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血清尿酸与不同水平葡萄糖的关系及相关因素。

Association of serum uric acid with different levels of glucose and related factors.

机构信息

Department of Endocrinology, Henan Provincial People's Hospital, Zhengzhou, Henan 450003, China.

出版信息

Chin Med J (Engl). 2011 May;124(10):1443-8.

Abstract

BACKGROUND

Previous studies have demonstrated that serum uric acid (UA) is an independent predictor of incident type 2 diabetes mellitus (T2DM) in general populations. This study aimed to investigate specific characteristics of UA and its relationship between UA and blood glucose and other risk factors in the Chinese population.

METHODS

A total of 946 subjects were included in this study. UA, glucose, insulin, fractional excretion of UA (FEua), creatinine clearance rate (Ccr), hemoglobin A1c (HbA1c), fructosamine (FA), blood pressure and lipids were studied and also reexamined after the patients underwent two weeks of combined therapeutics.

RESULTS

UA levels were the highest in subjects with impaired glucose regulation (IGR), followed by subjects with normoglycemia (NGT) and finally by subjects with T2DM. The level of the 2-hour postprandial insulin and the area under the curve for insulin (AUCins) showed a similar tendency. The UA levels initially increased with increasing fasting blood glucose (FBG) and postprandial blood glucose (PPBG) levels, up to 7 mmol/L and 10 mmol/L, respectively, and thereafter decreased at higher FBG and PPBG levels. Compared with subjects in the lower serum UA quartile, subjects in the upper quartile of serum UA levels had higher weights, triglyceride levels, and creatinine levels as well as lower Ccr and FEua levels. Compared with women's group, UA levels were higher, and FEua levels were lower in men's group. Sex, body mass index (BMI), mean arterial blood pressure (MAP), serum triglycerides (TG), FA and Ccr were independent correlation factors of UA. UA decreased and FEua increased after the patients underwent a combined treatment.

CONCLUSIONS

UA increased initially and then decreased as glucose levels increased from NGT to IGR and T2DM. Compared with NGT and T2DM, IGR subjects had higher SUA levels, which related to its high levels of insulin. Under T2DM, male gender, BMI, MAP, Ccr, TG and FA are independent correlation factors of UA. Glucose-lowering, antihypertensive, lipemia-regulating combined treatments were of advantage to decline of SUA of T2DM.

摘要

背景

先前的研究表明,血清尿酸(UA)是一般人群中 2 型糖尿病(T2DM)发病的独立预测因子。本研究旨在探讨 UA 的具体特征及其与中国人群中 UA 与血糖和其他危险因素之间的关系。

方法

本研究共纳入 946 例受试者。研究了 UA、血糖、胰岛素、UA 分数排泄(FEua)、肌酐清除率(Ccr)、糖化血红蛋白(HbA1c)、果糖胺(FA)、血压和血脂,并在患者接受两周联合治疗后进行了复查。

结果

在葡萄糖调节受损(IGR)的受试者中,UA 水平最高,其次是血糖正常(NGT)的受试者,最后是 T2DM 的受试者。餐后 2 小时胰岛素和胰岛素曲线下面积(AUCins)的水平也呈现出类似的趋势。UA 水平最初随空腹血糖(FBG)和餐后血糖(PPBG)水平的升高而升高,分别达到 7mmol/L 和 10mmol/L,此后在更高的 FBG 和 PPBG 水平下降低。与血清 UA 四分位较低的受试者相比,血清 UA 四分位较高的受试者体重、甘油三酯水平和肌酐水平较高,而 Ccr 和 FEua 水平较低。与女性组相比,男性组的 UA 水平较高,FEua 水平较低。性别、体重指数(BMI)、平均动脉压(MAP)、血清甘油三酯(TG)、FA 和 Ccr 是 UA 的独立相关因素。患者接受联合治疗后,UA 降低,FEua 升高。

结论

UA 随葡萄糖水平从 NGT 到 IGR 和 T2DM 的升高而先升高后降低。与 NGT 和 T2DM 相比,IGR 患者的 SUA 水平更高,这与其高水平的胰岛素有关。在 T2DM 中,男性、BMI、MAP、Ccr、TG 和 FA 是 UA 的独立相关因素。降糖、降压、调脂联合治疗有利于降低 T2DM 的 SUA。

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