摘要
目的探讨老年2型糖尿病患者血尿酸与内脏脂肪的关系。方法选取2017年10月至2021年6月于航空总医院体检中心参加体检的233例老年2型糖尿病患者作为研究对象,根据内脏脂肪等级(visceral fat grade,VFG)分为内脏脂肪正常组(A组,VFG 1~9级,n=66)、内脏脂肪偏高组(B组,VFG 10~14级,n=101)、内脏脂肪明显升高组(C组,VFG≥15级,n=66)。所有患者均进行血清学检查,比较3组临床资料,采用Pearson相关性分血清学指标与VFG的相关性,多因素Logistic回归分析VFG升高的影响因素,绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析血尿酸对VFG升高的预测价值。结果3组空腹血糖、餐后2 h血糖、糖化血红蛋白A1c、血尿酸水平比较差异有统计学意义(P<0.05),C组空腹血糖、餐后2 h血糖、糖化血红蛋白A1c及血尿酸水平均高于A组与B组,B组血尿酸水平高于A组,差异有统计学意义(P<0.05)。VFG与空腹血糖、餐后2 h血糖、糖化血红蛋白A1c、血尿酸水平均呈正相关(r>0,P<0.05),与尿素氮、肌酐、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平均无相关性。多因素Logistic回归分析结果显示,血尿酸水平升高是VFG升高的危险因素(P<0.05)。ROC曲线分析结果显示,血尿酸诊断灵敏度为89.2%,特异度为75.8%,假阳性率为24.2%,曲线下面积(area under the curve,AUC)为0.908,对VFG升高预测价值极高。结论老年2型糖尿病合并VFG升高人群的血糖及血尿酸水平明显高于VFG正常的老年2型糖尿病人群,血糖及血尿酸水平与VFG呈正相关,血尿酸是VFG升高的独立危险因素,其可预测VFG升高的风险。
Objective To explore the relationship between blood uric acid and visceral fat in elderly patients with type 2 diabetes mellitus.Methods A total of 233 elderly patients with type 2 diabetes mellitus who participated in physical examination in the physical examination center of Aviation General Hospital from October 2017 to June 2021 were selected as the study subjects,and they were divided into the normal visceral fat group(group A,visceral fat grade[VFG]1-9,n=66),high visceral fat group(group B,VFG 10-14,n=101)and the significantly high visceral fat group(group C,VFG≥15,n=66)according to visceral fat grade(VFG).Serological examination was performed on all subjects,the clinical data were compared among the three groups,Pearson correlation analyze was used to explore the correlation between serologic indicators VFG,multivariate Logistic regression was used to analyze the influencing factors of VFG elevation,the receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum uric acid for VFG elevation.Results There were statistically significant differences in fasting blood glucose,postprandial 2 h blood glucose,glycosylated hemoglobin A1c and blood uric acid levels among the three groups(P<0.05),the levels of fasting blood glucose,postprandial 2 h blood glucose,glycosylated hemoglobin A1c and blood uric acid in the group C were higher than those in the group A and the group B,and the level of blood uric acid in the group B was higher than that in the group A,the differences were statistically significant(P<0.05).VFG was positively correlated with fasting blood glucose,postprandial 2 h blood glucose,glycosylated hemoglobin A1c and uric acid level(r>0,P<0.05),there were no correlation with urea nitrogen,creatinine,total cholesterol,triglyceride,high density lipoprotein cholesterol,low density lipoprotein cholesterol.Multivariate Logistic regression analysis showed that elevated serum uric acid level was a risk factor for elevated VFG(P<0.05).The ROC analysis showed that the diagnostic sensitivity of blood uric acid was 89.2%,the specificity was 75.8%,the false positive rate was 24.2%,and the area under the curve(AUC)was 0.908,which had extremely high predictive value for VFG elevation.Conclusion The blood glucose and uric acid levels in the elderly type 2 diabetes mellitus patients with increased VFG were significantly higher than those in the elderly type 2 diabetes patients with normal VFG,blood glucose level and blood uric acid level were positively correlated with VFG,blood uric acid was an independent risk factor for increased VFG,and it can predict the risk of VFG increase.
作者
路盈
张金卉
郑旭东
张秀春
LU Ying;ZHANG Jinhui;ZHENG Xudong;ZHANG Xiuchun(Medical Care Center,Aviation General Hospital,Beijing,100012,China;Department of Endocrinology,Aviation General Hospital,Beijing,100012,China;Health Management Center,Aviation General Hospital,Beijing,100012,China)
出处
《当代医学》
2024年第36期80-84,共5页
Contemporary Medicine
关键词
老年2型糖尿病
血尿酸
内脏脂肪
Elderly type 2 diabetes mellitus
Uric acid
Visceral fat
