血尿酸与2型糖尿病患者颈动脉粥样硬化关系的Meta分析  

Relationship between Serum Uric Acid and Carotid Atherosclerosis in Patients with Type 2 Diabetes Mellitus:A Meta-analysis

作　　者：李钰萍 邓新玲 陈楠 廖秋云 庞翠军[2] 黄济华 LI Yuping;DENG Xinling;CHEN Nan;LIAO Qiuyun;PANG Cuijun;HUANG Jihua(Guangxi Medical University,Nanning 530021,China;Department of Endocrinology,the Second Affiliated Hospital of Guangxi Medical University,Nanning 530007,China)

机构地区：[1]广西医科大学,南宁530021 [2]广西医科大学第二附属医院内分泌科,南宁530007

出　　处：《医学综述》2019年第13期2683-2688,共6页Medical Recapitulate

基　　金：广西壮族自治区卫生和计划生育委员会基金项目(Z20170079);广西医疗卫生适宜技术开发与推广应用项目(S2018041)

摘　　要：目的 综合评价血尿酸与2型糖尿病(T2DM)患者颈动脉粥样硬化的关系。方法 运用计算机检索中国生物医学文献数据库(CBM)、中国学术期刊全文数据库(CNKI)、维普、万方和PubMed数据库,收集自建库以来至2018年9月国内外公开发表的有关血尿酸与T2DM患者颈动脉粥样硬化关系的研究文献,采用RevMan 5.3软件进行统计学分析。结果 共纳入18项研究,均为病例对照研究,根据颈动脉粥样硬化组颈动脉内膜中层厚度(CIMT)标准可分为两组,CIMT≥1.0 mm组包括2 499名研究对象;CIMT≥0.9 mm组包括1 469名研究对象。 Meta 分析结果均显示T2DM患者颈动脉粥样硬化组的血尿酸水平明显高于T2DM患者非颈动脉粥样硬化组[CIMT≥1.0 mm组 WMD=58.33,95% CI 49.20~67.47,P<0.000 01;CIMT≥0.9 mm组 WMD=73.87,95 % CI 57.89~ 89.86 ,P<0.000 01],漏斗图和Begg′s秩检验(CIMT≥1.0 mm组 P=0.251;CIMT≥0.9 mm组 P=0.917)显示未发现显著发表偏倚,可靠性较强。结论 高血尿酸与T2DM患者的颈动脉粥样硬化关系十分密切,说明高尿酸血症可能是导致动脉粥样硬化的原因之一。Objective To evaluate the relationship between serum uric acid(SUA) and carotid atherosclerosis in patients with type 2 diabetes mellitus(T2DM).Methods The databases including CNKI,CBM,VIP,Wan Fang and PubMed were searched by computer,and the published studies on the relationship between SUA and carotid atherosclerosis of T2DM patients were collected since the establishment of the database until Sep.2018.The results were statistically analyzed using RevMan 5.3 software.Results A total of 18 studies were included,all of which were case control studies.According to the standard of Carotid Intima Media Thickness(CIMT) of the carotid atherosclerosis group,they were divided into two groups.There were 2 499 subjects in the CIMT≥1.0 mm group and 1 469 subjects in the CIMT≥0.9 mm group.The results of Meta-analysis showed that the SUA level in the carotid atherosclerosis group of T2DM patients was significantly higher than that in the non-carotid atherosclerosis group of T2DM patients[CIMT≥1.0 mm(WMD=58.33,95% CI 49.20-67.47,P<0.000 01);CIMT≥0.9 mm(WMD=73.87,95% CI 57.89-89.86,P<0.000 01)],the funnel plot and Begg′s rank test (CIMT≥1.0 mm group P=0.251;CIMT≥0.9 mm groupP=0.917) showed no significant publication bias,with strong reliability.Conclusion High blood uric acid level is closely related to carotid atherosclerosis in T2DM patients ,and hyperuricemia may be one of the risks of atherosclerosis.

关 键 词：2型糖尿病 血尿酸 颈动脉粥样硬化 META分析 

分 类 号：R587.1[医药卫生—内分泌]