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2型糖尿病患者的高尿酸血症和蛋白尿

Hyperuricemia and albuminuria in patients with type 2 diabetes mellitus.

作者信息

Bonakdaran Shokufeh, Hami Maryam, Shakeri Mohammad Taghi

机构信息

Division of Endocrinology, Department of Internal Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Iran J Kidney Dis. 2011 Jan;5(1):21-4.

Abstract

INTRODUCTION. Hyperuricemia is an independent risk factor for kidney dysfunction in diabetic patients. On the other hand, albuminuria is considered as the proxy of early stages of diabetic nephropathy. We investigated the correlation between hyperuricemia and albuminuria in patients with diabetes mellitus. MATERIALS AND METHODS. In a cross-sectional study of 1275 patients (555 men and 720 women) with type 2 diabetes mellitus, serum uric acid and urinary albumin-creatinine ratio were determined. Other metabolic parameters including lipid profile, hemoglobin A1c, glomerular filtration rate, body mass index, blood pressure, blood glucose were assessed, as well. RESULTS. The mean age of the patients was 52.45 ± 10.11 years old. Serum uric acid levels for normoalbuminuric, microalbuminuric, and macroalbuminuric patients were 4.49 ± 1.22 mg/dL, 4.84 ± 1.52 mg/dL, and 6.15 ± 1.68 mg/dL, respectively. Among patients with clinical metabolic syndrome, 233 (27.5%) were in the forth upper quartile of uric acid level (> 5.3 mg/dL), but in diabetic patients without this syndrome, only 80 (18.7%) were in this group. There was a significant relationship between hyperuricemia and serum triglyceride, fasting blood glucose, hemoglobin A1c, glomerular filtration rate, and serum creatinine levels (P < .001). No significant correlation was found between hyperuricemia and cholesterol levels, age, duration of diabetes mellitus, and body mass index. Serum uric acid level correlated positively with urinary albumin-creatinine ratio (P = .04). CONCLUSIONS. We showed that higher serum uric acid concentrations were associated with a greater probability of albuminuria in patients with type 2 diabetes mellitus.

摘要

引言。高尿酸血症是糖尿病患者肾功能不全的独立危险因素。另一方面,蛋白尿被视为糖尿病肾病早期阶段的替代指标。我们研究了糖尿病患者高尿酸血症与蛋白尿之间的相关性。材料与方法。在一项对1275例2型糖尿病患者(555例男性和720例女性)的横断面研究中,测定了血清尿酸和尿白蛋白 - 肌酐比值。还评估了其他代谢参数,包括血脂谱、糖化血红蛋白、肾小球滤过率、体重指数、血压、血糖。结果。患者的平均年龄为52.45±10.11岁。正常白蛋白尿、微量白蛋白尿和大量白蛋白尿患者的血清尿酸水平分别为4.49±1.22mg/dL、4.84±1.52mg/dL和6.15±1.68mg/dL。在患有临床代谢综合征的患者中,233例(27.5%)处于尿酸水平的第四上四分位数(>5.3mg/dL),但在无此综合征的糖尿病患者中,只有80例(18.7%)处于该组。高尿酸血症与血清甘油三酯、空腹血糖、糖化血红蛋白、肾小球滤过率和血清肌酐水平之间存在显著关系(P<.001)。未发现高尿酸血症与胆固醇水平、年龄、糖尿病病程和体重指数之间存在显著相关性。血清尿酸水平与尿白蛋白 - 肌酐比值呈正相关(P = .04)。结论。我们表明,2型糖尿病患者中较高的血清尿酸浓度与蛋白尿的可能性更大相关。

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