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高尿酸血症与 2 型糖尿病患者的冠心病和肾功能障碍独立相关。

Hyperuricemia is independently associated with coronary heart disease and renal dysfunction in patients with type 2 diabetes mellitus.

机构信息

Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.

出版信息

PLoS One. 2011;6(11):e27817. doi: 10.1371/journal.pone.0027817. Epub 2011 Nov 18.

Abstract

AIMS

To investigate the relationship between hyperuricemia (HUA) and the clinical backgrounds in Japanese patients with type 2 diabetes mellitus.

METHODS

After a cross-sectional study evaluating the association of HUA with the clinical characteristics in 1,213 patients with type 2 diabetes mellitus, the estimated glomerular filtration rate (eGFR) and the incidence of diabetic macroangiopathies was investigated in a prospective observational study in 1,073 patients during a 3.5 year period. HUA was defined by serum uric acid levels >327 μmol/L or as patients using allopurinol.

RESULTS

The frequency of HUA was significantly higher in the diabetic patients (32% in men and 15% in women) than in the normal controls (14% in men and 1% in women). In total, HUA was found in 299 (25%) of the patients during the cross-sectional study. Even after adjusting for sex, drinking status, treatment for diabetes mellitus, body mass index, hypertension, use of diuretics, hyperlipidemia, HbA1c and/or the eGFR, the HUA was independently associated with some diabetic complications. The eGFR was significantly reduced in HUA patients compared to those with normouricemia in the 12 months after observation was started. HUA was also an independent risk factor for coronary heart disease even after adjustment in the Cox proportional hazard model.

CONCLUSIONS

HUA is a associated with diabetic micro- and macroangiopathies. HUA is a predictor of coronary heart disease and renal dysfunction in patients with type 2 diabetes mellitus. However, the influence of HUA is considered to be limited.

摘要

目的

探讨日本 2 型糖尿病患者高尿酸血症(HUA)与临床背景的关系。

方法

在一项横断面研究中,评估了 1213 例 2 型糖尿病患者中 HUA 与临床特征的相关性,随后对其中 1073 例患者进行了为期 3.5 年的前瞻性观察研究,评估估算肾小球滤过率(eGFR)和糖尿病大血管并发症的发生率。HUA 的定义为血清尿酸水平>327 μmol/L 或正在使用别嘌呤醇的患者。

结果

在糖尿病患者中(男性 32%,女性 15%),HUA 的发生率明显高于正常对照组(男性 14%,女性 1%)。在横断面研究中,共有 299 例(25%)患者存在 HUA。即使在校正性别、饮酒状况、糖尿病治疗、体重指数、高血压、利尿剂使用、血脂异常、HbA1c 和/或 eGFR 后,HUA 仍与某些糖尿病并发症独立相关。与血尿酸正常的患者相比,在观察开始后 12 个月,HUA 患者的 eGFR 显著降低。在 Cox 比例风险模型中进行校正后,HUA 也是冠心病的独立危险因素。

结论

HUA 与糖尿病的微血管和大血管并发症有关。HUA 是 2 型糖尿病患者冠心病和肾功能不全的预测因子。然而,HUA 的影响被认为是有限的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1585/3220675/3ffebad053d9/pone.0027817.g001.jpg

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