2型糖尿病患者中高尿酸血症的流行状况和相关因素研究

发布时间：2018-04-11 15:06

本文选题：高尿酸血症 + 2型糖尿病　；参考：《天津医科大学》2017年硕士论文

【摘要】：目的:分析2型糖尿病患者(T2DM)中高尿酸血症的流行状况和临床特征,探讨其相关因素,为T2DM患者高尿酸血症的早期筛查和预防控制提供科学依据。方法:摘录2008年1月1日至2013年3月1日在天津医科大学代谢病医院住院的2型糖尿病患者(2525例)的病历信息。以住院期间经非同日两次血尿酸水平检测的2178例2型糖尿病患者为研究对象,分析2型糖尿病患者中高尿酸血症的流行情况和临床特征;以患有高尿酸血症的2型糖尿病患者为病例组,血尿酸水平正常的患者为对照组,采用Logistic回归分析方法对T2DM患者高尿酸血症的相关因素进行分析探讨。结果1、2178例2型糖尿病患者中,有高尿酸血症的T2DM患者有318例,检出率为14.6%,女性检出率为17.6%,高于男性(12.2%),差异有统计学意义(P0.001);随着T2DM患者年龄、糖尿病病程的延长,高尿酸血症的检出率逐渐增加。2、以患有高尿酸血症的T2DM患者318例作为病例组,血尿酸水平正常者1860例作为对照组,采用非条件Logistic回归对T2DM患者高尿酸血症的相关因素进行单因素和多因素分析。单因素分析显示:女性、高龄、退休、糖尿病病程长、使用胰岛素治疗、肥胖、甘油三酯高、24h尿微量白蛋白高、C反应蛋白高、糖尿病并发视网膜病变、糖尿病肾病、高血压、冠心病、脂代谢紊乱、高纤维蛋白原血症以及具有冠心病家族史与T2DM患者高尿酸血症的高风险有统计学关联,而糖化血红蛋白水平高与T2DM患者高尿酸血症的低风险有统计学关联;经调整可能的混杂因素后,高龄、女性、糖尿病病程长、肥胖、甘油三酯高、24h尿微量白蛋白高、C反应蛋白高、糖尿病并发视网膜病变、糖尿病肾病、高血压、脂代谢紊乱以及高纤维蛋白原血症与T2DM患者高尿酸血症的高风险有统计学关联,糖化血红蛋白水平高与T2DM患者高尿酸血症的低风险有关;本研究未发现婚姻状况、民族、空腹血糖水平、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、行为因素、口服药治疗、具有糖尿病家族史、痛风家族史、高血压家族史、糖尿病并发脑血管病变、糖尿病足以及周围神经病变和T2DM患者高尿酸血症有关联。3、将以上所有单因素分析有意义的变量,采用前进法进行多因素Logistic回归分析,结果显示肥胖、糖化血红蛋白水平、女性和糖尿病肾病均与T2DM患者高尿酸血症相关,其OR(95%CI)分别为1.795(1.474~2.185)、0.534(0.433~0.660)、1.658(1.247~2.204)和2.790(2.094~3.718),即肥胖、女性、并发糖尿病肾病与2型糖尿病患者高尿酸血症的高风险相关,糖化血红蛋白水平高与T2DM患者高尿酸血症的低风险相关。结论:在T2DM住院患者中,高尿酸血症的检出率为14.6%,女性高于男性,且随着年龄越大、病程越长,高尿酸血症的检出率越高。女性、肥胖、并发糖尿病肾病均与T2DM患者高尿酸血症的高风险有关,糖化血红蛋白水平高与T2DM患者高尿酸血症的低风险有关。
[Abstract]:Objective: to analyze the prevalence and clinical characteristics of hyperuricemia in patients with type 2 diabetes mellitus (T2DM) and to explore its related factors so as to provide scientific basis for early screening and prevention and control of hyperuricemia in patients with T2DM.Patients with type 2 diabetes mellitus with hyperuricemia as case group and patients with normal serum uric acid level as control group were used to analyze the related factors of hyperuricemia in patients with T2DM by Logistic regression analysis.Results (1) among 2178 patients with type 2 diabetes, 318 patients with hyperuricemia had T2DM, the positive rate was 14.6and the detection rate of female was 17.6, which was higher than that of male patients (P 0.001), and the course of diabetes prolonged with the age of T2DM patients.The detectable rate of hyperuricemia increased gradually. 318cases of T2DM patients with hyperuricemia and 1860 cases of normal serum uric acid level were used as control group.Univariate and multivariate analysis was performed on the relative factors of hyperuricemia in T2DM patients by non-conditional Logistic regression.Univariate analysis showed that: female, old age, retirement, long course of diabetes, insulin therapy, obesity, high triglyceride high 24 h urinary albumin and high C-reactive protein, diabetes mellitus complicated with retinopathy, diabetic nephropathy, hypertension,Coronary heart disease, dyslipidemia, hyperfibrinogenemia and a family history of coronary heart disease were associated with a high risk of hyperuricemia in patients with T2DM.The high level of glycosylated hemoglobin was associated with the low risk of hyperuricemia in patients with T2DM.There was a significant correlation between hyperuricemia and high risk of hyperuricemia in T2DM patients, such as hypertriglyceride, 24 h urinary albumin, high C-reactive protein, diabetic retinopathy, diabetic nephropathy, hypertension, lipid metabolism disorder and hyperfibrinogenemia.High glycosylated hemoglobin levels were associated with low risk of hyperuricemia in patients with T2DM. No marital status, nationality, fasting blood glucose level, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, behavioral factors were found in this study.Oral drug therapy, family history of diabetes, family history of gout, family history of hypertension, diabetes complicated with cerebrovascular disease,Diabetic foot and peripheral neuropathy were associated with hyperuricemia in patients with T2DM. All of the above univariate variables were analyzed and multivariate Logistic regression analysis was carried out. The results showed that obesity and glycosylated hemoglobin levels were detected.High glycosylated hemoglobin levels were associated with low risk of hyperuricemia in patients with T2DM.Conclusion: the detection rate of hyperuricemia in T2DM patients is 14.6.The rate of hyperuricemia in women is higher than that in men, and with the age, the course of disease is longer, the detection rate of hyperuricemia is higher.Female obesity and diabetic nephropathy were associated with high risk of hyperuricemia in patients with T2DM and high glycosylated hemoglobin levels were associated with low risk of hyperuricemia in patients with T2DM.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.1;R589.7;R181.3

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