Fukui Michiaki, Tanaka Muhei, Shiraishi Emi, Harusato Ichiko, Hosoda Hiroko, Asano Mai, Kadono Mayuko, Hasegawa Goji, Yoshikawa Toshikazu, Nakamura Naoto
Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan.
Metabolism. 2008 May;57(5):625-9. doi: 10.1016/j.metabol.2007.12.005.
Hyperuricemia has been reported to be associated with increased risk of renal insufficiency as well as cardiovascular events. The aim of this study was to evaluate the relationships between serum uric acid concentration and degree of urinary albumin excretion as well as markers of subclinical atherosclerosis in men with type 2 diabetes mellitus. Serum uric acid concentrations were measured in 343 men with type 2 diabetes mellitus. We then evaluated relationships of serum uric acid concentrations to degree of urinary albumin excretion as well as to major cardiovascular risk factors, including age, blood pressure, serum lipid concentration, and glycemic control (hemoglobin A1c). The relationships between serum uric acid concentration and pulse wave velocity or ankle-brachial index (n=236) and between serum uric acid concentration and carotid intima-media thickness or plaque score (n=125) were investigated additionally in a subgroup of patients. Serum uric acid concentration correlated positively with logarithm of urinary albumin excretion (r=0.302, P<.0001). Positive correlation was found between serum uric acid concentration and intima-media thickness (r=0.233, P=.0087), whereas inverse correlation was found between serum uric acid concentration and ankle-brachial index (r=-0.150, P=.0207). Multiple regression analysis demonstrated that serum uric acid concentration (beta=.281, P<.0001), duration of diabetes (beta=.253, P<.0001), hemoglobin A1c (beta=.166, P=.0034), serum triglyceride concentration (beta=.125, P=.0472), and systolic blood pressure (beta=.275, P=.0013) were independent determinants of logarithm of urinary albumin excretion. In conclusion, serum uric acid concentration is associated with microalbuminuria and subclinical atherosclerosis in men with type 2 diabetes mellitus.
据报道,高尿酸血症与肾功能不全风险增加以及心血管事件有关。本研究的目的是评估2型糖尿病男性患者血清尿酸浓度与尿白蛋白排泄程度以及亚临床动脉粥样硬化标志物之间的关系。对343名2型糖尿病男性患者测量了血清尿酸浓度。然后,我们评估了血清尿酸浓度与尿白蛋白排泄程度以及主要心血管危险因素(包括年龄、血压、血脂浓度和血糖控制情况(糖化血红蛋白))之间的关系。在一个亚组患者中,还额外研究了血清尿酸浓度与脉搏波速度或踝臂指数(n = 236)之间以及血清尿酸浓度与颈动脉内膜中层厚度或斑块评分(n = 125)之间的关系。血清尿酸浓度与尿白蛋白排泄对数呈正相关(r = 0.302,P <.0001)。血清尿酸浓度与内膜中层厚度呈正相关(r = 0.233,P =.0087),而血清尿酸浓度与踝臂指数呈负相关(r = -0.150,P =.0207)。多元回归分析表明,血清尿酸浓度(β =.281,P <.0001)、糖尿病病程(β =.253,P <.0001)、糖化血红蛋白(β =.166,P =.0034)、血清甘油三酯浓度(β =.125,P =.0472)和收缩压(β =.275,P =.0013)是尿白蛋白排泄对数的独立决定因素。总之,2型糖尿病男性患者的血清尿酸浓度与微量白蛋白尿和亚临床动脉粥样硬化有关。