2型糖尿病患者糖化血红蛋白变异指数与血尿酸关系的研究  

Relationship between hemoglobin glycation index and serum uric acid in patients with type 2 diabetes mellitus

作　　者：赵阳婷 陈重阳 吕小羽 王亚雯 李凯[1] 刘靖芳[1,2] ZHAO Yangting;CHEN Chongyang;LYU Xiaoyu;WANG Yawen;LI Kai;LIU Jingfang(The First Clinical Medical College,Lanzhou University,Lanzhou,Gansu Province 730000,China)

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

出　　处：《中国慢性病预防与控制》2024年第10期727-732,740,共7页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：国家自然科学基金(82360161);国家自然科学基金(81960155);兰州大学第一医院院内基金(ldyyyn2020-01);兰州市科技厅基金(2022-3-46)。

摘　　要：目的 探讨2型糖尿病(T_(2)DM)患者糖化血红蛋白变异指数(HGI)与血尿酸(SUA)水平之间的关系,为临床上糖尿病患者SUA的监测和治疗提供参考.方法 选取2021年1月-2023年5月兰州大学第一医院内分泌科的住院治疗的1 878例T_(2)DM患者作为研究对象,收集患者一般资料和生化指标.计算HGI,HGI=实际的糖化血红蛋白(HbA1C)-预测的HbA1C[预测HbA1C=0.355 8×FPG(mmol/L)+5.239 1].将T_(2)DM患者根据HGI的三分位数水平由低到高分为T1组、T_(2)组和T3组.采用SPSS 26.0软件进行方差分析、χ^(2)检验、Spearman秩相关分析和多重线性回归分析.结果 男性T_(2)DM患者T1组SUA水平[(359.24±89.82)μmol/L]显著高于 T_(2)[(339.77±77.61)μmol/L]和 T3 组[(335.87±85.20)μmol/L],女性 T_(2)DM患者T1组SUA水平[(315.20±85.91)μmol/L]显著高于T_(2)[(306.99±77.89)μmol/L]和 T3 组[(287.36±83.36)μmol/L],T_(2) 组显著高于T3组,差异均有统计学意义(P<0.05).Spearman相关分析结果显示,男性、女性T_(2)DM患者HGI与SUA水平均呈负相关(r值分别为-0.111、-0.009,P<0.01).多重线性回归分析结果显示,男性和女性T_(2)DM患者HGI与SUA水平独立负相关(β值分别为-0.088、-0.090).分层分析显示,在男性T_(2)DM患者中,在HbA1C<6.5%或6.5%≤HbA1C<10%组中,SUA与HGI均呈显著负相关(β值分别为-0.203、-0.078),在HbA1C≥10%组中,HGI与SUA之间无相关关系;在女性T_(2)DM患者中,不同血糖控制水平组HGI与SUA之间的相关关系均无统计学意义(P>0.05).结论 T_(2)DM患者随着HGI水平的升高,SUA水平逐渐降低,HGI与SUA水平独立负相关,监测HGI水平的变化,可能对T_(2)DM患者HUA的诊治具有一定的参考价值.Objective To explore the relationship between hemoglobin glycation index(HCI)and serum uric acid(SUA)levels in patients with type 2 diabetes mellitus(T_(2)DM),and provide the reference for clinical SUA monitoring in T_(2)DM patients.Methods A total of 1878 inpatients with T_(2)DM in the Department of Endocrinology of the First Hospital of Lanzhou University from January 2021 to May 2023 were selected as the study subjects,and the general data and biochemical indexes of the inpatients were collected.The HGI level was calculated,HGI level=actual HbAic-predicted HbAic(predicted HbAic=0.3558xFPG(mmol/L)+5.2391).According to tertiary levels of HCI,the patients with T_(2)DM were divided into T,T_(2) and T,groups.One-way ANOVA,χ^(2) test,Spearman rank correlation analysis and multiple linear regression analysis were used to analyze the data.The used software was SPSS 26.0.Results In male T_(2)DM patients,SUA level[(359.24±89.82)μmol/L] in group T,was significantly higher than those[(339.77±77.61)μmol/L and(335.87±85.20)μmol/L]in groups T_(2) and T3,P<0.05.In female T_(2)DM patients,SUA level[(315.20±85.91)μmol/L]in group T,was significantly higher than those[(306.99±77.89)μmol/L and(287.36±83.36)μmol/L]in groups T_(2) and T,SUA level in T_(2) group was significantly higher than that in T group,P<0.05.Spearman rank correlation analysis showed that HGI levels negatively correlated to SUA levels in male and female T_(2)DM patients(r values were-0.111 and-0.009,P<0.01).Multiple linear regression showed that HGI was independently negatively correlated with SUA levels in male and female T_(2)DM patients(βvalues were-0.088 and-0.090).Stratified regression analysis showed that in male T_(2)DM patients,there was significant negative correlation between SUA and HCI when HbAic was<6.5%or HbAic was<10%but≥6.5%(βvalues were-0.203 and-0.078);however,there was no correlation between HGI and SUA when HbAic≥10%.In female T_(2)DM patients,there was no significant correlation between HGI and SUA in groups with different

关 键 词：2型糖尿病 糖化血红蛋白变异指数 血尿酸 

分 类 号：R587.1[医药卫生—内分泌]