摘要
目的探讨2型糖尿病患者高尿酸血症与尿白蛋白肌酐比（ACR）和血胱抑素C（Cysc）的关系。方法将135例符合条件的2型糖尿病住院患者分为正常尿酸组（NUA）和高尿酸血症组（HUA）。测定尿ACR、血CysC、肌酐清除率（Ccr）、血内皮素-1（ET-1）、高敏C反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF—α）、空腹血糖、空腹胰岛素（FINS）、糖化血红蛋白（HbAIc）、血脂、血尿酸、体重指数（BMI）、腰臀比（WHR）等临床指标。结果（1）HUA组ACR、CysC、ET-1、hs—CRP、TNF—α、BMI、WHR、收缩压（SBP）、舒张压（DBP）、三酰甘油（TG）、FINS、HOMA—IR较NUA组均明显升高（P〈0．05或P〈0．01），而高密度脂蛋白胆固醇（HDL-C）、Ccr明显低于NUA组（P均〈0．05）。（2）Pearson相关分析显示，ACR和CysC水平均与血尿酸水平呈正相关（r分别为0．195和0．231，P均〈0．05）；ET-1与TNF—α、hs—CRP水平均呈正相关（r分别为0．263、0．187，P均〈0．05）。多元回归分析显示，血尿酸为ACR（OR=1．24，95％CI1．33—6．04，P〈0．01）、CysC（OR=1．18，95％CI1．09～4．04，P〈0．05）独立危险因素。结论2型糖尿病合并高尿酸血症者更易出现早期肾脏损害，微炎症反应所致的血管内皮功能障碍可能是其发病机制之一。
Objective To investigate the relationship between hyperuricemia and early renal damages in patients with type 2 diabetes mellitus. Methods A total of 135 patients were divided into nor- mal uric aeie group（NUA） and hyperuricemia group（HUA） according to the level of uricemia in male and female respectively. Urine alhumin-to-creatinine ratio （ ACR ） , serum Cystain C （ Cys C ） , creatinine clearance （ Ccr）, serum endothelin-1 （ ET-1 ）, high sensitive c-reactive protein （ hs-CRP ）, tumor necrosis factor alpha（TNF-ct） and clinical characteristics such as body mass index（ BMI）, waist-hip circumstance ratio （WHR） , blood pressure, fasting glucose, fasting insulin, glycosylated hemoglobin （ HbA1 c ） , blood lip- ids etc. were detected in all subjects. Results （ 1 ） The values of ACR, serum Cys C, ET-1, TNF-α, hs- CRP, BMI, WHR, systolic blood pressure （ SBP）, diastolic blood pressure （ DBP）, triglyceride （ TG）, fasting insulin, HOMA model insulin resistance index （HOMA-IR） were significantly higher （ P 〈 0.05 or P 〈 0.01 ） in HUA group than those in NUA group. Otherwise,the levels of HDL-C and Ccr were significantly lower（ all P 〈 0.05 ） in HUA group than those in NUA group. （2）Correlation analysis showed that ACR as well as Cys C were positively related with UA（ r = 0. 195,0. 231 respectively, all P 〈 0.05 ） ; ET-1 was positively related with TNF-ot as well as hsCRP （ r = 0. 263,0.187 respectively, all P 〈 0.05 ）. Muhiple re- gression regression analysis showed that UA was a related factor of the independent effect on ACR（ OR = 1.24,95%CI 1.33 -6.04,P 〈0.01） and Cys C（OR=I. 18,95%CI 1.09 -4.1M,P 〈0.05）. Conclu- sion The patients with hyperuricemia and type 2 diabetes mellitus were susceptable to develop early re- nal damage, in which endothelial dysfunction and micro-inflammation may be an important mechanism.
出处
《临床内科杂志》
CAS
2012年第10期699-701,共3页
Journal of Clinical Internal Medicine
关键词
2型糖尿病
高尿酸血症
早期肾损害
Type 2 diabetes mellitus
Hyperuricemia
Early renal damage
