Guo Mei, Niu Jian-Ying, Li She-Ran, Ye Xian-Wu, Fang Hong, Zhao Yan-Ping, Gu Yong
Fifth People's Hospital, Fudan University, No. 128 Ruili Road,Minhang District, Shanghai 200240, China.
Center for Disease Prevention and Control of Minhang District, No. 965 Zhongyi Road, Shanghai 201101, China.
J Diabetes Complications. 2015 Nov-Dec;29(8):1042-9. doi: 10.1016/j.jdiacomp.2015.08.016. Epub 2015 Aug 22.
To investigate gender differences of the associations between hyperuricemia and diabetic kidney disease (DKD) in elderly patients with type 2 diabetes mellitus (T2DM) based on electronic health records (EHR).
A total of 20,207 older diabetic patients (mean age 71±7years) were investigated based on the EHR from 2012 to 2013 in the Minhang District of Shanghai-China. The status of hyperuricemia, albuminuric DKD and the odds ratios of DKD relative to hyperuricemia were analyzed among 8541 men and 11,666 women.
The overall rate of hyperuricemia was 20.5% (males: 17.2%, females: 23.0%) and that of albuminuric DKD was 36.2% (males: 32.2%, female: 39.1%) in these diabetic patients. Hyperuricemia was independently associated with increased risk of reduced renal function and albuminuria (p<0.001) in both genders. After adjustment of traditional DKD risk factors, hyperuricemia had a stronger association with albuminuric DKD in males (OR 1.67, 95% CI: 1.48-1.88) than in females (OR 1.23, 95% CI: 1.12-1.35).
This study showed an independent association of hyperuricemia with albuminuric DKD that was stronger in elderly males for the first time in China based on EHR. The level of uric acid should be monitored and managed in older diabetic patients.
基于电子健康记录（EHR），研究老年2型糖尿病（T2DM）患者中高尿酸血症与糖尿病肾病（DKD）之间关联的性别差异。
基于中国上海闵行区2012年至2013年的EHR，对总共20207例老年糖尿病患者（平均年龄71±7岁）进行了调查。分析了8541名男性和11666名女性中的高尿酸血症状态、蛋白尿性DKD以及DKD相对于高尿酸血症的比值比。
在这些糖尿病患者中，高尿酸血症的总体发生率为20.5%（男性：17.2%，女性：23.0%），蛋白尿性DKD的总体发生率为36.2%（男性：32.2%，女性：39.1%）。高尿酸血症与两性肾功能降低和蛋白尿风险增加独立相关（p<0.001）。在调整传统DKD危险因素后，高尿酸血症与男性蛋白尿性DKD的关联（OR 1.67，95%CI：1.48-1.88）比女性更强（OR 1.23，95%CI：1.12-1.35）。
本研究首次基于EHR表明，在中国老年男性中，高尿酸血症与蛋白尿性DKD存在独立关联，且这种关联更强。老年糖尿病患者应监测和管理尿酸水平。
