2型糖尿病患者血尿酸水平与尿白蛋白排泄率及颈动脉内中膜厚度的关系  

Relationship between serum uric acid and urinary albumin excretion and carotid intima-media thickness in patients with type 2 diabetes mellitus

作　　者：吴景程[1] 李晓华[1] 程群[1] 彭永德[1] 

机构地区：[1]上海交通大学第一人民医院内分泌代谢科,上海200080

出　　处：《上海交通大学学报（医学版）》2009年第10期1210-1213,共4页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家自然科学基金(30700381);上海市科委引领计划项目(74119638)~~

摘　　要：目的探讨2型糖尿病(T2DM)患者血清尿酸(SUA)水平与尿白蛋白排泄率(UAER)和颈动脉内中膜厚度(CIMT)的关系。方法2008年5月—2009年5月收治T2DM患者372例,其中男性184例,女性188例。收集相关临床资料。Pearson法检验患者SUA水平与各项临床指标的相关性;多元逐步回归法分析影响UAER和CIMT的相关因素。结果男性T2DM患者SUA水平明显高于女性(P<0.01)。男性和女性T2DM患者SUA水平均与UAER相关;在校正内生肌酐清除率(Ccr)的影响后,相关性仍然存在(男性:r=0.24,P<0.01;女性:r=0.29,P<0.01)。女性T2DM患者SUA水平与CIMT相关(r=0.29,P<0.01)。多元逐步回归分析显示,SUA是T2DM患者UAER(男性:β=0.16,P<0.05;女性:β=0.20,P<0.05)及女性T2DM患者CIMT的独立相关因素(β=0.16,P<0.05)。结论SUA在T2DM患者肾病和心血管病的发生和发展中起一定作用,控制SUA水平可能有助于延缓糖尿病肾病和防治糖尿病血管并发症。Objective To investigate the relationship between serum uric acid（SUA） concentration and urinary albumin excretion rate（UAER） and carotid intima-media thickness（CIMT） in patients with type 2 diabetes mellitus（T2DM）.Methods The clinical data of 372 patients with T2DM,including 184 males and 188 females,were collected.The correlations between SUA and the other clinical indexes were analysed by Pearson method,and multiple regression analysis was employed to examine the effects of various factors on UAER and CIMT. Results SUA concentration was higher in males than in females with T2DM（P〈0.01）,and was positively correlated with UAER both in males and females with T2DM,even after adjustment for the creatinine clearance（r=0.24,P〈0.01 for males;r=0.29,P〈0.01 for females）.Positive correlation was found between SUA concentration and CIMT in females（r=0.29,P〈0.01）.Multiple regression analysis demonstrated that SUA concentration was an independent determinant of UAER for males as well as females（β=0.16,P〈0.05 for males;β=0.20,P〈0.05 for females）,and was also an independent determinant of CIMT for females（β=0.16,P〈0.05）. Conclusion SUA plays an important role in the progression of diabetic nephropathy and cardiovascular diseases in patients with T2DM.SUA control may provide a novel approach for the treatment of diabetic nephropathy and vascular complications.

关 键 词：2型糖尿病 血清尿酸 尿白蛋白排泄率 颈动脉内中膜厚度 

分 类 号：R587.1[医药卫生—内分泌] R587.2[医药卫生—内科学]