血清尿酸基线水平与2型糖尿病视网膜病变进展的相关性  

Relationship between serum uric acid baseline level and progression of type 2 diabetic retinopathy

作　　者：彭紧紧 李青菊[1] 田晨光[1] 张东铭[1] PENG Jinjin;LI Qingju;TIAN Chenguang;ZHANG Dongming(The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, China)

机构地区：[1]郑州大学第二附属医院,郑州450014

出　　处：《山东医药》2018年第45期41-44,共4页Shandong Medical Journal

基　　金：河南省高等学校重点科研项目(17A320039)

摘　　要：目的探讨血清尿酸(SUA)基线水平与2型糖尿病(T2DM)患者糖尿病视网膜病变(DR)进展的相关性。方法采用回顾性队列研究纳入T2DM患者648例,非增殖性糖尿病视网膜病变(NPDR)患者159例,无糖尿病视网膜病变(NDR)患者489例。收集其临床资料,并追踪其3年后DR进展情况。将基线SUA水平按四分位法分为四组,即最低四分位数组(Ⅰ组)≤232.25μmol/L、第二四分位数组(Ⅱ组)>232.25～291.00μmol/L、第三四分位数组(Ⅲ组)>291.00～357.00μmol/L、最高四分位数组(Ⅳ组)>357.00μmol/L。按DR是否恶化,将研究对象分为恶化组和未恶化组,采用Logistic回归评估基线SUA水平与DR进展之间的相关性。结果 3年后,88例(13.58%)患者DR恶化,其中新发DR 67例(10.34%)。单因素分析中,恶化组与未恶化组SUA水平相比,P<0.05。采用Logistic回归校正糖尿病病程、糖化血红蛋白、甘油三酯、收缩压、舒张压、低密度脂蛋白胆固醇、C肽及尿肌酐/尿白蛋白等混杂因素后,与Ⅰ组相比,Ⅲ组和Ⅳ组OR (95%CI)分别为5.194(2.162～12.482)、6.680(2.785～16.022)(P均<0.05)。SUA>291.00μmol/L为DR恶化的独立危险因素(P<0.05)。结论 SUA水平>291.00μmol/L是T2DM患者DR进展的独立危险因素。Objective To investigate the relationship between baseline serum uric acid(SUA)level and progression of diabetic retinopathy(DR)in patients with type2diabetes mellitus(T2DM).Methods We selected648patients with T2DM,including159non-proliferative diabetic retinopathy(NPDR)patients and489non-diabetic retinopathy(NDR)patients for the retrospective cohort study.We collected their clinical data and tracked their DR progression after3years.The baseline SUA level was divided into four groups according to the quartile method:the lowest quartile array(≤232.25μmol/L,group I)the second quartile array(232.25-291.00μmol/L,group II),the third quantile array(291.00-357.00μmol/L,group III),and the highest quartile array(≥357.00μmol/L,group IV).According to whether the DR worsened,the subjects were divided into the deteriorating group and the non-deteriorating group,and the correlation between the baseline SUA level and the DR progression was evaluated by binary Logistic regression.Results Three years later,88patients(13.58%)had DR deterioration,including67new cases(10.34%).In the univariate analysis,the level of SUA in the deteriorating group was higher than that in the non-deteriorating group(P<0.05).After adjusting for confounding factors such as the course of diabetes,glycosylated hemoglobin(HbA1c),triglyceride(TG),systolic blood pressure(SBP),diastolic blood pressure(DBP),low-density lipoprotein cholesterol(LDL-C),C-peptide and urine creatinine/urine(UACR),compared with group I,the OR(95%CI)of groups III and IV were5.194(2.162-12.482)and6.680(2.785-16.022)(both P<0.05),respectively.Conclusion SUA level>291.00μmol/L is an independent risk factor for DR progression in patients with T2DM.

关 键 词：糖尿病视网膜病变 2型糖尿病 血清尿酸 

分 类 号：R587.2[医药卫生—内分泌]