早期糖尿病肾病患者血清尿酸水平与肾小球滤过率的相关性研究  

Correlation between serum uric acid and glomerular filtration rate in T2DM patients with early stages of diabetic kidney disease

作　　者：张莉[1,2] 朱翠颜[1,2] 王筱菁[1,2] 邢晓欢[1,2] 黎雅清[1,2] 林健才[1,2] 

机构地区：[1]中山大学附属江门医院 [2]江门市中心医院,江门529030

出　　处：《新医学》2015年第4期262-267,共6页Journal of New Medicine

摘　　要：目的：分析糖尿病肾病（DKD）1-3期血清尿酸水平与肾小球滤过率估计值（eG-FR）的关系，探讨血清尿酸在诊断早期 DKD 的应用价值。方法纳入2型糖尿病患者中已确诊合并DKD 的239例患者（A 组）、正常健康人228名（B 组），2组受检者的 eGFR 均≥30 ml／（min·1.73 m^2），并按 DKD 分期将 A 组分为 A1组（DKD 1期）96例、A2组（DKD 2期）101例、A3组（DKD 3期）42例。比较各组及各亚组间血清尿酸水平，分析 A、B 组各自血清尿酸水平与 eGFR 的相关性。结果A、B 组间 eGFR 比较差异无统计学意义（P ＞0.05），A 组血清尿酸水平高于 B 组（P ＜0.01）；A1-3组间血清尿酸比较差异有统计学意义（P ＜0.05），并且随 DKD 分期呈上升趋势（P ＜0.05）。A、B 组中，血清尿酸与 eGFR 均有良好相关性（P ＜0.01），多重线性回归显示，血清尿酸是DKD 患者 eGFR 下降的危险因素（P ＜0.01）。结论高血清尿酸与早期 DKD 的 eGFR 异常相关，是其危险因素之一，提示尿酸可能参与 DKD 早期肾损害的发生、发展。Objective To analyze the relationship between serum uric acid （SUA）and estimated glomerular filtration rate （eGFR）in type 2 diabetes mellitus （T2DM）patients with stages 1-3 of diabetic kid-ney disease （DKD）and evaluate the diagnostic value of SUA in early DKD.Methods In total,231 T2DM patients complicated with DKD were assigned into group A and 228 healthy controls in group B.All participants presented with eGFR ≥ 30 ml/（min·1.73 m^2 ）.Patients in group A were sub-grouped into A1 （stage DKD-1,n =96）,A2 （stage DKD-2,n =101）and A3 （stage DKD-3,n =42）groups according to DKD stag-ing.The SUA levels were statistically compared and the correlation between SUA and eGFR was analyzed among different groups and sub-groups.Results eGFR did not significantly differ between groups A and B （P〉0.05）,whereas SUA level in group A was significantly higher compared with that in group B （P 〈0.01）.The SUA levels significantly differed among subgroups A1,A2 and A3 （P 〈0.05）and were elevated along with DKD staging （P 〈0.05）.In both groups A and B,SUA level was significantly correlated with eGFR （both P 〈0.01）.Multiple linear regression analysis revealed that SUA was a risk factor for eGFR impairment in DKD patients （P 〈0.01）.Conclusions SUA is related to the abnormity of eGFR during early DKD and acts as one of the independent risk factors,prompting that SUA probably participates in the incidence and de-velopment of renal damage during early stage of DKD.

关 键 词：2型糖尿病 糖尿病肾病 血清尿酸 肾小球滤过率 

分 类 号：R587.2[医药卫生—内分泌]