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2型糖尿病患者血清尿酸水平与高敏C反应蛋白之间的关联

[Association between serum uric acid levels and high sensitive C-reactive protein in patients with type 2 diabetes].

作者信息

Li Z Y, Liu B, Ji Y, Zhuang X J, Shen Y D, Tian H R, Li L X, Liu F

机构信息

Department of Endocrinology and Metabolism, Jinshan Branch, Shanghai Sixth People's Hospital, Shanghai 201599, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2017 Jul 25;97(28):2181-2185. doi: 10.3760/cma.j.issn.0376-2491.2017.28.005.

Abstract

To investigate the relationship between serum uric acid (SUA) levels and high sensitive C-reactive protein (hs-CRP) in patients with type 2 diabetes mellitus (T2DM). A total of 400 patients who were hospitalized in the Department of Endocrinology and Metabolism of Jinshan Branch, Shanghai Sixth People's Hospital between April 2014 and December 2015 were divided into normouricemia (NUA, =319) group and hyperuricemia (HUA, =81) group according to the presence of HUA. Clinical features of the two groups were compared. Patients were further stratified into quartiles based on SUA levels, and then association between hs-CRP and SUA was analyzed. Compared to the NUA group, the patients with HUA had higher hs-CRP concentration [2.12 (1.15, 6.73) mg/L vs 1.14 (0.52, 3.44) mg/L, <0.001], erythrocyte sedimentation rate (ESR) [19.0 (10.5, 29.5) mm/h vs 12.0 (8.0, 17.0) mm/h, <0.001], body mass index (BMI) [(25.2±3.6) kg/m(2) vs (23.6±3.6) kg/m(2,) <0.001], and homeostasis model assessment-2 of insulin resistance (HOMA2-IR) index [1.88 (1.11, 2.94) vs 1.27 (0.77, 2.00), <0.001]. After adjusting for age, the median level of hs-CRP of female with HUA was higher than that of male, female with NUA, and male with NUA (2.59, 1.94, 1.25 and 1.09 mg/L, respectively, <0.001). There was significant difference in the prevalence of HUA among the patients with underweight, normal weight, overweight, and obesity (0, 12.3%, 21.6% and 25.8%, respectively, =0.002). After adjusting for age and gender, duration of diabetes, BMI, serum lipids, level of SUA was still correlated with hs-CRP, HOMA2-IR, fasting C-peptide, blood urea nitrogen, serum creatinine, Cystatin C, microalbuminuria, respectively(all <0.05). The level of SUA was positively associated with the increase of hs-CRP level (=0.001). Multiple linear regression analysis showed that there was an independent and positive association between SUA and hs-CRP levels. SUA was independently associated with hs-CRP in T2DM patients, which suggested that chronic inflammation exists in HUA patients.

摘要

探讨2型糖尿病(T2DM)患者血清尿酸(SUA)水平与高敏C反应蛋白(hs-CRP)之间的关系。选取2014年4月至2015年12月在上海第六人民医院金山分院内分泌代谢科住院的400例患者,根据是否存在高尿酸血症(HUA)分为正常尿酸血症(NUA,n = 319)组和高尿酸血症(HUA,n = 81)组,比较两组的临床特征。根据SUA水平将患者进一步分为四分位数,然后分析hs-CRP与SUA之间的关联。与NUA组相比,HUA组患者的hs-CRP浓度更高[2.12(1.15,6.73)mg/L对1.14(0.52,3.44)mg/L,P < 0.001]、红细胞沉降率(ESR)更高[19.0(10.5,29.5)mm/h对12.0(8.0,17.0)mm/h,P < 0.001]、体重指数(BMI)更高[(25.2±3.6)kg/m²对(23.6±3.6)kg/m²,P < 0.001]以及胰岛素抵抗稳态模型评估-2(HOMA2-IR)指数更高[1.88(1.11,2.94)对1.27(0.77,2.00),P < 0.001]。校正年龄后,HUA女性的hs-CRP中位数水平高于HUA男性、NUA女性和NUA男性(分别为2.59、1.94、1.25和1.09 mg/L,P < 0.001)。体重过轻、正常体重、超重和肥胖患者中HUA的患病率存在显著差异(分别为0、12.3%、21.6%和25.8%,P = 0.002)。校正年龄和性别后,糖尿病病程、BMI、血脂、SUA水平仍分别与hs-CRP、HOMA2-IR、空腹C肽、血尿素氮、血清肌酐、胱抑素C、微量白蛋白尿相关(均P < 0.05)。SUA水平与hs-CRP水平的升高呈正相关(P = 0.001)。多元线性回归分析显示SUA与hs-CRP水平之间存在独立的正相关。在T2DM患者中SUA与hs-CRP独立相关,这表明HUA患者存在慢性炎症。

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