本文選題：高尿酸血癥 + 2型糖尿病　； 參考：《天津醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:分析2型糖尿病患者(T2DM)中高尿酸血癥的流行狀況和臨床特征,探討其相關(guān)因素,為T2DM患者高尿酸血癥的早期篩查和預(yù)防控制提供科學(xué)依據(jù)。方法:摘錄2008年1月1日至2013年3月1日在天津醫(yī)科大學(xué)代謝病醫(yī)院住院的2型糖尿病患者(2525例)的病歷信息。以住院期間經(jīng)非同日兩次血尿酸水平檢測(cè)的2178例2型糖尿病患者為研究對(duì)象,分析2型糖尿病患者中高尿酸血癥的流行情況和臨床特征;以患有高尿酸血癥的2型糖尿病患者為病例組,血尿酸水平正常的患者為對(duì)照組,采用Logistic回歸分析方法對(duì)T2DM患者高尿酸血癥的相關(guān)因素進(jìn)行分析探討。結(jié)果1、2178例2型糖尿病患者中,有高尿酸血癥的T2DM患者有318例,檢出率為14.6%,女性檢出率為17.6%,高于男性(12.2%),差異有統(tǒng)計(jì)學(xué)意義(P0.001);隨著T2DM患者年齡、糖尿病病程的延長(zhǎng),高尿酸血癥的檢出率逐漸增加。2、以患有高尿酸血癥的T2DM患者318例作為病例組,血尿酸水平正常者1860例作為對(duì)照組,采用非條件Logistic回歸對(duì)T2DM患者高尿酸血癥的相關(guān)因素進(jìn)行單因素和多因素分析。單因素分析顯示:女性、高齡、退休、糖尿病病程長(zhǎng)、使用胰島素治療、肥胖、甘油三酯高、24h尿微量白蛋白高、C反應(yīng)蛋白高、糖尿病并發(fā)視網(wǎng)膜病變、糖尿病腎病、高血壓、冠心病、脂代謝紊亂、高纖維蛋白原血癥以及具有冠心病家族史與T2DM患者高尿酸血癥的高風(fēng)險(xiǎn)有統(tǒng)計(jì)學(xué)關(guān)聯(lián),而糖化血紅蛋白水平高與T2DM患者高尿酸血癥的低風(fēng)險(xiǎn)有統(tǒng)計(jì)學(xué)關(guān)聯(lián);經(jīng)調(diào)整可能的混雜因素后,高齡、女性、糖尿病病程長(zhǎng)、肥胖、甘油三酯高、24h尿微量白蛋白高、C反應(yīng)蛋白高、糖尿病并發(fā)視網(wǎng)膜病變、糖尿病腎病、高血壓、脂代謝紊亂以及高纖維蛋白原血癥與T2DM患者高尿酸血癥的高風(fēng)險(xiǎn)有統(tǒng)計(jì)學(xué)關(guān)聯(lián),糖化血紅蛋白水平高與T2DM患者高尿酸血癥的低風(fēng)險(xiǎn)有關(guān);本研究未發(fā)現(xiàn)婚姻狀況、民族、空腹血糖水平、總膽固醇、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇、行為因素、口服藥治療、具有糖尿病家族史、痛風(fēng)家族史、高血壓家族史、糖尿病并發(fā)腦血管病變、糖尿病足以及周圍神經(jīng)病變和T2DM患者高尿酸血癥有關(guān)聯(lián)。3、將以上所有單因素分析有意義的變量,采用前進(jìn)法進(jìn)行多因素Logistic回歸分析,結(jié)果顯示肥胖、糖化血紅蛋白水平、女性和糖尿病腎病均與T2DM患者高尿酸血癥相關(guān),其OR(95%CI)分別為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、并發(fā)糖尿病腎病與2型糖尿病患者高尿酸血癥的高風(fēng)險(xiǎn)相關(guān),糖化血紅蛋白水平高與T2DM患者高尿酸血癥的低風(fēng)險(xiǎn)相關(guān)。結(jié)論:在T2DM住院患者中,高尿酸血癥的檢出率為14.6%,女性高于男性,且隨著年齡越大、病程越長(zhǎng),高尿酸血癥的檢出率越高。女性、肥胖、并發(fā)糖尿病腎病均與T2DM患者高尿酸血癥的高風(fēng)險(xiǎn)有關(guān),糖化血紅蛋白水平高與T2DM患者高尿酸血癥的低風(fēng)險(xiǎn)有關(guān)。
[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.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R587.1;R589.7;R181.3

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