糖尿病人群和非糖尿病体检人群高尿酸血症与泌尿系统结石的关系  

Association between hyperuricemia and urinary calculus in patients with diabetes and non-diabetic healthy subjects

作　　者：韩莹[1] 郭凯锋[1] 张磊[1] 陆俊茜[1] 韩峻峰[1] 于浩泳[1] 刘风静[1] 徐伟斌[1] 包玉倩[1] 陈海冰[1] 贾伟平[1] 

机构地区：[1]上海交通大学附属第六人民医院内分泌代谢科、上海市糖尿病研究所、上海市糖尿病临床医学中心、上海市糖尿病重点实验室,200233

出　　处：《中华糖尿病杂志》2015年第9期542-546,共5页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：国家重点基础研究发展计划（973计划）子课题（2012CB517700）;国家自然科学基金面上项目（81070649）

摘　　要：目的：探讨糖尿病人群和非糖尿病体检人群高尿酸血症与泌尿系统结石的关系。方法回顾性分析2011年1月至2014年9月的非糖尿病体检人群和糖尿病患者的临床资料，记录体质指数（BMI）、空腹血糖、血尿酸、血肌酐、血脂、预估肾小球滤过率（eGFR）及泌尿系统超声检查结果。非糖尿病体检者共2186例，平均年龄（44±14）岁，男性762例（34.9%），女性1424例（65.1%）；糖尿病患者共4045例，平均年龄（59±13）岁，男性2260例（55.9%），女性1785例（44.1%）。组间比较采用c2检验，比较两人群高尿酸血症组和正常血尿酸组的泌尿系统结石患病率，不同血尿酸水平的泌尿系统结石患病率，以及高尿酸血症、糖尿病及合并这两种疾病对泌尿系统结石患病率的影响。结果非糖尿病体检人群，高尿酸血症组的泌尿系统结石患病率（7.9%）明显高于正常血尿酸组（3.5%）（c2=5.453，P〈0.05）；糖尿病人群，高尿酸血症组的泌尿系统结石患病率（13.9%）显著高于正常血尿酸组（10.5%）（c2=4.786，P〈0.05）。非糖尿病体检人群和糖尿病人群中，结石的患病率均随血尿酸水平的升高而升高（c2=9.008、9.278，均P〈0.05）。与血尿酸低于300μmol/L者相比，血尿酸高于420μmol/L的受试者发生泌尿系统结石的风险明显增加[体检人群：OR=3.037，95%可信区间（CI）：1.386～6.655，P〈0.01；糖尿病人群：OR=1.520，95%CI：1.120～2.063，P〈0.01]。与既无高尿酸血症也无糖尿病者相比，仅有高尿酸血症者、仅有糖尿病者或同时合并这两种疾病者的泌尿系统结石患病率均显著增加（高尿酸血症：7.9%比3.5%，OR=2.405，95%CI：1.125～5.140，P〈0.05；糖尿病：10.5%比3.5%，OR=3.292，95%CI：2.543～4.262，P〈0.01；合并两种疾病：13.9%比3.5%，OR=4.501，95%CI：3.170～6.390，P〈0.01）。结论非糖尿病体检人群和糖尿病人群中，高�Objective To investigate the association between hyperuricemia and urinary calculus in diabetic patients and non-diabetic healthy subjects. Methods Retrospectively analyzed the clinical data of diabetic patients and non-diabetic healthy subjects between January 2011 and September 2014, including body mass index, fasting plasma glucose, serum uric acid, serum creatinine, blood fat, estimated glomerular filtration rate（eGFR） and urinary ultrasound. A total of 2 186 non-diabetic healthy subjects and 4 045 diabetic patients were included in this study. The mean age of non-diabetic healthy subjects was （44 ± 14）nbsp;years;762 males and 1 424 females. The mean age of diabetic patients was（59±13） years;2 260 males and 1 785 females. The prevalences of urinary calculus in subjects with hyperuricemia and without in the two groups were compared withc2 test;and the prevalences of urinary calculus in subjects with different levels of uric acid were calculated too. Besides, the influence of hyperuricemia, diabetes on the prevalence of urinary calculus were also analyzed. Results The prevalence of urinary calculus in hyperuricemia group（7.9%） was significantly higher than that in normal serum uric acid group（3.5%） in non-diabetic group （c2=5.453, P〈0.05）;and it was significantly higher in hyperuricemia group than that in the subjects with normal serum uric acid in diabetic patients （13.9%vs 10.5%,c2=4.786, P〈0.05）. The prevalence of urinary calculus increased with serum uric acid （non-diabetic subjects： c2=9.008, P〈0.05; diabetic subjects： c2=9.278, P〈0.05）. The prevalence of urinary calculus was significantly higher in the group with serum uric acid〉420μmol/L than the subjects with serum uric acid≤300μmol/L （non-diabetic subjects：OR=3.037, 95%confidence interval （CI）：1.386-6.655, P〈0.01;diabetic subjects：OR=1.520, 95%CI：1.120-2.063, P〈0.01）. The risk of urinary calculus increased significantly in patients with hyperuricemia, diabetes or both diseases comp

关 键 词：糖尿病 高尿酸血症 泌尿系统结石 

分 类 号：R587.1[医药卫生—内分泌] R589.7[医药卫生—内科学] R691.4[医药卫生—临床医学]