台湾2型糖尿病患者尿酸水平与外周动脉疾病的独立关联。

Independent association of uric acid levels with peripheral arterial disease in Taiwanese patients with Type 2 diabetes.

作者信息

Tseng C-H

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7 Chung-Shan South Road, Taipei, Taiwan.

出版信息

Diabet Med. 2004 Jul;21(7):724-9. doi: 10.1111/j.1464-5491.2004.01239.x.

DOI:10.1111/j.1464-5491.2004.01239.x

PMID:15209765

Abstract

AIMS

Hyperuricaemia may be a risk factor for atherosclerotic disease. Its association with peripheral arterial disease (PAD) has not been studied in Taiwanese patients with Type 2 diabetes.

METHODS

Uric acid (UA) levels and PAD were evaluated in 508 Taiwanese outpatients with Type 2 diabetes (210 men, 298 women; mean age +/- sd, 63.8 +/- 10.6 years). PAD was diagnosed when the ankle-brachial index was < 0.9. Patients with an ankle-brachial index of > or = 1.3 were excluded because of possible medial arterial calcification. Potential confounding variables with P < 0.10 were adjusted for in multivariate analyses.

RESULTS

In univariate analyses, UA levels were higher in patients with PAD than in those without PAD (345.0 +/- 95.2 vs. 309.3 +/- 89.2 micromol/l; P < 0.0005). Prevalences of PAD for quintiles of UA levels were 6.8, 8.9, 10.2, 13.1 and 16.5%, respectively (P-trend < 0.05). With UA level as a continuous variable, the multivariate-adjusted odds ratio (95% confidence interval) for PAD was 1.005 (1.001-1.008) (P < 0.01). The optimal cut-off point for UA as determined by the receiver operating characteristic curve was 264.7 micromol/l. The sensitivity and specificity at this cut-off point was 82.6 and 33.3%, respectively. The area under curve was 0.60 (95% confidence interval: 0.53-0.68). The multivariate-adjusted odds ratio for PAD for UA above this level was 2.736 (1.239-6.043) (P < 0.05). The results after excluding 56 cases using diuretics were similar.

CONCLUSIONS

Elevated uric acid level is a significant and independent risk factor for PAD in Taiwanese patients with Type 2 diabetes.

摘要

目的

高尿酸血症可能是动脉粥样硬化疾病的一个危险因素。在台湾2型糖尿病患者中，尚未对其与外周动脉疾病（PAD）的关联进行研究。

方法

对508名台湾2型糖尿病门诊患者（210名男性，298名女性；平均年龄±标准差，63.8±10.6岁）的尿酸（UA）水平和PAD进行评估。当踝臂指数<0.9时诊断为PAD。踝臂指数>或=1.3的患者因可能存在动脉中层钙化而被排除。在多变量分析中对P<0.10的潜在混杂变量进行了校正。

结果

在单变量分析中，PAD患者的UA水平高于无PAD患者（345.0±95.2对309.3±89.2μmol/L；P<0.0005）。UA水平五分位数的PAD患病率分别为6.8%、8.9%、10.2%、13.1%和16.5%（P趋势<0.05）。将UA水平作为连续变量，PAD的多变量校正比值比（95%置信区间）为1.005（1.001-1.008）（P<0.01）。由受试者工作特征曲线确定的UA最佳切点为264.7μmol/L。该切点的敏感性和特异性分别为82.6%和33.3%。曲线下面积为0.60（95%置信区间：0.53-0.68）。高于此水平的UA的PAD多变量校正比值比为2.736（1.239-6.043）（P<0.05）。排除使用利尿剂的56例病例后的结果相似。