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高尿糖排泄率可降低肾功能正常的 2 型糖尿病患者的血清尿酸水平。

High urinary excretion rate of glucose attenuates serum uric acid level in type 2 diabetes with normal renal function.

机构信息

NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China.

Department of Endocrinology, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China.

出版信息

J Endocrinol Invest. 2021 Sep;44(9):1981-1988. doi: 10.1007/s40618-021-01513-8. Epub 2021 Jan 29.

Abstract

AIMS/INTRODUCTION: The relationship between urinary excretion rate of glucose (UEGL) and uric acid (UA) metabolism in adults with type 2 diabetes (T2D) remains unclear to date. This study aimed to investigate the relationships of UEGL with serum UA (SUA), urinary excretion rate of uric acid (UEUA), and renal clearance of uric acid (CLUA) in adults with T2D. We hypothesised that high UEGL increases UA excretion, which in turn leads to lower SUA.

MATERIALS AND METHODS

This was a cross-sectional study of 635 inpatients with T2D recruited between 2018 and 2019. The relationships of UEGL with UEUA, CLUA, and hyperuricaemia were assessed using analysis of covariance and multivariate regression analysis.

RESULTS

Patients in the higher quartile of UEGL tended to have lower SUA levels than those in the lower quartile. In contrast, patients in the higher quartile of UEGL tended to have higher CLUA (p for trend < 0.0001), and a similar trend was observed for UEUA. In adjusted multivariable linear regression model, UEGL was negatively correlated with SUA (β = - 0.023, 95% CI - 0.034 to - 0.013, p < 0.0001). However, positive correlations of UEGL with UEUA (β = 0.046, 95% CI 0.018-0.074, p = 0.001) and CLUA (β = 0.063, 95% CI 0.042-0.085, p < 0.0001) were found. Furthermore, consistent significant inverse associations were observed between quartiles of UEGL and hyperuricaemia in the adjusted multivariate logistic regression model.

CONCLUSIONS

A high UEGL level was positively correlated with UEUA and CLUA. Moreover, it was inversely associated with SUA level, and a consistently increased UEGL level reduced the risk of hyperuricaemia in patients with T2D.

摘要

目的/引言:2 型糖尿病(T2D)成人的尿葡萄糖排泄率(UEGL)与尿酸(UA)代谢之间的关系目前尚不清楚。本研究旨在探讨 T2D 成人 UEGL 与血清 UA(SUA)、尿尿酸排泄率(UEUA)和尿酸肾清除率(CLUA)的关系。我们假设高 UEGL 增加 UA 排泄,从而导致 SUA 降低。

材料和方法

这是一项 2018 年至 2019 年期间招募的 635 例 T2D 住院患者的横断面研究。使用协方差分析和多元回归分析评估 UEGL 与 UEUA、CLUA 和高尿酸血症的关系。

结果

UEGL 较高四分位的患者倾向于具有比低四分位更低的 SUA 水平。相反,UEGL 较高四分位的患者倾向于具有更高的 CLUA(p 趋势<0.0001),并且 UEUA 也存在类似的趋势。在调整后的多元线性回归模型中,UEGL 与 SUA 呈负相关(β=-0.023,95%CI-0.034 至-0.013,p<0.0001)。然而,UEGL 与 UEUA(β=0.046,95%CI0.018-0.074,p=0.001)和 CLUA(β=0.063,95%CI0.042-0.085,p<0.0001)呈正相关。此外,在调整后的多元逻辑回归模型中,UEGL 四分位与 T2D 患者高尿酸血症之间存在一致的显著负相关。

结论

高 UEGL 水平与 UEUA 和 CLUA 呈正相关。此外,它与 SUA 水平呈负相关,UEGL 水平的持续升高降低了 T2D 患者发生高尿酸血症的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93cd/8357730/d59fc93661e6/40618_2021_1513_Fig1_HTML.jpg

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