α-硫辛酸对T2DM患者血尿酸及肾功能的影响  

Effects ofα-lipoic acid on serum uric acid and renal function in patients of type 2 diabetes mellitus

作　　者：张学丽[1] 许斐琦 厉伟兰[1] 邵华[1] ZHANG Xueli;XU Feiqi;LI Weilan;SHAO Hua(Department of Pharmcy,Affiliated Zhongda Hospital,Southeast University,Jiangsu Nanjing 210009,China;School of Basic Medicine&Clinical Pharmacy,China Pharmaceutical University,Jiangsu Nanjing 210009,China)

机构地区：[1]东南大学附属中大医院药学部,江苏南京210009 [2]中国药科大学基础医学与临床药学院,江苏南京210009

出　　处：《中国医院药学杂志》2024年第12期1452-1456,共5页Chinese Journal of Hospital Pharmacy

基　　金：南京药学会常州四药医院药学科研基金(编号:2022YX004)。

摘　　要：目的:探索α-硫辛酸(α-lipoic acid,ALA)对2型糖尿病(T2DM)患者血清尿酸(serum uric acid,SUA)及肾功能的影响。方法:采用回顾性单臂前后对照研究的方法,选取2017年1月至2022年12月在东南大学附属中大医院接受ALA治疗的患者,以性别、年龄、糖尿病病程、SUA、eGFR和是否有合并症为指标,对患者治疗前后SUA、SUA/血肌酐和eGFR的变化进行分层分析;以基线SUA为因变量进行相关性和多元线性回归分析。结果:据纳、排标准,最终筛选入组病例163例。总体分析结果显示ALA治疗后SUA有显著降低(P<0.01);而分层分析结果表明仅在年龄≥50岁、基线SUA<480μmol·L^(-1)的患者中SUA有显著降低(P<0.01)。对于治疗前肾功能中、重度损害的患者,ALA治疗后eGFR有显著改善(P<0.01)。多元线性回归分析结果提示,基线SUA水平是治疗前后SUA变化量(P<0.01)的主要影响因素。结论:ALA可在年龄≥50岁、基线SUA<480μmol·L^(-1)的T2DM患者中发挥降低SUA水平的作用,并可在eGFR中、重度降低的T2DM患者中发挥改善肾功能的作用。研究结果可为T2DM合并高尿酸血症提供降尿酸候选药物,为ALA的老药新用提供参考。OBJECTIVE To explore the impact ofα-lipoic acid(ALA)on the level of serum uric acid(SUA)and renal function in patients of type 2 diabetes mellitus(T2DM).METHODS A retrospective single-arm before-after controlled study was performed for 163 patients on a therapy of ALA between January 2017 and December 2022.Gender,age,diabetic duration,SUA,estimated glomerular filtration rate(eGFR)and complications were employed as indicators for assessing the changes in SUA,SUA/creatinine ratio and eGFR before and after treatment.Correlation and multiple linear regression analyses were performed with baseline SUA as a dependent variable.RESULTS Overall analysis revealed a significant reduction in SUA level after ALA dosing(P<0.01).Stratified analysis demonstrated a significant reduction in SUA level exclusively in patients aged≥50 years or with a baseline level of SUA<480μmol·L^(–1)(P<0.01).Notably,ALA dosing significantly improved eGFR in patients of moderate-to-severe renal function impairment prior to treatment.Multiple linear regression analysis identified baseline level of SUA(P<0.01)as a primary influencing factor for changes in SUA before and after treatment.CONCLUSION ALA is effective in lowering the level of SUA in T2DM patients aged≥50 years and those with pre-treatment SUA<480μmol·L^(-1).Furthermore,it has also demonstrated some promise in enhancing renal function in T2DM patients with moderate-to-severe eGFR reduction.It offers potential therapeutic options for managing hyperuricemia in T2DM and provides valuable insights into a novel application of ALA.

关 键 词：Α-硫辛酸 高尿酸血症 2型糖尿病 肾功能 降尿酸药物 

分 类 号：R969.3[医药卫生—药理学]