[1]安秀敏 蔡婷婷 缪珩.2型糖尿病患者血尿酸与血栓弹力图的 相关性分析[J].国际内分泌代谢杂志,2018,38(04):217-221.[doi:10.3760/cma.j.issn.1673-4157.2018.04.001]
　An Xiumin,Cai Tingting,Miao Heng..Correlation between serum uric acid and thrombelastogram in patients with type 2 diabetes[J].International Journal of Endocrinology and Metabolism,2018,38(04):217-221.[doi:10.3760/cma.j.issn.1673-4157.2018.04.001]
点击复制

2型糖尿病患者血尿酸与血栓弹力图的 相关性分析()
分享到：

《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
38
期数:
2018年04期
页码:
217-221
栏目:
论著
出版日期:
2018-07-20

文章信息/Info

Title:
Correlation between serum uric acid and thrombelastogram in patients with type 2 diabetes
作者:
安秀敏 蔡婷婷 缪珩
210000 南京医科大学第二附属医院内分泌科
Author(s):
An Xiumin;  Cai Tingting;  Miao Heng.
Department of Endocrinology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
关键词:
2型糖尿病;  高尿酸血症;  血栓弹力图;  高凝状态
Keywords:
Type 2 diabetes mellitus;  Hyperuricemia;  Thrombelastogram;  Hypercoagulability
DOI:
10.3760/cma.j.issn.1673-4157.2018.04.001
摘要:
目的 通过血栓弹力图检测2型糖尿病患者在不同血尿酸水平下的凝血功能状态。方法 选取2016年2月至2017年12月南京医科大学第二附属医院内分泌科住院的2型糖尿病患者208例,根据血尿酸水平,分为血尿酸正常组(108例)和高尿酸血症组(HUA组,100例); 另选健康体检者102名为正常对照组(NC组),均予以血栓弹力图、血脂、肾功能、常规凝血功能等检测。血尿酸与血栓弹力图参数的相关性采用Pearson偏相关分析。结果 与正常对照组相比,血尿酸正常组及HUA组均呈现高凝趋势,表现为反应时间(R)、凝固时间(K)明显降低(F=29.30、12.63,P均<0.001),凝固角(angle)、最大振幅(MA)、纤维蛋白原升高(F=12.52、13.63、13.23,P均<0.001); 与血尿酸正常组相比,HUA组的K较低,angle、MA、纤维蛋白原较高(P均<0.05)。进一步对HUA组分别以性别及尿酸中位数分为4组,结果显示,与A1组(男<440.5 μmol/L)相比,A2组(男≥440.5 μmol/L)R、K降低,angle、MA升高(t=3.46、2.29、-2.52、-2.34,P均<0.05); 与B1组(女<452.5 μmol/L)相比,B2组(女≥452.5 μmol/L)K降低,angle、MA升高(t=2.56、-2.32、-2.07,P均<0.05)。各组间血小板计数差异无统计学意义。Pearson偏相关分析显示,在控制了年龄、性别、肌酐、总胆固醇、甘油三酯、高密度脂蛋白-胆固醇、低密度脂蛋白-胆固醇、高血压、冠心病、脑梗死等因素后,血尿酸与R、K呈负相关(r=-0.199、-0.284,P均<0.05),与angle、MA呈正相关(r=0.269、0.347,P均<0.01)。结论 2型糖尿病患者存在高凝状态,血尿酸可能与2型糖尿病患者高凝状态相关。
Abstract:
Objective To detect the coagulation status of type 2 diabetic patients with different levels of serum uric acid by thrombelastogram.Methods A total of 208 inpatients with type 2 diabetes, from the Department of Endocrinology of the Second Affiliated Hospital of Nanjing Medical University from February 2016 to December 2017, were divided into normal serum uric acid group(n=108)and hyperuricemia group(HUA group, n=100)according to their serum uric acid level. Another 102 healthy subjects were selected as normal control group(NC group).The thrombelastogram as well as serum lipid, renal function and conventional coagulation etc were tested. The correlation of serum uric acid and thrombelastogram parameters was analyzed by Pearson partial correlation analysis.Results Compared with NC group, both normal serum uric acid group and HUA group showed a hypercoagulable tendency, including a decrease in reaction time(R), coagulation time(K)(F=29.30, 12.63, all P<0.001), and an increase in angle, maximum amplitude(MA), and fibrinogen(F=12.52, 13.63, 13.23, all P<0.001). Compared with normal uric acid group, K in HUA group was lower, whereas angle, MA and fibrinogen were higher(all P<0.05). HUA group was further divided into four groups according to gender and uric acid level. The results showed that compared with A1 group(male<440.5 μmol/L), R and K were decreased, and angle and MA were increased in A2 group(male≥440.5 μmol/L, t=3.46, 2.29, -2.52, -2.34, all P<0.05). Compared with B1 group(female<452.5 μmol/L), K was decreased, angle and MA were increased in B2 group(female≥452.5 μmol/L, t=2.56, -2.32, -2.07, all P<0.05). There were no statistically significant differences in platelet counts in all groups. Pearson partial correlation analysis revealed that serum uric acid was negatively correlated with R and K(r=-0.199, -0.284, all P<0.05), and positively correlated with angle and MA(r=0.269, 0.347, all P<0.01)after controlling age, gender, creatinine, total cholesterol, triglycerides, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, hypertension, coronary heart disease and cerebral infarction.Conclusion Patients with type 2 diabetes have hypercoagulable state, and serum uric acid may be associated with hypercoagulability in type 2 diabetic patients.

参考文献/References:


[1] 高尿酸血症相关疾病诊疗多学科共识专家组. 中国高尿酸血症相关疾病诊疗多学科专家共识[J]. 中华内科杂志, 2017, 3(56): 235-248.DOI:10.3760/cma.j.issn.0578-1426.2017.03.021.
[2] Hess K.The vulnerable blood.Coagulation and clot structure in diabetes mellitus[J].Hamostaseologie,2015,35(1):25-33.DOI:10.5482/HAMO-14-09-0039.
[3] Lv Q,Meng XF,He FF,et al.High serum uric acid and increased risk of type 2 diabetes: a systemic review and meta-analysis of prospective cohort studies[J].PLoS One,2013,8(2):e56864.DOI:10.1371/journal.pone.0056864.
[4] Sluijs I,Holmes MV,van der Schouw YT,et al.A mendelian randomization study of circulating uric acid and type 2 diabetes[J].Diabetes,2015,64(8):3028-3036.DOI:10.2337/db14-0742.
[5] Chien KL,Chen MF,Hsu HC,et al.Plasma uric acid and the risk of type 2 diabetes in a Chinese community[J].Clin Chem,2008,54(2):310-316.DOI:10.1373/clinchem.2007.095190.
[6] Fu S,Luo L,Ye P,et al. Epidemiological associations between hyperuricemia and cardiometabolic risk factors: a comprehensive study from Chinese community[J].BMC Cardiovasc Disord,2015,15:129.DOI:10.1186/s12872-015-0116-z.
[7] Ruggiero C,Cherubini A,Ble A,et al.Uric acid and inflammatory markers[J].Eur Heart J,2006,27(10):1174-1181. DOI:10.1093/eurheartj/ehi879.
[8] Spiga R,Marini MA,Mancuso E,et al.Uric acid is associated with inflammatory biomarkers and induces inflammation via activating the NF-κB signaling pathway in hepG2 cells[J].Arterioscler Thromb Vasc Biol,2017,37(6):1241-1249.DOI:10.1161/ATVBAHA.117.309128.
[9] Ogˇuz N,K rça M, Çetin A,et al. Effect of uric acid on inflammatory COX-2 and ROS pathways in vascular smooth muscle cells[J].J Recept Signal Transduct Res,2017,37(5):500-505.DOI:10.1080/10799893.2017.1360350.
[10] Zapolski T,Waciński P,Kondracki B,et al.Uric acid as a link between renal dysfunction and both pro-inflammatory and prothrombotic state in patients with metabolic syndrome and coronary artery disease[J]. Kardiol Pol,2011,69(4):319-326.
[11] 丁丹丹,王伟,崔中光,等.原发性高尿酸血症患者血小板α-颗粒膜蛋白、血小板活化因子及血小板参数的变化[J].中国实验血液学杂志,2012,20(2):394-397.
[12] Yildiz BS,Ozkan E,Esin F,et al.Does high serum uric acid level cause aspirin resistance [J].Blood Coagul Fibrinolysis,2016,27(4):412-418.DOI:10.1097/MBC.0000000000000466.
[13] Perlstein TS,Gumieniak O,Hopkins PN,et al.Uric acid and the state of the intrarenal renin-angiotensin system in humans[J].Kidney Int,2004,66(4):1465-1470.DOI:10.1111/j.1523-1755.2004.00909.x.
[14] Rao GN,Corson MA,Berk BC.Uric acid stimulates vascular smooth muscle cell proliferation by increasing platelet-derived growth factor A-chain expression[J].J Biol Chem,1991,266(13):8604-8608.
[15] Zhen H,Gui F.The role of hyperuricemia on vascular endothelium dysfunction[J].Biomed Rep,2017,7(4):325-330. DOI:10.3892/br.2017.966.

相似文献/References:

[1]曾静波,王姮.2型糖尿病与自身免疫反应[J].国际内分泌代谢杂志,2007,(04):259.
[2]朱素君,谢锦桃,刘军,等.二甲双胍：2型糖尿病治疗的基础药[J].国际内分泌代谢杂志,2007,(04):280.
[3]刘艳清 易秋艳 邵加庆.肠道菌群与肥胖和糖尿病的关系[J].国际内分泌代谢杂志,2015,(01):31.[doi:DOI：10.3760/cma.j.issn.1673-4157.2015.01.007]
　Liu Yanqing,Yi Qiuyan,Shao Jiaqing..Relationship between gut microbiota, obesity and diabetes[J].International Journal of Endocrinology and Metabolism,2015,(04):31.[doi:DOI：10.3760/cma.j.issn.1673-4157.2015.01.007]
[4]姚旻 赵爱源 张宏.肠道菌群与2型糖尿病[J].国际内分泌代谢杂志,2015,(01):35.[doi:DOI：10.3760/cma.j.issn.1673-4157.2015.01.008]
　Yao Min*,Zhao Aiyuan,Zhang Hong..Relationship between gut microbiota and type 2 diabetes[J].International Journal of Endocrinology and Metabolism,2015,(04):35.[doi:DOI：10.3760/cma.j.issn.1673-4157.2015.01.008]
[5]赵丽娟,徐宽枫,杨涛,等.SLC30A8和PTPRD基因多态性与南京地区中老年人群2型糖尿病的相关性研究[J].国际内分泌代谢杂志,2015,(03):145.[doi:10.3760/cma.j.issn.1673-4157.2015.03.001]
　Zhao Lijuan*,Xu Kuanfeng,Yang Tao,et al.Relationship between SLC30A8 and PTPRD gene polymorphisms and type 2 diabetes in middle aged and elderly people in Nanjing area[J].International Journal of Endocrinology and Metabolism,2015,(04):145.[doi:10.3760/cma.j.issn.1673-4157.2015.03.001]
[6]王洁,何媛,于珮.糖尿病肾病的相关危险因素分析[J].国际内分泌代谢杂志,2015,(03):153.[doi:10.3760/cma.j.issn.1673-4157.2015.03.003]
　Wang Jie*,He Yuan,Yu Pei..Risk factors of diabetic nephropathy[J].International Journal of Endocrinology and Metabolism,2015,(04):153.[doi:10.3760/cma.j.issn.1673-4157.2015.03.003]
[7]刘帅,张萍,方毅,等.2型糖尿病合并无症状冠状动脉钙化的相关危险因素分析[J].国际内分泌代谢杂志,2015,(03):158.[doi:10.3760/cma.j.issn.1673-4157.2015.03.004]
　Liu Shuai*,Zhang Ping,Fang Yi,et al.Analysis of the risk factors related with asymptomatic coronary calcification for type 2 diabetic patients[J].International Journal of Endocrinology and Metabolism,2015,(04):158.[doi:10.3760/cma.j.issn.1673-4157.2015.03.004]
[8]徐庆海,马颖,李铁马.2型糖尿病患者高甘油三酯血症-腰围表型与甲状腺功能异常的关系[J].国际内分泌代谢杂志,2015,(04):222.[doi:10.3760/cma.j.issn.1673-4157.2015.04.002]
　Xu Qinghai,Ma Ying,Li Tiema..Association of hypertriglyceridaemic-waist phenotype with thyroid dysfunction in patients with type 2 diabetes mellitus[J].International Journal of Endocrinology and Metabolism,2015,(04):222.[doi:10.3760/cma.j.issn.1673-4157.2015.04.002]
[9]潘道延,沈洁,朱筱,等.利格列汀对2型糖尿病大鼠代谢性内毒素血症的影响[J].国际内分泌代谢杂志,2015,(04):230.[doi:10.3760/cma.j.issn.1673-4157.2015.04.004]
　Pan Daoyan,Shen Jie,Zhu Xiao,et al.Effects of linagliptin on metabolic endotoxemia in type 2 diabetic rats[J].International Journal of Endocrinology and Metabolism,2015,(04):230.[doi:10.3760/cma.j.issn.1673-4157.2015.04.004]
[10]黄桥,白洁,杜洪泉.一种新的脂肪细胞因子——cartonectin[J].国际内分泌代谢杂志,2015,(04):265.[doi:10.3760/cma.j.issn.1673-4157.2015.04.014]
　Huang Qiao*,Bai Jie,Du Hongquan..A novel adipokine--cartonectin[J].International Journal of Endocrinology and Metabolism,2015,(04):265.[doi:10.3760/cma.j.issn.1673-4157.2015.04.014]
[11]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.[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(04):73.[doi:10.3760/cma.j.issn.1673-4157.2018.02.001]

备注/Memo

备注/Memo:

通信作者:缪珩,Email:miaoheng@medmail.com.cn
更新日期/Last Update: 2018-04-30