[1]高忠爱 韩菲 袁欣欣 孙梦迪 李晓晨 刘然 姜文慧 张立弋 常宝成 杨菊红.2型糖尿病合并不同类型高尿酸血症的 临床特征及危险因素分析[J].国际内分泌代谢杂志,2018,38(02):73-77.[doi:10.3760/cma.j.issn.1673-4157.2018.02.001]
　Gao Zhongai,Han Fei,Yuan Xinxin,et al.Analysis of clinical characteristics and risk factors of different types of hyperuricemia in patients with type 2 diabetes[J].International Journal of Endocrinology and Metabolism,2018,38(02):73-77.[doi:10.3760/cma.j.issn.1673-4157.2018.02.001]
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2型糖尿病合并不同类型高尿酸血症的 临床特征及危险因素分析()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
38
期数:
2018年02期
页码:
73-77
栏目:
论著
出版日期:
2018-03-20

文章信息/Info

Title:
Analysis of clinical characteristics and risk factors of different types of hyperuricemia in patients with type 2 diabetes
作者:
高忠爱 韩菲 袁欣欣 孙梦迪 李晓晨 刘然 姜文慧 张立弋 常宝成 杨菊红
300070 天津医科大学代谢病医院内分泌研究所,卫生部激素与发育重点实验室,天津市代谢性疾病重点实验室
Author(s):
Gao Zhongai;  Han Fei;  Yuan Xinxin;  Sun Mengdi;  Li Xiaochen;  Liu Ran;  Jiang Wenhui;  Zhang Liyi;  Chang Baocheng;  Yang Juhong.
Key Laboratory of Hormones and Development(Ministry of Health), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300070, China
关键词:
2型糖尿病;  高尿酸血症;  生成增多型高尿酸血症;  排泄减少型高尿酸血症;  混合型高尿酸血症
Keywords:
Type 2 diabetes mellitus;  Hyperuricemia;  Synthesis-increased hyperuricemia;  Excretion-reduced hyperuricemia;  Mixed type of hyperuricemia
DOI:
10.3760/cma.j.issn.1673-4157.2018.02.001
摘要:
目的 研究2型糖尿病患者中不同类型高尿酸血症的比例及其各自的危险因素。方法 采用分层随机抽样法收集2016年1月至12月在天津医科大学代谢病医院住院的435例肾功能正常的2型糖尿病患者,根据血尿酸、尿酸排泄分数和尿酸排泄率,将其分为血尿酸正常组、生成增多型组、混合型组和排泄减少型高尿酸血症组,统计各组所占的比例,运用单因素方差分析法比较各组一般资料和生化指标,并运用多因素二元logistic回归分析法统计各组的独立危险因素。结果 高尿酸血症的检出率为20.68%(90/435)。其中生成增多型高尿酸血症占28%(25/435)、混合型高尿酸血症占23%(21/435)、排泄减少型高尿酸血症占49%(44/435)。与血尿酸正常组相比,生成增多型高尿酸血症组24 h尿尿酸和尿酸排泄率升高(F=16.496、40.042,P均<0.05),其独立危险因素是估算的肾小球滤过率(OR=0.939, 95%CI:0.891～0.990, P<0.05)、总胆红素(OR=0.755, 95%CI: 0.594～0.960, P<0.05)和甘油三酯(OR=1.215, 95%CI: 1.001～1.473, P<0.05); 混合型高尿酸血症组24 h尿尿酸和尿酸排泄率升高(F=16.496、40.042,P均<0.05),尿酸排泄分数下降(F=22.692,P<0.05),其独立危险因素是甘油三酯(OR=1.230, 95%CI: 1.083～1.396, P<0.01); 排泄减少型高尿酸血症组24 h尿尿酸、尿酸排泄分数和尿酸排泄率都明显下降(F=16.496、22.692、40.042,P均<0.05),其独立危险因素是体重指数(OR=1.163,95%CI:1.086～1.247,P<0.001)。 结论 在2型糖尿病合并高尿酸血症患者中,生成增多型和混合型高尿酸血症患者比例占50%左右,不同类型的高尿酸血症的特征和危险因素不同,因此应给予不同的治疗方法。
Abstract:
Objective To investigate the proportion of different types of hyperuricemia(HUA)and their respective risk factors in patients with type 2 diabetes mellitus.Methods A total of 435 inpatients with normal renal function were enrolled in the Metabolic Disease Hospital of Tianjin Medical University from January to December 2016 by stratified random sampling method. According to serum uric acid, fraction of uric acid excretion(FEUA)and uric acid excretion rate(UEUA), the patients were divided into four groups: normal serum uric acid group, synthesis-increased HUA group, mixed type of HUA group and excretion-decreased HUA group. One-factor analysis of variance(ANOVA)test was used to analyze the general information and biochemical indicators of each group. The independent risk factors of each group were analyzed by multivariate binary logistic regression.Results The overall detection rate of HUA in type 2 diabetes was 20.68%(90/435). The proportions of synthesis-increased HUA was 28%(25/435), mixed type of HUA was 23%(21/435), excretion-decreased HUA was 49%(44/435). The 24 hour urinary uric acid and UEUA in synthesis-increased HUA group were higher than those in normal uric acid group(F=16.496, 40.042, all P<0.05), and the independent risk factors of synthesis-increased HUA group were estimated glomerular filtration rate(OR=0.939, 95%CI: 0.891-0.990, P<0.05), total bilirubin(OR=0.755, 95%CI: 0.594-0.960, P<0.05), and triglyceride(OR=1.215, 95%CI: 1.001-1.473, P<0.05). The 24 h urinary uric acid and UEUA in mixed type of HUA group were higher than those in normal uric acid group(F=16.496, 40.042, all P<0.05), FUEA was lower than that in normal uric acid group(F=22.692, P<0.05), and its independent risk factor was triglyceride(OR=1.230, 95%CI: 1.083-1.396, P<0.01). The 24 hour urinary uric acid, FEUA and UEUA in excretion-decreased HUA group were lower than those in normal uric acid group(F=16.496, 22.692, 40.042,all P<0.05), and its independent risk factor was body mass index(OR=1.163, 95%CI: 1.086-1.247, P<0.001).Conclusions In patients with type 2 diabetes and HUA, about 50% patients are synthesis-increased HUA or mixed type of HUA. Different types of HUA have different characteristics and risk factors, therefore should be treated with different methods.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金(81373864,81603461,81473472); 天津市自然科学基金(17JCZDJC34700)
通信作者: 杨菊红,Email: megii0315@126.com
更新日期/Last Update: 1900-01-01