarithm of urinary albumin excretion (all P < 0.05). Conclusion: The elevated serum uric acid level was positively correlated with renal and carotid atherosclerotic lesions in patients with type 2 diabetes mellitus.