高尿酸血症与女性Graves眼病的相关性研究  

The study on the correlation between hyperuricemia and Graves'eye disease in women

作　　者：周莹 程献[2] 高芸[1] 包建东[1] 陈侃[1] ZHOUYing;CHENG Xian;GAO Yun;BAO Jian-dong;CHEN Kan(Department of endocrinology,Jiang Yuan Hospital Affliated to Jiangsu Institute of Nuclear Medicine,Wuxi 214063,China)

机构地区：[1]江苏省原子医学研究所附属江原医院内分泌科,江苏无锡214063 [2]江苏省原子医学研究所,江苏无锡214063

出　　处：《中国实用内科杂志》2024年第8期659-664,共6页Chinese Journal of Practical Internal Medicine

基　　金：江苏省卫健委面上项目(M2021060);无锡市科技局项目(Y20212052)。

摘　　要：目的 为了明确血尿酸(serum uric acid,SUA)与Graves眼病(Graves’ophthalmopathy,GO)之间的关系,我们在未服药治疗的Graves病(Graves’disease,GD)患者中开展了一项回顾性研究。方法 共纳入2018年1月至2021年9月江源医院154例未服用抗甲状腺药物治疗的GD患者,根据是否存在GO,分为No GO组(男36例,女47例)与GO组(男35例,女36例)。入组患者完善甲状腺激素、甲状腺球蛋白抗体(TgAb)、抗甲状腺过氧化物酶抗体(TPOAb)、促甲状腺素受体抗体(TRAb)、SUA、肌酐、空腹血糖、血脂、甲状腺超声、眼眶CT等检查。存在GO的患者需要完善眼部CAS评分、NONSPECS评级。采用SPSS 22.0软件进行统计分析。结果 (1)GO组的CAS评分、NONSPECS评级、TRAb高于No GO组(P<0.05),两组间患者在性别比例、年龄、甲亢病程、体质指数(BMI)、游离三碘甲腺原氨酸(FT3)、游离甲状腺激素(FT4)、促甲状腺素(TSH)、胱抑素C、TgAb、TPOAb、血糖、尿素氮、肌酐水平之间差异均无统计学意义。(2)GO组的SUA水平高于No GO组(P<0.05),两组间高尿酸血症(HUA)的比例差异无统计学意义。(3)按照性别进行亚组分析,在女性组内GO组的SUA平均水平显著高于No GO组(P<0.05),GO组HUA的比例显著高于No GO组(P<0.05)。在男性组内GO组与No GO组间的SUA平均水平、HUA的比例差异无统计学意义。(4)采用相关性分析发现,女性组内存在GO与SUA(r=0.304,P<0.05)呈正相关。(5)采用二元logistic回归分析发现,相对于无HUA的女性GD患者,合并HUA的女性GD患者发生GO的风险增加3.23倍。结论 HUA是GD患者发生GO的新型独立危险因素,尤其是女性GD患者。ObjectiveTTo determine the relationship between serum uric acid(SUA)and Graves'ophthalmopathy(GO),We conducted a retrospective study in untreated patients with Graves'disease(CD).Methods A total of 154 patients with GD in Jiang Yuan Hospital from Jan.2018 to Sep.2021 who had not taken antithyroid drugs were included in this study.According to the presence or absence of CO,they were divided into the No CO group(M/F 36/47 cases)and the GO group(M/F 35/36 cases).All enrolled patients met the diagnostic criteria of GD and GO.The patients with Hyperuricemia(HUA),gout,and chronic kidney disease were excluded,as well as drugs affecting uric acid metabolism.All enrolled patients required to test thyroid function,TPOAb,TRAb,TgAb,SUA,creatinine,fasting blood glucose,serum lipids,thyroid ultrasound,and orbital CT.Patients with GO underwent a complete eye examination and evaluated CAS score and NONSPECS score.SPSS 22.0 software was used for statistical analysis.Results(1)The CAS score and NONSPECS score and TRAb lerel in the GO group were higher than those in the No GO group(P<0.05).There were no significant differences in sex ratio,age,hyperthyroidism course,BMI,FT,FTa,TSH,TPOAb,TgAb,cystein C,blood glucose,BUN and creatinine levels between the two groups.(2)The SUA level in the GO group was higher than that in the No GO group(P<0.05).There was no significant differencein the proportion of HUA between the two groups.(3)We conducted subgroup analysis according to gender.In the female subgroup,the mean SUA level in the GO group was significantly higher than that in the No GO group(P<0.05),the proportion of HUA in GO group was significantly higher than that in No CO group(P<0.05).In the male subgroup,the mean SUA level and the proportion of HUA in GO group were not different from that in No GO group.(4)We found that the presence of GO in female was positively correlated with female SUA(r=0.304,P<0.05),but not with smoking,FT,,FT4,TRAb,TPOAb and TgAb.(5)With the presence or absence of CO as the dependent variable,and the total

关 键 词：GRAVES病 GRAVES眼病 血尿酸 高尿酸血症 

分 类 号：R581.1[医药卫生—内分泌]