尿酸与Ⅱ型糖尿病并发冠心病的关系

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目的探讨尿酸(uric acid,UA)在Ⅱ型糖尿病(type 2diabetes mellitus,T2DM)并发冠心病(coronaryheart disease,CHD)发生发展过程中的作用及其相关性因素。方法入选正常对照组(A组)40例,T2DM组(B组)80例,T2DM合并CHD组(C组)82例,收集一般临床资料,用全自动生化分析仪测定空腹血UA水平。应用SPSS13.0软件进行统计分析。结果血UA水平在C组较A组及B组均显著升高(P<0.05),但在A组和B组之间无显著性差异(P>0.05)。各组进行pearson相关分析显示,UA在A组与脂蛋白(a)[lipoprotein(a),LP(a)]呈正相关,与高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDLC)呈负相关,相关系数r分别为0.442(P=0.004)、-0.366(P=0.020),UA在B组与腰臀比(waist to hip ratio,WHR)、超敏C反应蛋白(high-sensitivity C-reactive protein,HsCRP)呈正相关,相关系数r分别为0.227(P=0.043)、0.301(P=0.007),在C组与年龄、HsCRP呈正相关,相关系数r分别为0.279(P=0.011)、0.292(P=0.008)。Logistic逐步回归分析显示,年龄、WHR、LP(a)、UA是T2DM并发CHD的独立危险因素。而HDLC是T2DM并发CHD的保护因素。结论 T2DM并发CHD患者UA显著升高,它是T2DM并发CHD的独立危险因素。 Objective To investigate the role of uric acid (UA) in the development and progression of type 2 diabetes mellitus (T2DM) complicated with coronary heart disease (CHD) and its related factors. Methods Forty cases of normal control group (A group), 80 cases of T2DM group (B group) and 82 cases of T2DM combined with CHD group (C group) were enrolled in this study. General clinical data were collected. UA level in fasting blood was measured by automatic biochemical analyzer. Application SPSS13.0 software for statistical analysis. Results Blood UA levels in group C were significantly higher than those in group A and B (P <0.05), but there was no significant difference between group A and group B (P> 0.05). Pearson correlation analysis showed that UA was positively correlated with lipoprotein (a), LP (a) in group A and negatively correlated with high density lipoprotein cholesterol (HDLC) The correlation coefficients r were 0.442 (P = 0.004) and -0.366 (P = 0.020), respectively. There was no significant difference between the two groups in the ratio of WHR to high-sensitivity C-reactive protein (P = 0.043), 0.301 (P = 0.007). There was a positive correlation between HsCRP and age, the correlation coefficients r were 0.279 (P = 0.011), 0.292 (P = 0.008). Logistic stepwise regression analysis showed that age, WHR, LP (a), UA were independent risk factors for T2DM complicated by CHD. HDLC is a protective factor for T2DM complicated by CHD. Conclusion The UA in patients with T2DM complicated with CHD is significantly increased, which is an independent risk factor for T2DM complicated with CHD.
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