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血尿酸水平升高的 2 型糖尿病男性患者的利钠肽、大内皮素-1 和胰岛β细胞功能改善。

Raised natriuretic peptides, big-endothelin-1 and improved beta-cell function in type 2 diabetic males with hyperuricaemia.

机构信息

Endocrinology and Nutrition Unit, Cliniques Universitaires St-Luc, Brussels, Belgium.

出版信息

Diab Vasc Dis Res. 2009 Jul;6(3):190-3. doi: 10.1177/1479164109336689.

Abstract

Urate, a naturally-occurring antioxidant, is a marker/factor for cardiovascular disease. Hyperuricaemia is associated with IR, MetS and endothelial dysfunction. We characterised the associations between neurohormones, uricaemia, and glucose homeostasis in type 2 diabetes mellitus (T2DM) males. Cross-sectional; 705 T2DM males divided into two groups: uric acid < 7.0 mg/dl (normouricaemic; n=476) versus uric acid >or= 7.0 mg/dl (hyperuricaemic; n=229). HOMA beta-cell function (B), insulin sensitivity (S), hyperbolic product (BxS), and (BxS) loss rate were determined alongside neurohormones (Nt-proANP, BNP, Big ET-1 and UII). Mean age and diabetes duration were not different between groups. Hyperuricaemics had more macroangiopathy, total/central adiposity, IR, hypertension, dyslipidemia and MetS prevalence. Nt-proANP and BNP levels were more than twice as high in hyperuricaemics, whereas Big ET-1 and UII were higher by 46% and 14%, respectively. HOMA (BxS) was higher in hyperuricaemics: 31 (16)% vs. 26 (18)% (p=0.0004). BxS loss rate was faster in normouricaemics: 1.36 (0.54)% vs. 1.20 (0.43)%/year(-1) (p<0.0001 ). The proportion with HbA(1C) < 7.0% was 39% (normouricaemics) vs. 49% (hyperuricaemics; p=0.0091). In T2DM males, hyperuricaemia is associated with raised neurohormones together with better beta-cell indices. Urate's dual properties may translate into beneficial (glucose homeostasis) and detrimental (raised neurohormones) effects.

摘要

尿酸是一种天然存在的抗氧化剂,是心血管疾病的标志物/因素。高尿酸血症与胰岛素抵抗、代谢综合征和内皮功能障碍有关。我们描述了 2 型糖尿病男性中神经激素、尿酸和葡萄糖稳态之间的关系。横断面研究;705 名 2 型糖尿病男性分为两组:尿酸<7.0mg/dl(正常尿酸血症;n=476)和尿酸≥7.0mg/dl(高尿酸血症;n=229)。测定了 HOMA 胰岛β细胞功能(B)、胰岛素敏感性(S)、双曲线乘积(BxS)和(BxS)丧失率,以及神经激素(Nt-proANP、BNP、Big ET-1 和 UII)。两组的平均年龄和糖尿病病程无差异。高尿酸血症患者有更多的大血管病变、总/中心肥胖、胰岛素抵抗、高血压、血脂异常和代谢综合征患病率。高尿酸血症患者的 Nt-proANP 和 BNP 水平高出两倍以上,而 Big ET-1 和 UII 分别高出 46%和 14%。高尿酸血症患者的 HOMA(BxS)更高:31(16)%比 26(18)%(p=0.0004)。正常尿酸血症患者的 BxS 丧失率更快:1.36(0.54)%比 1.20(0.43)%/年(-1)(p<0.0001)。HbA1C<7.0%的比例为 39%(正常尿酸血症)和 49%(高尿酸血症;p=0.0091)。在 2 型糖尿病男性中,高尿酸血症与升高的神经激素以及更好的胰岛β细胞指数有关。尿酸的双重特性可能转化为有益(葡萄糖稳态)和有害(升高的神经激素)作用。

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