2型糖尿病患者血尿酸与同型半胱氨酸相关性及其与胰岛素抵抗的关系  

Correlation between serum uric acid and homocysteine and its relationship with insulin resistance in type 2 diabetic patients

作　　者：刘湘茹 李玥 杨斌 梁勇前 冯耀然 LIU Xiang-ru;LI Yue;YANG Bin(Department of Endocrinology, Shunde Hospital of Southern Medical University （Foshan Shunde District First People＇s Hospital）, Foshan 528300, Chin)

机构地区：[1]南方医科大学顺德医院(佛山市顺德区第一人民医院)内分泌科,528300 [2]南方医科大学顺德医院(佛山市顺德区第一人民医院)风湿免疫科,528300

出　　处：《中国实用医药》2018年第17期32-34,共3页China Practical Medicine

基　　金：佛山市科学技术局科技计划项目(项目编号:2016AB003573)

摘　　要：目的研究2型糖尿病患者血尿酸与同型半胱氨酸的相关性以及与胰岛素抵抗的关系。方法选取180例2型糖尿病患者,其中高尿酸血症者78例作为A组,尿酸正常者102例作为B组;另选同期65例非糖尿病健康体检者作为C组。对所有受试者进行体格检查,并检测同型半胱氨酸、血尿酸、血糖指标、血脂指标等的水平,比较各组指标差异,分析血尿酸、同型半胱氨酸与上述指标之间的相关性,以及2型糖尿病高尿酸血症的预测因素。结果 A组与B组患者的体质量指数、腰臀比、空腹血糖、餐后2 h血糖、糖化血红蛋白、胆固醇、甘油三酯、空腹胰岛素、肌酐、血尿酸、同型半胱氨酸、胰岛素抵抗指数均显著高于C组,差异具有统计学意义(P<0.05);A组患者体质量指数、腰臀比、血尿酸、同型半胱氨酸、胰岛素抵抗指数均显著高于B组,差异具有统计学意义(P<0.05)。经Pearson相关分析显示,2型糖尿病患者的血尿酸水平与体质量指数、腰臀比、同型半胱氨酸、肌酐呈正相关(r=0.2943、0.1736、0.5230、0.3974,P<0.05);同型半胱氨酸水平与体质量指数、血尿酸、空腹血糖、肌酐呈现正相关(r=0.1510、0.5230、0.1522、0.5173,P<0.05)。以高尿酸血症作为因变量,进行多因素Logistic回归分析发现,2型糖尿病患者肌酐、同型半胱氨酸水平是高尿酸血症发病的预测因素(OR=1.02、1.41,P<0.05)。结论 2型糖尿病患者血尿酸与同型半胱氨酸可能协同参与了胰岛素抵抗的发生,2型糖尿病的综合管理不可忽视这两种风险因素的强化干预。Objective To study the correlation between serum uric acid and homocysteine and its relationship with insulin resistance in type 2 diabetic patients. Methods There were 180 type 2 diabetic patients, including 78 patients with hyperuricemia, selected as group A, and 102 patients with normal uric acid as group B. Concurrent 65 non-diabetic healthy persons were selected as group C. A physical examination was performed on all subjects and the levels of homocysteine, blood uric acid, blood glucose, and blood glucose index were measured. Differences among the indexes were compared to analyze the correlation between serum uric acid, homocysteine and the above mentioned indexes, as well as predictors of hyperuricemia in type 2 diabetes. Results Group A and group B had obviously higher body mass index, waist to hip ratio, fasting blood glucose, 2 h postprandial blood glucose, glycated hemoglobin, cholesterol, triglyceride, fasting insulin, creatinine, uric acid, homocysteine, insulin resistance index than group C, and their difference was statistically significant（P〈0.05）. Group A had obviously higher body mass index, waist to hip ratio, serum uric acid, homocysteine, insulin resistance index than group B, and their difference was statistically significant（P〈0.05）. Pearson correlation analysis showed that serum uric acid level was positively correlated with body mass index, waist hip ratio, homocysteine and creatinine in type 2 diabetic patients（r=0.2943, 0.1736, 0.5230, 0.3974, P〈0.05）. Homocysteine level was positively correlated with body mass index, serum uric acid, fasting blood glucose and creatinine（r=0.1510, 0.5230, 0.1522, 0.5173, P〈0.05）. With hyperuricemia as a dependent variable, multiple factor Logistic regression analysis showed that creatinine and homocysteine levels were predictors of hyperuricemia in type 2 diabetic patients（OR=1.02, 1.41, P〈0.05）. Conclusion The blood uric acid and homocysteine in type 2 diabetic patients may be involved in the occurrence of insulin resistan

关 键 词：2型糖尿病 血尿酸 同型半胱氨酸 胰岛素抵抗 

分 类 号：R587.2[医药卫生—内分泌]