2型糖尿病老年患者血清尿酸水平与糖尿病视网膜病变发生及进展的关系  

Relationship between serum uric acid level and the occurrence and progression of diabetic retinopathy in elderly patients with type 2 diabetes

作　　者：魏静 张金成[1] 史亚男 张慧芹[2] 吴岩[1] WEI Jing;ZHANG Jin-cheng;SHI Ya-nan;ZHANG Hui-qin;WU Yan(Department of EndocrinologyⅠ,Cangzhou Central Hospital,Cangzhou Clinical Medical College of Hebei Medical University,Cangzhou 061000,Hebei,China;Department of OphthalmologyⅠ,Cangzhou Central Hospital,Cangzhou Clinical Medical College of Hebei Medical University,Cangzhou 061000,Hebei,China)

机构地区：[1]河北省沧州市中心医院·河北医科大学沧州临床医学院内分泌一科,河北沧州061000 [2]河北省沧州市中心医院·河北医科大学沧州临床医学院眼一科,河北沧州061000

出　　处：《川北医学院学报》2024年第4期528-531,共4页Journal of North Sichuan Medical College

基　　金：河北省沧州市重点研发计划项目(204106110)。

摘　　要：目的:探究老年2型糖尿病(T2DM)患者血清尿酸(SUA)水平与糖尿病视网膜病变(DR)发生及进展的关系。方法:回顾性分析300例T2DM患者的临床资料,将其中100例T2DM伴DR且SUA>420μmol/L(高尿酸血症)的患者设为HUDR组;将100例T2DM伴DR且SUA≤420μmol/L(无高尿酸血症)的患者设为DR组;将100例T2DM不伴DR患者设为T2DM组,比较各组SUA、血管内皮生长因子(VEGF)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)及超敏C反应蛋白(hs-CRP)水平;比较HUDR组和DR组DR分期构成。Logistic回归分析不同SUA水平对DR发生的影响。结果:各组SUA、VEGF及hs-CRP水平比较:HUDR组>DR组>T2DM组(P<0.05)。DR组与HUDR组DR分期差异有统计学意义(P<0.05)。将患者SUA水平按四分位数分组,纳入Logistic回归方程,结果显示,SUA≤221μmol/L不是DR发生的危险因素,SUA>221μmol/L时开始对DR的发生有影响,且SUA水平越高,影响程度越大[221μmol/L≤SUA<350μmol/L(OR=2.069,95%CI:1.492~3.559)、350μmol/L≤SUA<438μmol/L(OR=3.270,95%CI:1.908~5.173)、SUA≥438μmol/L(OR=3.802,95%CI:2.163~7.091)]。结论:T2DM伴DR患者SUA水平高于T2DM不伴DR患者,SUA水平升高是DR发生的独立危险因素,也是导致DR进展的重要原因。Objective:To investigate the relationship between serum uric acid(SUA)level and the occurrence and progression of diabetic retinopathy(DR)in elderly patients with type 2 diabetes mellitus(T2DM).Methods:A retrospective analysis was performed to collect 300 T2DM patients who met the inclusion and exclusion criteria,among which 100 patients with T2DM and DR patients with SUA>420μmol/L(hyperuricemia)were assigned as HUDR group.A total of 100 T2DM patients with SUA≤420μmol/L(without hyperuricemia)were assigned to the DR Group,and 100 T2DM patients without DR were assigned to the T2DM group.The levels of SUA,vascular endothelial growth factor(VEGF),fasting blood glucose(FBG)and glycosylated hemoglobin(HbA1c)among all groups were compared.The DR stages of HUDR group and DR group were compared.The influence of different SUA levels on the occurrence of DR was analyzed by Logistic regression equation.Results:The SUA,VEGF and hs-CRP levels in HUDR group were higher than that in DR Group and T2DM group,and the DR group was higher than the T2DM group(P<0.05).There was statistically significant difference in DR staging between the DR group and the HUDR group(P<0.05).Logistic regression equation was used to divide patients'SUA levels into quartiles.The results showed that SUA≤221μmol/L was not a risk factor for the occurrence of DR,and SUA>221μmol/L had an impact on the occurrence of DR,and the higher the SUA level,the greater the degree of impact[221μmol/L≤SUA<350μmol/L(OR=2.069,95%CI=1.492~3.559),350μmol/L≤SUA<438μmol/L(OR=3.270,95%CI=1.908~5.173),and SUA≥438μmol/L(OR=3.802,95%CI=2.163~7.091)].Conclusion:The level of SUA in T2DM with DR is higher than that in T2DM without DR.Elevated SUA level is an independent risk factor for DR and an important reason for the progression of DR.

关 键 词：2型糖尿病 老年人 血尿酸 糖尿病视网膜病变 

分 类 号：R587.1[医药卫生—内分泌]