中老年2型糖尿病患者血清FGF21水平与糖代谢、血清尿酸关系的研究  

Study on the relationship between glucose metabolism,serum uric acid level and FGF21 in middle-aged and elderly patients with type 2 diabetes

作　　者：刘露霞 吕小羽 赵阳婷 陈重阳 李凯 王亚雯 刘靖芳 Liu Luxia;Lyu Xiaoyu;Zhao Yangting;Chen Chongyang;Li Kai;Wang Yawen;Liu Jingfang(The First Clinical Medical School,Lanzhou University,Lanzhou 730000,China;Department of Endocrinology,The First Hospital of Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第一临床医学院,甘肃兰州730000 [2]兰州大学第一医院内分泌科,甘肃兰州730000

出　　处：《兰州大学学报（医学版）》2024年第5期56-63,共8页Journal of Lanzhou University（Medical Sciences）

基　　金：国家自然科学基金资助项目(81960155);甘肃省自然科学基金资助项目(20JR10RA690)。

摘　　要：目的分析中老年2型糖尿病(T2DM)患者血清中成纤维细胞生长因子21(FGF21)与糖代谢、血清尿酸(SUA)的关系。方法随机选取2020年6月—2020年11月在兰州大学第一医院内分泌科住院治疗的245例平均年龄(58.64±9.80)岁T2DM患者(男性171例,女性74例)。收集所有研究对象的一般资料及生化指标,ELISA法检测血清FGF21水平,根据糖化血红蛋白水平(HbA1c)将患者分为3组:血糖控制达标组(HbA1c≤7%)、血糖控制较差组(7%<HbA1c≤10%)、血糖控制极差组(HbA1c>10%),比较各组之间血清FGF21水平的差异。其次根据血清FGF21水平的四分位数将T2DM患者分为4组:Q1[10.00,55.00]mmol/L、Q2[55.01,88.00]mmol/L、Q3[88.01,129.00]mmol/L、Q4[129.01,213.00]mmol/L组,比较各组患者生化指标之间的差异。Spearman相关分析血清FGF21与糖代谢、SUA水平的相关性。多元线性回归分析血清FGF21的独立影响因素。结果血糖控制极差组血清FGF21水平([81.48±43.29)mmol/L]显著低于血糖控制达标组(104.56±52.67)和血糖控制较差组[(97.64±48.28)mmol/L,P<0.05]。Q3组[(355.92±70.15)、Q4组SUA水平(365.49±81.45)mmol/L]显著高于Q1组[(322.92±77.35)mmol/L,均P<0.05]。Q4组HbA1c水平[7.55(6.70,9.10)%]显著低于Q1组[8.50(7.00,10.40)%]、Q2组[9.00(7.60,11.00)%]、Q3组[8.80(7.30,9.90)%]。SUA水平与血清FGF21水平呈正相关关系(r=0.183,P=0.004),与HbA1c水平、空腹血糖(FPG)呈负相关关系(r=-0.157,P=0.013;r=-0.133,P=0.038)。多元线性回归显示SUA与血清FGF21水平呈独立正相关关系[B=0.086,95%CI:[0.001,0.172],P=0.048]。结论中老年T2DM患者血清FGF21水平与SUA呈正相关关系,与HbA1c、FPG呈负相关关系,并且FGF21与SUA水平增加独立相关。高水平血清FGF21与中老年T2DM患者血糖控制达标有关,但是会增加高尿酸血症的风险。Objective To analyze the relationship between fibroblast growth factor21(FGF21)and glucose metabolism and serum uric acid(SUA)in middle-aged and elderly patients with type 2 diabetes mellitus(T2DM).Methods 245 middle-aged and elderly T2DM patients(171 males and 74 females)hospitalized in Department of Endocrinology of The Frist Hospital of Lanzhou University were randomly selected,the general data and biochemical indexes of all subjects were collected.The level of serum FGF21 was detected by ELISA.Firstly,the patients were divided into three groups according to glycosylated hemoglobin(HbA1c):blood glucose control standard group(HbA1c≤7%)、poor blood glucose control group(7%<HbA1c≤10%)、poorer blood glucose control group(HbA1c>10%),and the difference of serum FGF21 levels among three groups was compared.Secondly,according to the quartile levels of serum FGF21,T2DM patients were divided into 4 groups:Q1[10.00,55.00]mmol/L,Q2[55.01,88.00]mmol/L,Q3[88.01,129.00]mmol/L,Q4[129.01,213.00]mmol/L,the difference of biochemical indexes among the groups was compared.Spearman correlation analysis was used to analyze the correlation between serum FGF21 and glucose metabolism and SUA levels.The independent influencing factors of serum FGF21 were analyzed by multiple linear regression.Result The serum FGF21 level in the poorer blood glucose control group(81.48±43.29)mmol/L was significantly lower than that in the standard blood glucose control group and the poor blood glucose control group[(104.56±52.67)mmol/L and(97.64±48.28)mmol/L,P<0.05].The levels of SUA in Q3 and Q4 groups[(355.92±70.15)and(365.49±81.45)mmol/L]were significantly higher than those in Q1 group[(322.92±77.35),all P<0.05].The HbA1c level of Q4 group[7.55(6.70,9.10)%]was significantly lower than that in Q1 group[8.50(7.00,10.40)%]、Q2 group[9.00(7.60,11.00)%]and Q3 group[8.80(7.30,9.90)%].Serum FGF21 level was positively correlated with SUA(r=0.183,P=0.004),negatively correlated with HbA1c and FPG(r=-0.157,P=0.013;r=-0.133,P=0.038).Multiple linear r

关 键 词：2型糖尿病 成纤维细胞生长因子21 糖代谢 血清尿酸 

分 类 号：R587.1[医药卫生—内分泌]