血尿酸与2型糖尿病主要代谢指标的相关性研究
发布时间：2018-09-01 08:57
【摘要】：背景： 糖尿病作为一种慢性代谢性疾病，其流行趋势逐渐扩大，已引起全世界的关注。糖尿病并发症引起的死亡率和致残率也在增长，2010年中国慢病监测[13]报道，2010年全世界因糖尿病导致的死亡人数达到130万。其中血管病变是导致糖尿病患者死亡率上升的主要原因。近些年，研究表明，血尿酸水平与糖尿病血管病变相关[14,15]，且高尿酸是糖尿病的独立危险因素[11]。高尿酸血症（HUA）是一种以嘌呤代谢障碍为主的疾病，与年龄、性别、饮酒、脂代谢紊乱、脂肪肝、冠心病、高血压、脑梗塞及糖尿病等有关。关于尿酸与糖尿病微血管病变的研究较少，因此，本文主要探讨血尿酸水平与2型糖尿病主要代谢指标的相关性，同时分析血尿酸水平与糖尿病肾病、糖尿病视网膜病变患病率之间的关系。 目的： 探讨血尿酸水平与2型糖尿病主要代谢指标的相关性，并分析其可能的机制。 方法： 选择2009年1月~2014年5月于吉林大学第一医院二部内分泌科住院的2型糖尿病患者1517例，分为三组：总人群组、男性组和女性组，同时各根据尿酸水平，分为HUA组和NUA组。记录患者性别、年龄、病程、腹围、体重指数、血压等一般资料，测量SUA、FBG、HbA1c、TG、TC、LDL-C、HDL-C、γ-GGT、UAE等。数据分析采用SPSS17.0进行分析，其中P0.05提示差异有统计学意义。 结果： 1、1517例2型糖尿病患者中，高尿酸血症患者175例，占总人数的11.54%。其中，男性HUA患病率15.43%，女性HUA患病率6.41%，男性患病率高于女性。 2、（1）2型糖尿病患者总人群中，HUA组与NUA组两组间年龄、DBP、TG、HDL-C、γ-GGT、FBG、HbA1c、UAE的差异有统计学意义（P0.05），而TC、LDL-C、SBP、病程、体重、BMI、腹围较NUA组差异均无统计学意义（P0.05）；（2）男性患者中，HUA组与NUA组两组间年龄、TG、HDL-C、γ-GGT、FBG、HbA1c、UAE的差异有统计学意义（P0.05），，而TC、LDL-C、SBP、DBP、病程、体重、BMI、腹围较NUA组差异均无统计学意义（P0.05）；（3）在女性患者中，HUA组与NUA组两组间TG、γ-GGT、UAE的差异有统计学意义（P0.05），年龄、HDL-C、FBG、HbA1c、TC、LDL-C、SBP、DBP、病程、体重、BMI、腹围较NUA组差异均无统计学意义（P0.05）。 3、2型糖尿病患者中，HUA组与NUA组相比：（1）总人群中，TG、DBP、γ-GGT、UAE水平高于NUA组，年龄、FBG、HbA1c、HDL-C低于NUA组；（2）男性患者中，TG、γ-GGT、UAE水平高于NUA组，年龄、FBG、HbA1c、HDL-C低于NUA组；（3）女性患者中，TG、γ-GGT、UAE水平高于NUA组。 4、相关性分析显示：（1）总人群中，血尿酸水平与年龄、FBG、HbA1c、TG、HDL-C、γ-GGT及UAE的相关性有统计学意义（P0.05)，与DBP相关性无统计学意义；其中血尿酸水平与TG、γ-GGT、UAE呈正相关（P0.05)，与年龄、FBG、HbA1c、HDL-C呈负相关(P0.05)。（2）男性患者中，血尿酸水平与年龄、FBG、HbA1c、TG、HDL-C、γ-GGT及UAE的相关性有统计学意义（P0.05)；其中血尿酸水平与TG、γ-GGT、UAE呈正相关（P0.05)，与年龄、FBG、HbA1c、HDL-C呈负相关(P0.05)。（3）女性患者中，血尿酸水平与TG、γ-GGT、UAE呈正相关(P0.05)。 5、2型糖尿病患者中HUA组与NUA组DN，DR患病率的差异有统计学意义（P0.05），HUA组DN、DR患病率高于NUA组。 结论： 2型糖尿病患者中，高尿酸血症的发生率较高，且以男性为主；总人群及男性患者中，随着血尿酸水平增高，TG、γ-GGT、UAE呈显著增高趋势，与年龄、FBG、HbA1c、HDL-C呈负相关；女性患者中，随着尿酸水平升高，TG、γ-GGT、UAE呈上升趋势。2型糖尿病患者合并HUA的患者DN、DR的发生率升高。提示在临床工作中对2型糖尿病患者不仅需要进行饮食控制，体育锻炼，控制血糖、血压、血脂，还应重视对血尿酸的管理。
[Abstract]:Background:
As a chronic metabolic disease, diabetes mellitus has attracted worldwide attention. The mortality and disability rate caused by diabetic complications are also increasing. According to the report of China Chronic Disease Surveillance in 2010, the number of deaths caused by diabetes mellitus in the world reached 1.3 million. Vascular disease is the cause of diabetes mellitus. In recent years, studies have shown that serum uric acid levels are associated with diabetic angiopathy [14,15], and hyperuricemia is an independent risk factor for diabetes [11].Hyperuricemia (HUA) is a disorder of purine metabolism, with age, sex, alcohol consumption, lipid metabolism disorders, fatty liver, coronary heart disease, hypertension, brain. There are few studies on uric acid and diabetic microangiopathy. Therefore, this paper mainly discusses the correlation between serum uric acid level and the main metabolic indicators of type 2 diabetes mellitus, and analyzes the relationship between serum uric acid level and the prevalence of diabetic nephropathy and diabetic retinopathy.
Objective:
Objective to investigate the correlation between serum uric acid level and major metabolic markers in type 2 diabetes mellitus, and analyze its possible mechanism.
Method:
From January 2009 to May 2014, 1517 patients with type 2 diabetes were divided into three groups: total population group, male group and female group. They were divided into HUA group and NUA group according to uric acid level. HbA1c, TG, TC, LDL-C, HDL-C, gamma-GGT, UAE, etc. Data were analyzed by SPSS17.0, and the difference was statistically significant in P 0.05.
Result:
Among 1,1517 patients with type 2 diabetes mellitus, 175 (11.54%) had hyperuricemia. Among them, the prevalence of HUA was 15.43% in males and 6.41% in females. The prevalence of HUA in males was higher than that in females.
2. (1) There were significant differences in age, DBP, TG, HDL-C, gamma-GGT, FBG, HbA1c, UAE between HUA group and NUA group (P 0.05), while there were no significant differences in TC, LDL-C, SBP, course of disease, weight, BMI, abdominal circumference between HUA group and NUA group (P 0.05); (2) Age, TG, HDL-C, gamma-GT, FBG, HbA1c, SBP, duration of disease, BMI, abdominal circumference between HUA group and NUA group were not statistically significant (P 0.05). AE difference was statistically significant (P 0.05), while TC, LDL-C, SBP, DBP, course of disease, weight, BMI, abdominal circumference than NUA group were not statistically significant (P 0.05); (3) In female patients, the differences of TG, gamma-GT, UAE between HUA group and NUA group were statistically significant (P 0.05), age, HDL-C, FBG, HbA1c, TC, LDL-C, SBP, DBP, course of disease, weight, BMI, abdominal circumference were worse than NUA group. The difference was not statistically significant (P0.05).
3. In type 2 diabetes mellitus, the levels of TG, DBP, gamma-GGT and UAE in HUA group were higher than those in NUA group, while those in age, FBG, HbA1c and HDL-C were lower than those in NUA group. (2) In male patients, the levels of TG, gamma-GGT and UAE were higher than those in NUA group, age, FBG, HbA1c and HDL-C were lower than those in NUA group. (3) In female patients, the levels of TG, gamma-GT and UAE were higher than those in NUA group.
4. Correlation analysis showed that: (1) The correlation between serum uric acid and age, FBG, HbA1c, TG, HDL-C, gamma-GGT and UAE was statistically significant (P 0.05), but not statistically significant (P 0.05) with DBP, in which serum uric acid was positively correlated with TG, gamma-GGT, UAE (P 0.05), and negatively correlated with age, FBG, HbA1c, HDL-C (P 0.05). The correlation between serum uric acid level and age, FBG, HbA1c, TG, HDL-C, gamma-GGT and UAE was statistically significant (P 0.05). Among them, serum uric acid level was positively correlated with TG, gamma-GGT and UAE (P 0.05), and negatively correlated with age, FBG, HbA1c, HDL-C (P 0.05). (3) In female patients, serum uric acid level was positively correlated with TG, gamma-GT and UAE (P 0.05).
5. In type 2 diabetes mellitus, the prevalence of DN and DR in HUA group was significantly higher than that in NUA group (P 0.05).
Conclusion:
In type 2 diabetes mellitus, the incidence of hyperuricemia is high, and mainly male; in the total population and male patients, with the increase of serum uric acid level, TG, gamma-GGT, UAE increased significantly, and age, FBG, HbA1c, HDL-C was negatively correlated; in female patients, with the increase of uric acid level, TG, gamma-GT, UAE showed an upward trend. The incidence of DN and DR increased in patients with HUA, suggesting that not only diet control, physical exercise, blood glucose control, blood pressure, blood lipid control, but also the management of serum uric acid should be emphasized in clinical work.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.1
本文编号：2216700
[Abstract]:Background:
As a chronic metabolic disease, diabetes mellitus has attracted worldwide attention. The mortality and disability rate caused by diabetic complications are also increasing. According to the report of China Chronic Disease Surveillance in 2010, the number of deaths caused by diabetes mellitus in the world reached 1.3 million. Vascular disease is the cause of diabetes mellitus. In recent years, studies have shown that serum uric acid levels are associated with diabetic angiopathy [14,15], and hyperuricemia is an independent risk factor for diabetes [11].Hyperuricemia (HUA) is a disorder of purine metabolism, with age, sex, alcohol consumption, lipid metabolism disorders, fatty liver, coronary heart disease, hypertension, brain. There are few studies on uric acid and diabetic microangiopathy. Therefore, this paper mainly discusses the correlation between serum uric acid level and the main metabolic indicators of type 2 diabetes mellitus, and analyzes the relationship between serum uric acid level and the prevalence of diabetic nephropathy and diabetic retinopathy.
Objective:
Objective to investigate the correlation between serum uric acid level and major metabolic markers in type 2 diabetes mellitus, and analyze its possible mechanism.
Method:
From January 2009 to May 2014, 1517 patients with type 2 diabetes were divided into three groups: total population group, male group and female group. They were divided into HUA group and NUA group according to uric acid level. HbA1c, TG, TC, LDL-C, HDL-C, gamma-GGT, UAE, etc. Data were analyzed by SPSS17.0, and the difference was statistically significant in P 0.05.
Result:
Among 1,1517 patients with type 2 diabetes mellitus, 175 (11.54%) had hyperuricemia. Among them, the prevalence of HUA was 15.43% in males and 6.41% in females. The prevalence of HUA in males was higher than that in females.
2. (1) There were significant differences in age, DBP, TG, HDL-C, gamma-GGT, FBG, HbA1c, UAE between HUA group and NUA group (P 0.05), while there were no significant differences in TC, LDL-C, SBP, course of disease, weight, BMI, abdominal circumference between HUA group and NUA group (P 0.05); (2) Age, TG, HDL-C, gamma-GT, FBG, HbA1c, SBP, duration of disease, BMI, abdominal circumference between HUA group and NUA group were not statistically significant (P 0.05). AE difference was statistically significant (P 0.05), while TC, LDL-C, SBP, DBP, course of disease, weight, BMI, abdominal circumference than NUA group were not statistically significant (P 0.05); (3) In female patients, the differences of TG, gamma-GT, UAE between HUA group and NUA group were statistically significant (P 0.05), age, HDL-C, FBG, HbA1c, TC, LDL-C, SBP, DBP, course of disease, weight, BMI, abdominal circumference were worse than NUA group. The difference was not statistically significant (P0.05).
3. In type 2 diabetes mellitus, the levels of TG, DBP, gamma-GGT and UAE in HUA group were higher than those in NUA group, while those in age, FBG, HbA1c and HDL-C were lower than those in NUA group. (2) In male patients, the levels of TG, gamma-GGT and UAE were higher than those in NUA group, age, FBG, HbA1c and HDL-C were lower than those in NUA group. (3) In female patients, the levels of TG, gamma-GT and UAE were higher than those in NUA group.
4. Correlation analysis showed that: (1) The correlation between serum uric acid and age, FBG, HbA1c, TG, HDL-C, gamma-GGT and UAE was statistically significant (P 0.05), but not statistically significant (P 0.05) with DBP, in which serum uric acid was positively correlated with TG, gamma-GGT, UAE (P 0.05), and negatively correlated with age, FBG, HbA1c, HDL-C (P 0.05). The correlation between serum uric acid level and age, FBG, HbA1c, TG, HDL-C, gamma-GGT and UAE was statistically significant (P 0.05). Among them, serum uric acid level was positively correlated with TG, gamma-GGT and UAE (P 0.05), and negatively correlated with age, FBG, HbA1c, HDL-C (P 0.05). (3) In female patients, serum uric acid level was positively correlated with TG, gamma-GT and UAE (P 0.05).
5. In type 2 diabetes mellitus, the prevalence of DN and DR in HUA group was significantly higher than that in NUA group (P 0.05).
Conclusion:
In type 2 diabetes mellitus, the incidence of hyperuricemia is high, and mainly male; in the total population and male patients, with the increase of serum uric acid level, TG, gamma-GGT, UAE increased significantly, and age, FBG, HbA1c, HDL-C was negatively correlated; in female patients, with the increase of uric acid level, TG, gamma-GT, UAE showed an upward trend. The incidence of DN and DR increased in patients with HUA, suggesting that not only diet control, physical exercise, blood glucose control, blood pressure, blood lipid control, but also the management of serum uric acid should be emphasized in clinical work.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.1
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