绝经后女性2型糖尿病患者血尿酸水平与体质指数、血脂及肾功能相关性的研究

目的 探讨绝经后女性2型糖尿病(T2DM)患者不同血尿酸(SUA)水平与体质指数(BMI)、血脂、肾功能的相关性.方法 选取绝经后女性T2DM患者327例,依据SUA水平分为高尿酸(HUA)组59例和正常尿酸(NUA)组268例.比较两组BMI、血脂、肾功能等临床相关指标及糖尿病慢性并发症和合并症.结果 在绝经后女性T2DM患者中,HUA患病率为18%.与NUA组相比,HUA组BMI、三酰甘油(TG)、 血肌酐(SCr)、以C肽代替胰岛素改良的稳态模型胰岛素抵抗指数HOMA-IR(CP)]、尿白蛋白/肌酐显著升高(P<0.05),估算的肾小球滤过率(eGFR)显著降低(P<0.05);糖尿病肾脏病(DKD)、脂肪肝(NAFLD)的发病率明显升高(P<0.05).Logistic回归分析显示,BMI(OR=1.199,P<0.001)、TG(OR=1.293,P=0.012)、SCr(OR=1.019,P=0.008)是绝经后女性T2DM患者HUA的独立危险因素.结论 绝经后女性T2DM患者HUA与体重增加、脂代谢紊乱、肾功能下降有关,且有较高的DKD及NAFLD发病率.

Study on the relationship between serum uricacid level and body mass index,blood lipids and renal functionin postmenopausal women with type 2 diabetes mellitus

Objective To study the relationship of hyperuricemia with BMI, blood lipids and renal function in postmenopausal women with type 2 diabetes mellitus(T2DM).Methods 327 postmenopausal T2DM women were divided into hyperuricemia(HUA) group(n=59) and normal serum uric acid(NUA) group(n=268) according to SUA levels.Their clinical data, diabetic complications and comorbidities were detected.Results The prevalence of hyperuricemia was 18% in postmenopausal T2DM women.Compared with NUA group, patients in HUA group showed higher BMI, TG,SCr, HOMA-IR(CP), urine albumin to creatinine ratio(P<0.05),and lower glomerular filtration rate(P<0.05) than those in NUA group.The incidence of diabetic kidney disease(DKD)and nonalcoholic fatty liver disease(NAFLD) were significantly higher in HUA group than in NUA group(P<0.05).Logistic regression analysis showed that BMI(OR=1.199,P<0.001),TG(OR=1.293,P=0.012), SCr(OR=1.019,P=0.008)were the independent risk factors for hyperuricemia.Conclusion HUA is related to increased BMI and TG, and decreased renal function in postmenopausal T2DM women.The incidence of DKD and NAFLD is high in postmenopausal women with HUA.