尿酸/高密度脂蛋白胆固醇比值对2型糖尿病合并非酒精性脂肪性肝病的预测价值  

Value of UHRin predicting type 2 diabetes mellitus combined with NAFLD

作　　者：高佳敏 王涛[2] 朱云峰[2] 付瑞瑞 洪彬 翁孝刚[2] GAO Jiamin;WANG Tao;ZHU Yunfeng;FU Ruirui;HONG Bin;WENG Xiaogang(Department of Endocrinology,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,China;Department of Endocrinology,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,China)

机构地区：[1]新乡医学院第三附属医院内分泌科,河南新乡453003 [2]新乡医学院第一附属医院内分泌科,河南新乡453100

出　　处：《陕西医学杂志》2025年第3期323-327,共5页Shaanxi Medical Journal

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20220593)。

摘　　要：目的:在2型糖尿病(T2DM)患者中探讨尿酸/高密度脂蛋白胆固醇比值(UHR)与非酒精性脂肪性肝病(NAFLD)的相关性,以及UHR对T2DM患者发生NAFLD的预测价值。方法:选取216例T2DM患者作为研究对象。检测血清肌酐(SCr)和血清尿酸(SUA)水平,并计算UHR。根据超声结果将患者分为T2DM合并NAFLD组(155例)和单纯T2DM组(61例)。根据UHR三份位数将患者分为U1组(UHR≤197.60)、U2组(197.60<UHR≤272.57)、U3组(UHR>272.57),每组各72例,比较三组患者的NAFLD发生率。分析T2DM合并NAFLD的危险因素,评估UHR对NAFLD的预测价值。结果:T2DM合并NAFLD组BMI、舒张压(DBP)、白蛋白(ALB)、丙氨酸转氨酶(ALT)、天门冬氨基转移酶(AST)、空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、稳态模型胰岛素抵抗指数(HOMA-IR)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、空腹C肽(FC-P)、SUA、UHR高于单纯T2DM组,高密度脂蛋白胆固醇(HDL-C)、年龄、病程低于单纯T2DM组(均P<0.05)。U1组、U2组、U3组患者NAFLD患病率呈显著增加趋势(P<0.05)。年龄、病程、BMI、ALT、FPG、LDL-C、UHR是T2DM患者合并NAFLD的影响因素(均P<0.05)。总人群和不同性别UHR对T2DM合并NAFLD均有一定的预测价值,且男性UHR的预测价值高于女性(均P<0.05)。结论:UHR是T2DM合并NAFLD的危险因素,对T2DM合并NAFLD具有良好的预测价值,且男性患者UHR的预测价值高于女性。Objective:To investigate the association between uric acid/high-density lipoprotein cholesterol ratio(UHR)and non-alcoholic fatty liver disease(NAFLD)in patients with type 2 diabetes mellitus(T2DM),and the predictive value of UHRin the development of NAFLD in T2DM patients.Methods:A total of 216 T2DM patients were selected as the study objects.Serum creatinine(SCr)and serum uric acid(SUA)levels were measured,and UHRwas calculated.The patients were divided into T2DM combined with NAFLD group(155 cases)and simple T2DM group(61 cases).The patients were divided into U1 group(UHR≤197.60),U2 group(197.60<UHR≤272.57)and U3 group(UHR>272.57)according to the UHRtriplet,with 72 patients in each group.The incidence of NAFLD in three groups was compared.The risk factors of T2DM combined with NAFLD was analyzed,and the predictive value of UHRfor NAFLD was evaluated.Results:BMI,DBP,ALB,ALT,AST,FPG,TC,TG,LDL-C,HOMA-IR,HbA1c,FINS,FC-P),SUA and UHRin T2DM combined with NAFLD group were higher than those in simple T2DM group,but HDL-C,age and disease course were lower than those in simple T2DM group(all P<0.05).The prevalence of NAFLD in U1,U2 and U3 groups was significantly increased(P<0.05).Age,course of disease,BMI,ALT,FPG,LDL-C and UHRwere the influencing factors of T2DM patients combined with NAFLD(all P<0.05).Both the general population and different gender UHRhad certain predictive value for T2DM combined with NAFLD,and the predictive value of male UHRwas higher than that of female(all P<0.05).Conclusion:UHRis a risk factor for T2DM combined with NAFLD,and has good predictive value,and the predictive value of UHRin male patients is higher than that in female patients.

关 键 词：2型糖尿病 非酒精性脂肪性肝病 尿酸/高密度脂蛋白胆固醇比值 性别 影响因素 预测价值 

分 类 号：R587.2[医药卫生—内分泌]