不同血尿酸水平的糖尿病患者病情进展比较及其影响因素分析

doi:10.13481/j.1671-587x.20150126

吉林大学学报(医学版) ›› 2015, Vol. 41 ›› Issue (01): 135-139.doi: 10.13481/j.1671-587x.20150126

不同血尿酸水平的糖尿病患者病情进展比较及其影响因素分析

王月娟¹, 高立超^1,2, 方芳¹, 崔巍巍¹, 刘娅¹, 郭晖²

1. 吉林大学公共卫生学院营养与食品卫生学教研室, 吉林长春 130021;
2. 吉林大学第一医院二部内分泌科, 吉林长春 130031

收稿日期:2014-05-22 发布日期:2015-01-30
通讯作者: 刘娅,教授,博士研究生导师(Tel:0431-85166352,E-mail:liuya@jlu.edu.cn);郭晖,教授,硕士研究生导师(Tel:0431-84808355,E-mail:nfmguohui@126.com) E-mail:liuya@jlu.edu.cn;nfmguohui@126.com
作者简介:王月娟(1988-),女,吉林省长春市人,在读医学硕士,主要从事营养与食品卫生学方面的研究。
基金资助:
吉林省科技厅科技发展计划项目资助课题(20050413-4)

Comparison of progression between diabetic patients with different levels of uric acid and analysis on influencing factors

WANG Yuejuan¹, GAO Lichao^1,2, FANG Fang¹, CUI Weiwei¹, LIU Ya¹, GUO Hui²

1. Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun 130021, China;
2. Department of Endocrinology, First Hospital, Jilin University, Changchun 130031, China

Received:2014-05-22 Published:2015-01-30

摘要/Abstract

摘要：

目的: 了解不同血尿酸水平的糖尿病患者病情进展情况,探讨糖尿病并发高尿酸血症的相关影响因素,为糖尿病并发高尿酸血症的预防及治疗提供科学依据。方法: 利用EpiData 3.0建立2型糖尿病住院患者的病例资料数据库,纳入完整病例资料1 411例,按血尿酸水平将2型糖尿病患者分为高尿酸(HUA)组和正常尿酸(NUA)组,比较2组患者临床指标及糖尿病并发症发生率的差异,并采用单因素分析和多因素Logistic回归分析筛选糖尿病并发高尿酸血症的影响因素。结果: HUA组患者中大血管并发症和微血管并发症的发生率均高于NUA组(P<0.05),糖尿病患者神经病变发生率组间比较差异无统计学意义(P>0.05);单因素分析,性别、体质量指数(BMI)、收缩压(SBP)、舒张压(DBP)和血清门冬酰胺氨基转移酶(AST)、丙氨酰胺基转移酶(ALT) 、谷氨酰转肽酶(GGT) 、胆碱酯酶(CHE)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和糖化血红蛋白(HbA1c)水平2组间比较差异均有统计学意义(P<0.05);多因素分析,女性、高HbA1c、高HDL-C可能是糖尿病患者并发高尿酸血症的保护性因素(女性:OR=0.705,95%CI=0.501~0.993,P<0.05; HbA1c:OR=0.912,95%CI=0.840~0.991,P<0.05;HDL-C:OR=0.539,95%CI=0.335~0.868,P<0.05),BMI≥25 kg·m^-2、高SBP和高TG可能是糖尿病患者并发高尿酸血症的危险性因素(BMI:OR=2.107,95%CI=1.473~3.014,P<0.05;SBP:OR=1.767,95%CI=1.210~2.581,P<0.05;TG:OR=1.111,95%CI=1.057~1.168,P<0.05)。结论: 对于糖尿病并发高尿酸血症的患者应重点筛查大血管及微血管并发症;控制体质量,同时将血压和TG控制在正常范围内,可以有效预防糖尿病并发高尿酸血症的发生。

关键词: 糖尿病, 2型, 高尿酸血症, 并发症, 影响因素

Abstract:

Objective To understand the progression of the diabetic patients with different levels of uric acid and to analyze its influencing factors, and to provide evidence for the prevention and treatment of diabetes complicated with hyperuricemia. Methods A clinical record database for type 2 diabetes mellitus (T2DM) patients was established with EpiData 3.0 software and 1 411 cases of complete data were selected. According to serum uric acid (SUA) levels, 1 411 cases of T2DM patients were divided into high uric acid (HUA)group and normal uric acid (NUA)group. The differences of the main clinical indicators and the incidence of complications of the patients between two groups were compared. Univariate and multivariate Logistic regression were carried out to analyze the influencing factors of diabetes complicated with hyperuricemia. Results The incidences of diabetic macroangiopathy and diabetic microvasculopathy of the patients in HUA group were significantly higher than those in NUA group (P<0.05), but there was no significant difference of the incidence of dabetic neuropathy between two groups(P>0.05).Univariate analysis showed that there were significant differences of the gender, body mass index(BMI), systolie pressure(SBP), diastolic pressure(DBP), asparagine aminotransferase(AST), alaninamide transferase (ALT), gamma-glutamyltransferase (GGT), cholinesterase(CHE), triglyeerides(TG), low-density lipoprotein(LDL-C), high-density lipoprotein(HDL-C), gycosylated hemoglobin(HbA1c) between two groups(P<0.05). The multivariable non-conditional Logistic analysis results showed that female, higher HbA1c, higher HDL-C were the protective factors of diabetes complicated with hyperuricemia (female:OR=0.705, 95%CI=0.501-0.993, P<0.05;HbA1c:OR=0.912, 95%CI=0.840-0.991, P<0.05;HDL-C:OR=0.539, 95%CI=0.335-0.868, P<0.05); but the BMI≥25 kg·m^-2, higher SBP, and higher TG were the risk factors of diabetes complicated with hyperuricemia(BMI:OR=2.107, 95%CI=1.473-3.014, P<0.05;SBP:OR=1.767, 95%CI=1.210-2.581, P<0.05;TG:OR=1.111, 95%CI=1.057-1.168, P<0.05). Conclusion The macrovascular and microvascular complications for the patients with diabetes complicated with hyperuricemia should be screened;the BMI of the patients should be controlled as well as SBP and TG, so the incidence of diabetes complicated with hyperuricemia should be prevented.

Key words: type 2 diabetes mellitus, hyperuricemia, complication, influencing factors

中图分类号:

R587.1

王月娟, 高立超, 方芳, 崔巍巍, 刘娅, 郭晖. 不同血尿酸水平的糖尿病患者病情进展比较及其影响因素分析[J]. 吉林大学学报(医学版), 2015, 41(01): 135-139.

WANG Yuejuan, GAO Lichao, FANG Fang, CUI Weiwei, LIU Ya, GUO Hui. Comparison of progression between diabetic patients with different levels of uric acid and analysis on influencing factors[J]. Journal of Jilin University Medicine Edition, 2015, 41(01): 135-139.

参考文献

[1] Yang W,Lu J,Weng J,et al.Prevalence of diabetes among men and women in China [J].N Engl J Med,2010,362(12): 1090-1101.

[2] Dobesh PP.Managing hypertension in patients with type 2 diabetes mellitus[J].Am J Heath Syst Pharm,2006,63(15):1140-1149.

[3] Zoppini G,Targher G,Negir C,et al.Elevated serum urice acid concentration independently predict cardiovascular mortality in type 2 diabetic patients[J].Diabetes Care,2009,32(9):1716-1720.

[4] 徐蓉.血尿酸水平与2型糖尿病血管并发症的关系[D].天津:天津医科大学,2012: 8-15.

[5] Bandrau P,Shankar A.Association between serum uric acid levels and diabetes mellitus [J].Int J Endocrinol,2011,1(1):22.

[6] 郭立新.从《高尿酸血症和痛风治疗中国专家共识》谈高尿酸血症的治疗[J].药物与临床,2014,11(1):21-23.

[7] 陈颖越,金星,蒋兰兰,等.2型糖尿病高尿酸血症患病特点及代谢综合征关系的分析研究[J].中国糖尿病杂志,2012,4(1):910-912.

[8] 叶山东,黄芝.2型糖尿病患者血尿酸水平及其有关因素的研究进展[J].安徽医学,2013,34(5):659-661.

[9] 苗蕾.炎症因子及脂肪因子与高尿酸血症的关系及民族异质性研究[D].乌鲁木齐:新疆医科大学,2012:49-57.

[10] Sehimid ML,Watson RT,DunCan BB,et al.Clustering of dyslipidemia,hyperuricemia,diabetes,and hypertension and its association with fasting insulin and central and overall obesity in a general population [J].Metabolism,2004,45(6):699-706.

[11] Nan H,Dong Y,Gao W,et al.Diabetes associated with a low serum uric acid level in a general Chinese population [J].Diabetes Res Clin Pract,2007,76(1):72-73.

[12] 张冰清.遗传背景对痛风和/或高尿酸血症影响的初探 [D].北京:北京协和医学院,2013:37-39.

[13] 李婵,付正菊,李长贵,等.高尿酸血症病人雌激素对糖代谢的影响[J].青岛大学医学院学报,2012,48(3):227-230.

[14] Garcia-Escobar E,Perez-Valero V,Maseda D,et al.Glycosylated hemoglobin as ahyperurecemia risk marker in general population[A].Med Clin(Barc)[C].Spanish:2011,2.

[15] Bo S,Cavallo PP,Gentile L,et al.Hypouricema and hyperuricemia in type 2 diabetes:two different phenotype [J].Eur J Clin Invest,2001,31(3):317-318.

[16] Ito H,Abe M,Mifune M,et al.Hyperuricemia is independently associated with coronary heart disease and renal dysfunction in patients with type 2 diabetes mellitus[J].PLoS One,2011,6(11):2-4.

不同血尿酸水平的糖尿病患者病情进展比较及其影响因素分析

Comparison of progression between diabetic patients with different levels of uric acid and analysis on influencing factors

RichHTML

PDF (PC)

赞

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

Metrics

本文评价

推荐阅读 0

[1]	潘鸿, 王宇峰, 黄海鹏, 张丽颖, 钟祯, 马诗棋, 董理, 王洪峰. “调脏通络”电针对糖尿病周围神经病变大鼠坐骨神经细胞中GRP78表达的影响及其神经保护作用[J]. 吉林大学学报(医学版), 2018, 44(06): 1124-1130.
[2]	崔奇, 王曼伊, 农琳琳, 翟晓雅, 冯乐平. NMN在糖尿病肾病大鼠肾脏纤维化中的作用及其机制[J]. 吉林大学学报(医学版), 2018, 44(06): 1156-1162.
[3]	漆璐, 白微, 于玮莹, 李媛媛, 华婉晴, 寇长贵. 沙格列汀联合胰岛素治疗2型糖尿病疗效随机对照试验的Meta分析[J]. 吉林大学学报(医学版), 2018, 44(06): 1235-1242.
[4]	祁冰雪, 孙亚东. 东北汉族人群2型糖尿病患者大血管病变一级预防的前瞻性研究[J]. 吉林大学学报(医学版), 2018, 44(06): 1243-1248.
[5]	王海彬, 董志军, 郭立涛, 石晶, 董微丽. 菩人丹超微粉对STZ诱导糖尿病大鼠视网膜病变的保护作用及其对NF-κB信号通路的影响[J]. 吉林大学学报(医学版), 2018, 44(04): 759-763.
[6]	屠培培, 黄彬, 路景涛, 薛绍礼, 夏觅珍, 吴琳梅, 张耀方, 李明刚. DNA和组蛋白表观遗传修饰在2型糖尿病发病中作用的研究进展[J]. 吉林大学学报(医学版), 2018, 44(04): 853-858.
[7]	孙成博, 孙波, 刘春禹, 李星儒, 王志琴, 张璟祎, 张雪绵, 王泽红, 于晓艳. 茵陈提取物对糖尿病大鼠肾组织中miRNAs表达谱的影响及其肾脏保护作用[J]. 吉林大学学报(医学版), 2018, 44(03): 493-498.
[8]	孙竹梅, 梁伟时, 康佳丽, 孟徐兵, 王建行, 韩淑英. 2型糖尿病db/db小鼠肾脏动态病理特点[J]. 吉林大学学报(医学版), 2018, 44(03): 499-503.
[9]	潘贵, 刘建萍. 微小RNA在干细胞向胰岛素分泌细胞转化过程中表达的研究进展[J]. 吉林大学学报(医学版), 2018, 44(03): 675-678.
[10]	庞春艳, 王慧, 王志华, 冯秀媛, 王永福. 腺病毒介导的“睡美人”转座子与IL-10共表达对NOD小鼠Th17/Treg细胞平衡的影响[J]. 吉林大学学报(医学版), 2018, 44(02): 205-210.
[11]	孙敏英, 周红月, 接晶, 谢飞, 翟瑞萍, 陈潭秀, 袁红艳, 台桂香. 胸腺肽α1诱导MUC1特异性Th2型免疫应答[J]. 吉林大学学报(医学版), 2018, 44(02): 299-304.
[12]	戴惠咛, 吕帅, 王德利, 李丹, 张师桃, 刘嘉凝, 刘阳, 刘小波, 李婉南. 葵花盘粉有效成分对小鼠高尿酸血症的治疗作用[J]. 吉林大学学报(医学版), 2018, 44(02): 327-331.
[13]	刘晓洁, 梅涛, 麻红艳, 叶山东. 单纯2型糖尿病患者颈动脉粥样硬化斑块形成及其稳定性影响因素分析[J]. 吉林大学学报(医学版), 2018, 44(02): 350-355.
[14]	朱涛, 张国明, 严飞, 刘正, 霍强. 心肌灌注显像与双源CT冠状动脉成像对糖尿病并发冠心病患者冠状动脉狭窄诊断价值的比较[J]. 吉林大学学报(医学版), 2018, 44(02): 425-430.
[15]	李春花, 郭昕, 豆静, 丁铭宣, 姚燕, 张艳秋. 2型糖尿病患者认知功能障碍及其影响因素调查分析[J]. 吉林大学学报(医学版), 2018, 44(02): 431-437.