Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai Clinical Center for Diabetes; Shanghai Diabetes Institute; Shanghai Key Laboratory. of Diabetes Mellitus; Shanghai Key Clinical Center for Metabolic Disease; 600 Yishan Road, Shanghai 200233, China.
Department of VIP, Shanghai Jiao Tong University Affiliated Sixth People's Hospital; 600 Yishan Road, Shanghai 200233, China.
Sci Rep. 2017 Jan 4;7:40009. doi: 10.1038/srep40009.
We aim to explore the associations between serum uric acid (SUA) and obesity and cardio-cerebrovascular events (CCEs) in Chinese inpatients with type 2 diabetes mellitus (T2DM). 2 962 inpatients with T2DM were stratified into quartile based on SUA concentrations. There were significant increases in the prevalence of both obesity (32.6%, 41.9%, 50.1%, and 62.8%, respectively, p < 0.001 for trend) and severe obesity (0.4%, 0.6%, 0.8%, and 1.3%, respectively, p < 0.001 for trend) across the SUA quartiles. A fully adjusted multiple logistic regression analysis revealed that SUA quartiles were independently associated with the presence of obesity (p < 0.001). The prevalence of CCEs was significantly higher in the obese diabetics than in the nonobese diabetics (16.8% vs. 13.2%, p = 0.027). After controlling for multiple confounding factors, BMI levels were also significantly correlated with the presence of CCEs (p = 0.020). However, there was no significant association of SUA quartiles/SUA levels with the presence of CCEs in T2DM. This study suggested that SUA levels were independently associated with obesity but not with CCEs in patients with T2DM. In selected populations such as subjects with T2DM, the role of uric acid in cardiovascular complications might be attributable to other cardiovascular risk factors, such as obesity.
我们旨在探讨血清尿酸(SUA)与肥胖症以及中国 2 型糖尿病(T2DM)住院患者心脑血管事件(CCEs)之间的相关性。将 2962 例 T2DM 住院患者按 SUA 浓度分为四等份。肥胖症(32.6%、41.9%、50.1%和 62.8%,p<0.001 趋势)和重度肥胖症(0.4%、0.6%、0.8%和 1.3%,p<0.001 趋势)的患病率均呈显著升高趋势。经完全校正的多因素逻辑回归分析显示,SUA 四分位数与肥胖症的存在独立相关(p<0.001)。肥胖型糖尿病患者的 CCEs 患病率显著高于非肥胖型糖尿病患者(16.8%比 13.2%,p=0.027)。在校正多种混杂因素后,BMI 水平与 CCEs 的存在也显著相关(p=0.020)。然而,SUA 四分位值/SUA 水平与 T2DM 患者 CCEs 的发生并无显著相关性。该研究表明,SUA 水平与 T2DM 患者的肥胖症独立相关,但与 CCEs 无关。在特定人群(如 T2DM 患者)中,尿酸在心血管并发症中的作用可能归因于肥胖等其他心血管危险因素。