Shi Rong, Niu Zheyun, Wu Birong, Hu Fan
School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China.
Risk Manag Healthc Policy. 2020 Sep 21;13:1661-1675. doi: 10.2147/RMHP.S255042. eCollection 2020.
The study aimed to identify diseases that exhibit significant differences between hyperuricaemia (HUA) and non-hyperuricaemia (NHUA) groups and analyse the risk factors for HUA based on the related diseases in type 2 diabetes mellitus (T2DM).
A total of 3264 T2DM patients were investigated from 2013 to 2017 in the Jinyang and Sanlin communities by obtaining basic data from the electronic medical record system (EMRS). From September 2018 to July 2019, 3000 patients (264 patients were missing during follow-up) were investigated with questionnaires, physical examinations and biochemical index tests. After removing missing values, 2899 patients were divided into HUA and NHUA groups. The chi-square test was used to identify diseases with differences. Using Lasso analysis and logistic regression analysis, risk factors for HUA based on the related diseases were obtained. The C-index, receiver operating characteristic (ROC) curve and calibration plot were used to validate the discrimination and accuracy of the factors.
The chi-square test showed that there were significant differences in coronary heart disease (CHD) and diabetic nephropathy (DN) between the HUA group and the NHUA group. Through Lasso regression, glycosylated haemoglobin A1c (HbA1c), triglyceride (TG), blood urea nitrogen (BUN) and serum creatinine (SCR) were screened in the CHD group. Body mass index (BMI), HbA1c, total cholesterol (TC), TG, BUN, SCR and urine microalbumin (UMA) were screened in the DN group. The P-value of all the variables was less than 0.05. Through the C-index, calibration, and ROC curve analyses, these risk factors had medium accuracy.
HUA was significantly related to CHD and DN. The level of UA was correlated with HbA1c, TG, BUN, and SCR based on CHD. The level of UA was associated with BMI, HbA1c, TC, TG, BUN, SCR, and UMA based on DN.
本研究旨在确定在高尿酸血症(HUA)组和非高尿酸血症(NHUA)组之间表现出显著差异的疾病,并基于2型糖尿病(T2DM)中的相关疾病分析HUA的危险因素。
2013年至2017年期间,通过电子病历系统(EMRS)获取基础数据,对晋阳和三林社区的3264例T2DM患者进行了调查。2018年9月至2019年7月,对3000例患者(随访期间有264例患者失访)进行了问卷调查、体格检查和生化指标检测。去除缺失值后,将2899例患者分为HUA组和NHUA组。采用卡方检验确定有差异的疾病。使用Lasso分析和逻辑回归分析,基于相关疾病获得HUA的危险因素。使用C指数、受试者工作特征(ROC)曲线和校准图来验证这些因素的鉴别能力和准确性。
卡方检验显示,HUA组和NHUA组在冠心病(CHD)和糖尿病肾病(DN)方面存在显著差异。通过Lasso回归,在CHD组中筛选出血红蛋白A1c(HbA1c)、甘油三酯(TG)、血尿素氮(BUN)和血清肌酐(SCR)。在DN组中筛选出体重指数(BMI)、HbA1c、总胆固醇(TC)、TG、BUN、SCR和尿微量白蛋白(UMA)。所有变量的P值均小于0.05。通过C指数、校准和ROC曲线分析,这些危险因素具有中等准确性。
HUA与CHD和DN显著相关。基于CHD,尿酸水平与HbA1c、TG、BUN和SCR相关。基于DN,尿酸水平与BMI、HbA1c、TC、TG、BUN、SCR和UMA相关。