2型糖尿病患者血尿酸与非酒精性脂肪肝的相关性分析  

Association between serum uric acid and NAFLD in type 2 diabetic patients

作　　者：夏振华[1] 范能光[1] 张丽娟[1] 

机构地区：[1]上海市第一人民医院松江分院内分泌科,上海201600

出　　处：《南京医科大学学报（自然科学版）》2016年第1期51-54,72,共5页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金青年基金(81400785)

摘　　要：目的：研究2型糖尿病（type 2 diabetic patients,T2DM）患者中血尿酸（serum uric acid,SUA）水平与非酒精性脂肪肝（nonalcoholic fatty liver disease,NAFLD）之间的关系。方法 ：533例T2DM患者按SUA的四分位数将其分为4组（Q1~Q4）,分析SUA水平与代谢指标及NAFLD之间的关系。结果：随着SUA水平的升高,T2DM患者的体重指数（body mass index,BMI）、收缩压、甘油三酯、空腹胰岛素及胰岛素抵抗指数（HOMA-IR）均显著升高,而高密度脂蛋白胆固醇则明显降低（组间趋势P均〈0.05）;同时,患者的肝损标志物丙氨酸氨基转移酶和天门冬氨酸氨基转移酶亦随着SUA的升高而显著升高（组间趋势P〈0.001）。此外,从Q1组至Q4组,NAFLD的患病率逐渐递增（分别为41.2%、54.9%、59.3%和71.8%,组间趋势P〈0.001）;多元Logistic回归分析进一步发现,在校正性别、年龄、BMI等因素后,Q4组的NAFLD患病风险较Q1组增加239%（OR=3.39,P=0.011）。结论：T2DM患者中SUA与NAFLD密切相关,是NAFLD的独立危险因素。Objective：To investigate the association between serum uric acid（SUA）and nonalcoholic fatty liver disease（NAFLD） in type 2 diabetic patients（T2DM）. Methods：A total of 533 T2 DM subjects were recruited to undergo anthropometric measurements and fasting blood sampling for biochemical assay such as blood glucose,lipid,uric acid and insulin. All subjects were divided into four groups according to the quartiles of SUA,and we compared the differences of metabolic indexes among them and analyzed the association between SUA level and NAFLD. Results：BMI,SBP,TG,fasting insulin and insulin resistance index（HOMA-IR）were significantly elevated with the increase of SUA concentration（P for trend 〈 0.05）. Similarly,ALT and AST was increased with the elevation of SUA. The prevalence rates of NAFLD in participants with increasing SUA quartiles were 41.2%,54.9%,59.3% and71.8%,respectively（P for trend 〈 0.001）. Logistic regression analysis showed that the risk of NAFLD was increased by 239% in participants of the fourth SUA quartile as compared with participants in the first quartile. Conclusion：SUA was significantly and independently associated with NAFLD in T2 DM patients.

关 键 词：2型糖尿病 尿酸 非酒精性脂肪肝 

分 类 号：R587.4[医药卫生—内分泌]