血尿酸與2型糖尿病主要代謝指標(biāo)的相關(guān)性研究
發(fā)布時(shí)間：2018-09-01 08:57
【摘要】：背景： 糖尿病作為一種慢性代謝性疾病，其流行趨勢逐漸擴(kuò)大，已引起全世界的關(guān)注。糖尿病并發(fā)癥引起的死亡率和致殘率也在增長，2010年中國慢病監(jiān)測[13]報(bào)道，2010年全世界因糖尿病導(dǎo)致的死亡人數(shù)達(dá)到130萬。其中血管病變是導(dǎo)致糖尿病患者死亡率上升的主要原因。近些年，研究表明，血尿酸水平與糖尿病血管病變相關(guān)[14,15]，且高尿酸是糖尿病的獨(dú)立危險(xiǎn)因素[11]。高尿酸血癥（HUA）是一種以嘌呤代謝障礙為主的疾病，與年齡、性別、飲酒、脂代謝紊亂、脂肪肝、冠心病、高血壓、腦梗塞及糖尿病等有關(guān)。關(guān)于尿酸與糖尿病微血管病變的研究較少，因此，本文主要探討血尿酸水平與2型糖尿病主要代謝指標(biāo)的相關(guān)性，同時(shí)分析血尿酸水平與糖尿病腎病、糖尿病視網(wǎng)膜病變患病率之間的關(guān)系。 目的： 探討血尿酸水平與2型糖尿病主要代謝指標(biāo)的相關(guān)性，并分析其可能的機(jī)制。 方法： 選擇2009年1月~2014年5月于吉林大學(xué)第一醫(yī)院二部內(nèi)分泌科住院的2型糖尿病患者1517例，分為三組：總?cè)巳航M、男性組和女性組，同時(shí)各根據(jù)尿酸水平，分為HUA組和NUA組。記錄患者性別、年齡、病程、腹圍、體重指數(shù)、血壓等一般資料，測量SUA、FBG、HbA1c、TG、TC、LDL-C、HDL-C、γ-GGT、UAE等。數(shù)據(jù)分析采用SPSS17.0進(jìn)行分析，其中P0.05提示差異有統(tǒng)計(jì)學(xué)意義。 結(jié)果： 1、1517例2型糖尿病患者中，高尿酸血癥患者175例，占總?cè)藬?shù)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型糖尿病患者總?cè)巳褐�，HUA組與NUA組兩組間年齡、DBP、TG、HDL-C、γ-GGT、FBG、HbA1c、UAE的差異有統(tǒng)計(jì)學(xué)意義（P0.05），而TC、LDL-C、SBP、病程、體重、BMI、腹圍較NUA組差異均無統(tǒng)計(jì)學(xué)意義（P0.05）；（2）男性患者中，HUA組與NUA組兩組間年齡、TG、HDL-C、γ-GGT、FBG、HbA1c、UAE的差異有統(tǒng)計(jì)學(xué)意義（P0.05），，而TC、LDL-C、SBP、DBP、病程、體重、BMI、腹圍較NUA組差異均無統(tǒng)計(jì)學(xué)意義（P0.05）；（3）在女性患者中，HUA組與NUA組兩組間TG、γ-GGT、UAE的差異有統(tǒng)計(jì)學(xué)意義（P0.05），年齡、HDL-C、FBG、HbA1c、TC、LDL-C、SBP、DBP、病程、體重、BMI、腹圍較NUA組差異均無統(tǒng)計(jì)學(xué)意義（P0.05）。 3、2型糖尿病患者中，HUA組與NUA組相比：（1）總?cè)巳褐�，TG、DBP、γ-GGT、UAE水平高于NUA組，年齡、FBG、HbA1c、HDL-C低于NUA組；（2）男性患者中，TG、γ-GGT、UAE水平高于NUA組，年齡、FBG、HbA1c、HDL-C低于NUA組；（3）女性患者中，TG、γ-GGT、UAE水平高于NUA組。 4、相關(guān)性分析顯示：（1）總?cè)巳褐�，血尿酸水平與年齡、FBG、HbA1c、TG、HDL-C、γ-GGT及UAE的相關(guān)性有統(tǒng)計(jì)學(xué)意義（P0.05)，與DBP相關(guān)性無統(tǒng)計(jì)學(xué)意義；其中血尿酸水平與TG、γ-GGT、UAE呈正相關(guān)（P0.05)，與年齡、FBG、HbA1c、HDL-C呈負(fù)相關(guān)(P0.05)。（2）男性患者中，血尿酸水平與年齡、FBG、HbA1c、TG、HDL-C、γ-GGT及UAE的相關(guān)性有統(tǒng)計(jì)學(xué)意義（P0.05)；其中血尿酸水平與TG、γ-GGT、UAE呈正相關(guān)（P0.05)，與年齡、FBG、HbA1c、HDL-C呈負(fù)相關(guān)(P0.05)。（3）女性患者中，血尿酸水平與TG、γ-GGT、UAE呈正相關(guān)(P0.05)。 5、2型糖尿病患者中HUA組與NUA組DN，DR患病率的差異有統(tǒng)計(jì)學(xué)意義（P0.05），HUA組DN、DR患病率高于NUA組。 結(jié)論： 2型糖尿病患者中，高尿酸血癥的發(fā)生率較高，且以男性為主；總?cè)巳杭澳行曰颊咧�，隨著血尿酸水平增高，TG、γ-GGT、UAE呈顯著增高趨勢，與年齡、FBG、HbA1c、HDL-C呈負(fù)相關(guān)；女性患者中，隨著尿酸水平升高，TG、γ-GGT、UAE呈上升趨勢。2型糖尿病患者合并HUA的患者DN、DR的發(fā)生率升高。提示在臨床工作中對2型糖尿病患者不僅需要進(jìn)行飲食控制，體育鍛煉，控制血糖、血壓、血脂，還應(yīng)重視對血尿酸的管理。
[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.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R587.1
本文編號：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.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R587.1
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