血浆尿酸水平升高并非中国人群二型糖尿病的致病因素  

Plasma Uric Acid is Not Contribute A Causal Role for Type 2 Diabetes in Chinese

作　　者：刘献成[1] 姜先雁[1] 王松涛[1] 孙凯[2] 惠汝太 

机构地区：[1]青岛阜外心血管病医院,青岛市266034 [2]中国医学科学院阜外心血管病医院心血管疾病国家重点实验室,北京市100037

出　　处：《中国分子心脏病学杂志》2014年第5期1063-1066,共4页Molecular Cardiology of China

基　　金：国家重大基础项目2010CB732601

摘　　要：目的探讨血浆尿酸水平升高是否能导致中国人群二型糖尿病的发生。方法青岛港健康研究建立于1999至2000年,共15208例18岁以上港口职工参加。本研究来自于青岛港健康研究2000-2001年体检数据,13665例非糖尿病患者入选,进行详细的问卷调查、体格及生化检查。对所有研究对象按照血浆尿酸水平高低分为4组,进行了平均5.29年随访,观察二型糖尿病的发生情况。结果 :754例调查对象发展成为二型糖尿病。在男性,校正年龄因素的影响后,血浆尿酸水平最高组发生糖尿病的风险是最低组的1.47倍(1.19-1.82,<0.001),在女性,该值为2.56(1.42-4.62,P<0.001).进一步校正吸烟,饮酒,家庭糖尿病史及肾小球滤过率后,得到与上述值接近的结果。但进一步校正基线血糖,血脂、血压及腰围等代谢综合征的组成危险因子后,血浆尿酸水平最高组与最低组比较,发生糖尿病的风险分别是0.82(0.65-1.03,P=0.089)及1.49(0.8-2.77,P=0.210)。结论血浆尿酸水平升高并非中国人群二型糖尿病的主要致病因素。Objective To investigate the relationship between plasma levels of uric acid and increasing of the risk of type 2 diabetes. Methods The Qingdao Port Health study, established from 1999 to 2000, 15,208 individuals with age 18 years and older were recruited. Total of 13,665 individuals, free of diabetes at baseline, were followed up （10,488 men and 3,177 women） for a mean of 5.29 years. All participants were personally interviewed with a structured questionnaire at the baseline survey. We classified all participants on the basis of sex-specific quartiles of plasma uric acid concentrations. The incidence of type 2diabetes was investigated yearly by monitoring blood glucose for 7 years. Results During the mean of 5.29 years of follow-up, 754 subjects developed diabetes. All analyses were sex-specific, the age-adjusted RRs （95% CI） for developing diabetes were 1.47（1.19-1.82, P〈0.001） for the fourth quartile of plasma uric acid, compared with the first quartile for men and 2.56（1.42-4.62 P〈0.001） for women （Model 1）. After further adjusting for alcohol drinking, smoking, family history of diabetes and eGFR （Model 2）, approximate results were obtained. Nevertheless, when metabolic syndrome components including waist circumference, baseline blood glucose, total cholesterol, triglyceride, HDL cholesterol, systolic and diastolic blood pressure were entered in the model, the RRs were 0.82（0.65-1.03, P=0.089） for men and 1.49（0.8-2.77, P=0.210） for women （Model 3） by comparing the highest and lowest quartiles of uric acid. Conclusions The results of this population-based prospective study do not support that plasma uric acid contribute a causal role for type 2 diabetes.

关 键 词：血浆尿酸 二型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]