血尿酸/高密度脂蛋白胆固醇比值与糖尿病肾病及颈动脉粥样硬化斑块的相关性研究  

Correlation of Serum Uric Acid/High-density Lipoprotein Cholesterol Ratio with Diabetic Nephropathy and Carotid Atherosclerotic Plaque

作　　者：李新 田晨光[1] 张真真[1] 王泽渊 LI Xin;TIAN Chenguang;ZHANG Zhenzhen(Department of Endocrinology,The Second Affiliated Hospital of Zhengzhou University,Henan 450000,China)

机构地区：[1]郑州大学第二附属医院内分泌科,450000

出　　处：《医学研究杂志》2023年第10期112-116,共5页Journal of Medical Research

基　　金：河南省科技厅科技攻关项目(182102310596)。

摘　　要：目的 探讨血尿酸(serum uric acid,SUA)/高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)比值(URH)水平与糖尿病肾病(diabetic kidney disease,DKD)及颈动脉粥样硬化(carotid arteriosclerosis,CAS)间的关系。方法 选取2021年9月~2022年5月于郑州大学第二附属医院内分泌科住院治疗的T2DM患者406例为研究对象。首先初步探讨DKD与CAS的相关性,然后根据是否伴有DKD、CAS分为无并发症组(n=93)、一种并发症组(n=229)与两种并发症组(n=84)3组。收集患者一般临床资料及生化指标,计算URH、单核细胞/高密度脂蛋白胆固醇比值(MHR)等。结果 在T2DM患者中,DKD与CAS存在统计学关联(P=0.002)。单因素分析显示,在无并发症组、一种并发症组、两种并发症组3组组间,年龄、DM病程、高血压病史、收缩压(systolic blood pressure,SBP)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、单核细胞、血尿酸(serum uric acid,SUA)、血肌酐(serum creatinine,Scr)、肾小球滤过率(estimation of glomerular filtration rate,eGFR)、尿白蛋白/肌酐比值(UACR)、单核细胞/HDL-C(MHR)和SUA/HDL-C(URH)等指标比较,差异有统计学意义。Spearman相关分析显示,URH与UACR、MHR、Scr、TG呈正相关(P<0.05),与eGFR、LDL-C呈负相关(P<0.05)。无序多因素Logistic回归分析显示,在无并发症组与两种并发症组中,URH、MHR与DKD伴CAS独立相关(OR=1.025,95%CI:1.016~1.034,P<0.001;OR=1.219,95%CI:1.137~1.306,P<0.001);在一种并发症组与两种并发症组中,URH、MHR与DKD伴CAS独立相关(OR=1.015,95%CI:1.010~1.021,P<0.001;OR=1.083,95%CI:1.032~1.136,P=0.001)。结论 在住院T2DM患者中,DKD与CAS具有统计学关联。URH、MHR与DKD伴CAS独立相关,在T2DM患者中,高URH、MHR水平对DKD伴CAS有一定的预测价值。Objective To investigate the relationship between serum uric acid/high-density lipoprotein ratio(URH)level and diabetic kidney disease(DKD)and carotid arteriosclerosis(CAS).Methods A total of 406 patients with type 2diabetes mellitus(T2DM)were selected from Endocrinology Department of the Second Affiliated Hospital of Zhengzhou University from September 2021 to May 2022.First,the correlation between DKD and CAS was preliminarily discussed,and then they were divided into three groups:no complication group(n=93),one complication group(n=229)and two complications group(n=84)according to whether it was accompanied by DKD and CAS.The general clinical data and biochemical indexes of all patients were collected.UHR and monocyte/high-density lipoprotein cholesterol ratio(MHR)were calculated.Results In T2DM patients,DKD was associated with CAS(P=0.002).Univariate analysis showed that age,duration of DM,history of hypertension,SBP,TC,HDL-C,LDL-C,monocytes,SUA,Scr,eGFR,UACR,MHR and URH were statistically different among the three groups.Spearman correlation analysis showed that URH was positively correlated with UACR,MHR,Scr,and TG(P<0.05),and negatively correlated with eGFR and LDL-C(P<0.05).Logistic regression analysis showed that in no complication group and two complications group,URH and MHR were independently correlated with DKD with CAS(OR=1.025,95%CI:1.016-1.034,P<0.001;OR=1.219,95%CI:1.137-1.306,P<0.001);in one complication group and two complications group,URH and MHR were independently correlated with DKD with CAS(OR=1.015,95%CI:1.010-1.021,P<0.001;OR=1.083,95%CI:1.032-1.136,P=0.001).Conclusion Among hospitalized patients with T2DM,DKD was associated with CAS.URH and MHR were associated with DKD with CAS.In T2DM patients,high URH and MHR levels had predictive value for DKD with CAS.

关 键 词：URH MHR 2型糖尿病 糖尿病肾病 颈动脉粥样硬化 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]