Crrelation of serum uric acid level with new emerging cardiovascular disease and diabeticnephropathy
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摘要:
目的 探讨Ⅱ型糖尿病患者血尿酸水平与新发心血管疾病及糖尿病肾病的相关性。 方法 筛选西安市中心医院2014年11月~2016年11月280例糖尿病患者，以血尿酸水平为基准分为高尿酸组和正常尿酸组，各140例，检测两组患者心血管相关指标和肾损害指标，评价血尿酸水平与新发心血管疾病及糖尿病肾病的关系。 结果 高尿酸组患者的颈动脉内-中膜厚度、尿白蛋白/肌酐比值及甘三油酯高于正常尿酸组，差异有统计学意义（P<0.01）；高尿酸组高血压、冠状动脉粥样硬化及糖尿病肾病的发生率高于正常尿酸组（P<0.05）；高尿酸组冠状动脉粥样硬化和糖尿病肾病的发生时间分别为12.58±2.36月和11.75±1.96月，短于正常尿酸组（P<0.05）；多元回归分析显示血尿酸水平是颈动脉内-中膜厚度、尿白蛋白/肌酐比值的主要影响因素。 结论 Ⅱ型糖尿病患者血尿酸水平与新发心血管疾病及糖尿病肾病呈正相关，随着血尿酸水平升高新发心血管疾病及糖尿病肾病的概率更高、发病时间更早。 Abstract:Objective To explore the relationship between serum uric acid level with new emerging cardiovascular disease and diabetic nephropathy in patients with type II diabetes. Methods A total of 280 patients with type II diabetic in xi’an central hospital from November 2014 to November 2016 were chosed as subject. Accrording to the level of serum uric acid, patients were divide into hyperuricemia group and normal uric acid group, with 140 cases in each group. Cardiovascular and renal damage indexes were detected in two groups, which were used to evaluate the relationship between serum uric acid level with newly emerging cardiovascular disease and diabetic nephropathy. Results The carotid artery medial thickness (IMT), urinary albumin/creatinine ratio (ACR) and the three oil ester (TG) in hyperuricemia group were significantly higher than those in normal uric acid group (P<0.01). The morbidity and occurrence time of cardiovascular disease and diabetic nephropathy in 2 groups showed significant differences (P<0.05). Multiple regression analysis showed that serum uric acid level was the main influence factor of IMT and ACR. Conclusion The relationship between serum uric acid level with new emerging cardiovascular disease and diabetic nephropathy was positive. Wish a rising of serum uric acid level, the morbidity of new emerging cardiovascular disease and diabetic nephropathy is higher and the occurrence time is earlier. -
表 1 高尿酸组与正常尿酸组各项检测结果分析（n=140，
$\, \overline{{x}}{{±}}{{s}}$ ）指标 高尿酸组 正常尿酸组 t P IMT（mm） 1.12±0.36 0.84±0.27 3.584 0.001 BMI（kg/m2） 27.93±3.53 25.28±1.69 2.415 0.023 SBP（mmHg） 143.25±12.34 134.41±9.76 2.195 0.036 DBP（mmHg） 92.64±10.82 81.72±8.39 2.858 0.010 BUN（mmol/L） 9.33±6.76 6.41±2.27 2.413 0.018 Cr（μmol/L） 140.82±127.76 83.97±76.94 2.291 0.025 ACR（mg/mmol） 598.72±283.20 29.34±12.11 4.388 0.000 UAER（μg/min） 677.31±112.7 27.34±7.49 2.432 0.039 Cys-C（mg/L） 1.75±0.91 1.09±0.48 2.608 0.021 HbA1c（%） 11.35±3.21 11.28±2.99 0.08 0.936 FPG（mmol/L） 10.36±7.74 9.58±4.11 0.444 0.658 TC（mmol/L） 4.73±1.44 4.48±1.23 0.803 0.425 TG（mmol/L） 2.59±1.56 1.69±1.17 2.767 0.007 LDL-c（mmol/L） 2.75±1.17 2.74±1.02 0.041 0.967 HDL-c（mmol/L） 1.12±0.31 1.28±0.42 0.078 0.896 病程（年） 10.93±3.97 5.76±2.31 2.454 0.032 IMT: 颈动脉内-中膜厚度; BMI: 体质量指数; SBP: 收缩压; DBP: 舒张压; BUN: 尿素氮; Cr: 肌酐; ACR: 尿白蛋白/肌酐比值; UAER: 尿白蛋白排泄率; Cys-C: 血清胱抑素C; HbA1c: 糖化血糖蛋白; FPG: 空腹血糖; TC: 总胆固醇; TG: 甘三油酯; LDL-c: 度脂蛋白胆固醇; HDL-c: 高密度脂蛋白胆固醇. 
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表 2 两组患者心血管疾病与糖尿病肾病发生率及发生时间
高血压 动脉粥样硬化 糖尿病性肾病 发生率（n，%） 发生时间（月） 发生率（n，%） 发生时间（月） 发生率（n，%） 发生时间（月） 高尿酸组 58（41.43） 17.93±3.44 57（40.71） 12.58±2.36 89（63.57） 11.75±1.96 正常尿酸组 41（29.29） 32.58±2.88 34（24.29） 25.67±3.22 46（32.86） 20.66±3.03 χ2 4.516 5.829 8.612 11.557 26.448 4.997 P <0.05 <0.05 <0.01 <0.01 <0.01 <0.05
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