Department of Endocrinology, The First People's Hospital of Wujiang District Suzhou, Suzhou, China.
Eur Rev Med Pharmacol Sci. 2018 Jan;22(2):506-511. doi: 10.26355/eurrev_201801_14202.
To investigate the relationships between blood uric acid (BUA) level and the incidence, progression and deterioration of diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM).
A total of fifty patients with T2DM alone whose glycosylated hemoglobin (HbA1c) were under normal range (4-6.5%) at their admission to our hospital were randomly selected as diabetes mellitus (DM) group. Fifty patients with hyperuricemia alone were randomly selected as hyperuricemia (HUA) group. Fifty patients with T2DM complicated with hyperuricemia who were admitted to the hospital with HbAlc of 4-6.5% were randomly selected as diabetes mellitus hyperuricemia (DM-HUA) group. In addition, fifty healthy persons who passed the health examination were randomly selected as normal control (NC) group. The general data such as name and body mass index (BMI), metabolic-related indexes such as fasting blood glucose (FBG), total cholesterol (TC) and triglyceride (TG) as well as kidney-related indexes such as blood urea nitrogen (BUN), creatinine (Cr) and albumin-creatinine-ratio (ACR) in four groups were tested and recorded at the same time. The interrelationships between uric acid (UA) and the above indexes were statistically analyzed.
In DM-HUA group, serum TC, TG and low density lipoprotein (LDL) as well as urine ACE were greatly increased (p<0.05) compared with the other three groups, high-density lipoprotein (HDL) was significantly decreased compared with the remaining three groups (p<0.05), and BMI and Cr were increased compared with those in NC group and DM group (p<0.05). There were no significant differences in metabolic indexes and renal functions in DM group and HUA group. Compared with NC group, TC, LDL, serum β2 macroglobulin and BMI in above two groups were greatly increased (p<0.05); BUN and Cr in HUA group were slightly higher than those in NC group (p<0.05). Multiple linear regression analysis showed that UA level was the main factor affecting ACR (R2=0.636, p<0.001).
UA level is an independent risk factor for early renal disease in patients with T2DM, which can promote the progression and deterioration of renal disease in T2DM patients.
探讨血尿酸（BUA）水平与 2 型糖尿病（T2DM）患者糖尿病肾病（DN）的发生、进展和恶化的关系。
选取我院收治的糖化血红蛋白（HbA1c）正常范围（4-6.5%）的单纯 T2DM 患者 50 例作为糖尿病组（DM 组），单纯高尿酸血症（HUA）患者 50 例作为高尿酸血症组（HUA 组），T2DM 合并 HUA 患者 50 例作为糖尿病高尿酸血症组（DM-HUA 组），同期选择我院体检健康者 50 例作为正常对照组（NC 组）。同时检测并记录四组患者的一般资料（姓名、体质量指数（BMI））、代谢相关指标（空腹血糖（FBG）、总胆固醇（TC）、三酰甘油（TG））及肾脏相关指标（血尿素氮（BUN）、肌酐（Cr）、白蛋白-肌酐比（ACR）），并对尿酸（UA）与上述指标的相关性进行统计学分析。
DM-HUA 组患者血清 TC、TG、低密度脂蛋白（LDL）及尿 ACE 较其他三组明显升高（p<0.05），高密度脂蛋白（HDL）较其余三组明显降低（p<0.05），且 BMI 和 Cr 较 NC 组和 DM 组升高（p<0.05）；DM 组和 HUA 组的代谢指标和肾功能无明显差异。与 NC 组相比，两组 TC、LDL、血清β2 微球蛋白和 BMI 明显升高（p<0.05），HUA 组 BUN 和 Cr 略高于 NC 组（p<0.05）。多元线性回归分析显示，UA 水平是影响 ACR 的主要因素（R2=0.636，p<0.001）。
UA 水平是 T2DM 患者早期肾病的独立危险因素，可促进 T2DM 患者肾病的进展和恶化。
