血清尿酸水平对新诊断2型糖尿病患者非酒精性脂肪性肝病的影响  

Effect of serum uric acid on non-alcoholic fatty liver disease in patients with newly diagnosed type 2 diabetes

作　　者：张洁[1] 蒋晓红[1] 杨丽惠[1] 华飞[1] 王龙[1] 周佳雁[1] 

机构地区：[1]苏州大学附属第三医院内分泌科,常州213003

出　　处：《中国糖尿病杂志》2017年第1期30-34,共5页Chinese Journal of Diabetes

基　　金：国家自然科学基金(81300687)

摘　　要：目的探讨血清尿酸(SUA)水平对新诊断T2DM患者非酒精性脂肪性肝病(NAFLD)的影响。方法选取新诊断T2DM住院患者523例,其中不伴NAFLD患者(Non-NAFLD组)131例,伴NAFLD患者(NAFLD组)392例;按SUA水平分为SUA<360μmol/L(N-SUA组)436例,SUA≥360μmol/L(H-SUA组)87例。分别比较两组一般临床指标、SUA、肝功、血脂、血糖、C-P、胰岛素抵抗指数(HOMA-IR)并行相关性分析。结果与Non-NAFLD组比较,NAFLD组SUA水平、SBP、WC、臀围、WHR、体重、谷草转氨酶(AST)、谷丙转氨酶(ALT)、谷氨酰转肽酶(GGT)、TC、TG、LDL-C、FC-P、2hC-P、HOMA-IR升高(P<0.05或P<0.01)。在男性新诊断T2DM患者中,H-SUA组和N-SUA组NAFLD的发生率分别为87.9%、71.3%(P<0.05);在女性新诊断T2DM患者中,H-SUA组和N-SUA组NAFLD的发生率分别为87.4%、75.5%(P>0.05);Logistic回归分析显示,高SUA水平是新诊断T2DM患者伴NAFLD的独立危险因素(OR=1.003,95%CI:1.000~1.007,P<0.05)。SUA水平预测新诊断T2DM合并NAFLD的受试者工作特征(ROC)曲线下面积为0.646(95%CI:0.594~0.697),当SUA水平≥276.55μmol/L时有最大敏感性(52%)和特异性(69.5%)。结论新诊断T2DM患者NAFLD的发生与SUA水平有相关性,高SUA是新诊断T2DM患者发生NAFLD的独立危险因素。Objective To explore the impact of serum uric acid（SUA）on non-alcoholic fatty liver disease（NAFLD）in patients with newly diagnosed type 2 diabetes（T2DM）. Methods A total of 523 hospitalized newly diagnosed T2 DM patients were enrolled in this study and divided into two groups：patients without NAFLD（Non-NAFLD group,n=131）and patients with NAFLD（NAFLD group,n=392）.In addition,all subjects were also divided into two groups according to serum uric acid level：serum uric acid〈360 μmol/L group（N-SUA,n=436）and serum uric acid≥360 μmol/L group（H-SUA,n=87）.General clinical data,SUA,liver function,lipid,glucose C-peptide,HOMA-IR were measured and compared between groups. Results The level of SUA,SBP,waist circumference（WC）,hip circumference,waist hip ratio（WHR）,body weight,AST,ALT,GGT,TC,TG,LDL-C,fasting C-peptide,C-peptide（2h）and HOMA-IR increased significantly in NAFLD group than in non-NAFLD group（P〈0.05）.In male patients with newly diagnosed T2 DM,the prevalence of NAFLD was 87.9%and 71.3%in H-SUA group and N-SUA group respectively（P〈0.05）.However,in female patients,the prevalence ofNAFLD was 87.4% and 75.5% in H-SUA group and N-SUA group respectively（P〈0.05）.Logistic regression analysis showed that high SUA level was an independent risk factor for NAFLD in patients with T2DM（OR=1.003,95%CI：1.000～1.007,P〈0.05）.The AUC of SUA in predicting NAFLD in newly diagnosed T2 DM was 0.646（95%CI：0.594～0.697）.SUA had the maximum sensitivity（52%）and specificity（69.5%）in predicting NAFLD in newly diagnosed T2 DM when≥276.55 μmol/L. Conclusion In newly diagnosed T2 DM patients,there is a significant correlation between SUA and NAFLD.SUA is an independent risk factor for NAFLD in newly diagnosed T2 DM patients.

关 键 词：糖尿病 2型 非酒精性脂肪性肝病 血清尿酸 

分 类 号：R575.5[医药卫生—消化系统]