血清尿酸水平与糖尿病各代谢因子的相关性研究
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Association between serum uric acid concentration and the metabolic factors of diabetes
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    摘要:

    目的:分析血清尿酸水平与2型糖尿病发生的相关性。方法:选择1 416例符合条件的2008~2011年在南京医科大学第一附属医院内分泌科及老年科住院的患者,进行病史询问,测量身高-体重-血压并检测其血清尿酸水平-血糖-血脂-口服糖耐量试验等相关代谢指标,根据血清尿酸水平对所有受试者进行四分位分组,依次分为Ⅰ-Ⅱ-Ⅲ-Ⅳ组,分析不同尿酸水平与各代谢指标的相关性。结果:①随着血清尿酸浓度的升高,女性糖尿病患者的百分比逐渐下降,在Ⅰ-Ⅱ-Ⅲ组中,体质指数随着尿酸浓度升高而升高;②患者的空腹血糖及餐后血糖均随着尿酸浓度的升高而降低,血清尿酸浓度较高组的餐后2 h胰岛素-空腹C肽-餐后2 h C肽-甘油三酯-尿素氮-肌酐,明显高于血清尿酸浓度较低组;在Ⅰ-Ⅱ-Ⅲ组中高密度脂蛋白胆固醇随着尿酸浓度的升高而降低;③糖耐量正常组受试者的平均尿酸水平高于糖耐量异常组;④尿酸与糖化血红蛋白-空腹血糖-餐后血糖呈负相关(P < 0.001-= 0.001-< 0.001);尿酸与空腹胰岛素-餐后2 h胰岛素-空腹C肽-餐后2 h C肽呈正相关(P 均< 0.001);⑤随着尿酸水平升高,空腹血糖高于正常值的风险明显升高,尤其是血清尿酸> 372 -滋mol/L 组与血清尿酸< 258 -滋mol/L组比较, 差异有统计学意义(P < 0.001),也可以理解为发生糖尿病的风险明显升高。结论:血清尿酸水平与性别-年龄-糖尿病病程-高血压及冠心病发病率-体质指数-血脂异常-血糖及糖代谢相关指标密切相关。尿酸水平升高是发生糖尿病的危险因素之一。而糖尿病患者正常范围之内的高尿酸水平对糖代谢水平也是一种保护因素。

    Abstract:

    Objective:To examine the association of serum uric acid level and the incidence of type 2 diabetes. Methods:From 2008 to 2011,1 416 eligibles were collected from the inpatients of Department of Endocrinology and Gerontology in the First Affiliated Hospital of NJMU. The disease history was surveyed,the biochemical indexes were detected and the general physical data were measured. All of the patients were divided into four groups(Ⅰ,Ⅱ,Ⅲand Ⅳ group)according to the level of serum uric acid,and association between uric acid level and metabolic indexes in each group was evaluated. Results:① With the rise of uric acid concentration,the incidences of diabetes in women were gradually decreased. In the first three groups,BMI increased with the rise of uric acid concentration. ② The levels of FPG and PPG were reduced with the increasing of uric acid concentration. PINS,FC-P,PC-P,TG,BUN,and Cr in the higher uric acid group were significantly higher than the lower group. The level of HDL-C was inversely varied with uric acid concentration in the first three groups of quartiles. ③The average uric acid level of participants with normal glucose tolerance was higher than that in the patients with abnormal glucose tolerance. ④ The levels of uric acid were negatively related to HbA1c,FPG and PPG(P < 0.001,= 0.001,< 0.001)and positively related to FINS,PINS,FC-P and PC-P(P < 0.001). ⑤The risk of abnormal fasting blood glucose significantly raised with the elevation of uric acid level,especially in the group Ⅳ,which predicted the increased risk of diabetes (P < 0.001). Conclusion:The serum uric acid level is closely related to gender,age,duration of diabetes,incidence of hypertension and coronary heart disease,BMI,dyslipidemia and glucose. It can be used as a predictive index for diabetes. Elevated level of uric acid is one of the risk factors of diabetes. Within normal range,the increased uric acid level is also a protective factor to glucose metabolism of patients with diabetes. [Key words] serum uric acid;diabetes;relative factors

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张媛媛,张日华,杜新丽,薛 一,黄 琼,刘梦兰,刘 云.血清尿酸水平与糖尿病各代谢因子的相关性研究[J].南京医科大学学报(自然科学版),2013,(1):62-67

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  • 收稿日期:2012-05-13
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  • 在线发布日期: 2013-03-25
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