中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2012年
8期
541-545
,共5页
凌雁%李晓牧%顾迁%高鑫
凌雁%李曉牧%顧遷%高鑫
릉안%리효목%고천%고흠
糖尿病,2型%血尿酸%β细胞功能
糖尿病,2型%血尿痠%β細胞功能
당뇨병,2형%혈뇨산%β세포공능
Diabetes,type 2%Serum uric acid%Beta cell function
目的 研究女性2型糖尿病患者血尿酸水平与胰岛β细胞功能的相关性.方法 2007年1月至2008年12月在上海中山医院内分泌科住院533例女性2型糖尿病患者为研究对象,测定人体参数、相关生化指标及精氨酸刺激的胰岛β细胞一相胰岛素分泌功能(AIR)和一相C肽分泌功能(ACPR).其中262例患者行75 g口服葡萄糖耐量试验并计算胰岛素曲线下面积(AUC)和C肽AUC.以血尿酸＞360 μmol/L为高尿酸血症.结果 高尿酸组(86例)与正常尿酸组(447例)的血尿酸水平分别为(430±8)和(248 ±3) μmol/L.高尿酸组的AIR、ACPR、AUC及C肽AUC均高于正常尿酸组(均P＜0.01).单因素相关分析发现血尿酸水平分别与AIR(r=0.194,P＜0.01)、ACPR(r=0.146,P＜0.01)、胰岛素AUC(r=0.307,P＜0.01)及C肽AUC(r=0.420,P＜0.01)呈正相关.按AIR三分位分组的血尿酸水平分别为(260±7)、(264±8)、(302±7)μmoL/L；按ACPR三分位分组的血尿酸水平分别为(263±8)、(271±7)、(296±7) μmol/L;按胰岛素AUC 三分位分组的血尿酸水平分别为(241±10)、(279±10)、(301±8)μmol/L；按C肽AUCe三分位分组的血尿酸水平分别为(229±8)、(265±9)、(326±10) μmol/L,差异均有统计学意义(均P＜0.01).多元线性回归分析显示在校正了多个相关危险因素后,血尿酸水平分别与AIR(β=0.002,95％ CI:0.0010 -0.0030,P＜0.01)、ACPR(ββ =0.001,95％ CI:0.0002—0.0020,P=0.02)、胰岛素AUC( β=0.002,95％ CI:0.0004～0.0030,P＜0.01)及C肽AUC(β=0.003,95％ CI:0.0020～0.0030,P＜0.01)独立相关.结论 血尿酸水平可能是预测女性2型糖尿病患者胰岛β细胞功能的独立危险因素.
目的 研究女性2型糖尿病患者血尿痠水平與胰島β細胞功能的相關性.方法 2007年1月至2008年12月在上海中山醫院內分泌科住院533例女性2型糖尿病患者為研究對象,測定人體參數、相關生化指標及精氨痠刺激的胰島β細胞一相胰島素分泌功能(AIR)和一相C肽分泌功能(ACPR).其中262例患者行75 g口服葡萄糖耐量試驗併計算胰島素麯線下麵積(AUC)和C肽AUC.以血尿痠＞360 μmol/L為高尿痠血癥.結果 高尿痠組(86例)與正常尿痠組(447例)的血尿痠水平分彆為(430±8)和(248 ±3) μmol/L.高尿痠組的AIR、ACPR、AUC及C肽AUC均高于正常尿痠組(均P＜0.01).單因素相關分析髮現血尿痠水平分彆與AIR(r=0.194,P＜0.01)、ACPR(r=0.146,P＜0.01)、胰島素AUC(r=0.307,P＜0.01)及C肽AUC(r=0.420,P＜0.01)呈正相關.按AIR三分位分組的血尿痠水平分彆為(260±7)、(264±8)、(302±7)μmoL/L；按ACPR三分位分組的血尿痠水平分彆為(263±8)、(271±7)、(296±7) μmol/L;按胰島素AUC 三分位分組的血尿痠水平分彆為(241±10)、(279±10)、(301±8)μmol/L；按C肽AUCe三分位分組的血尿痠水平分彆為(229±8)、(265±9)、(326±10) μmol/L,差異均有統計學意義(均P＜0.01).多元線性迴歸分析顯示在校正瞭多箇相關危險因素後,血尿痠水平分彆與AIR(β=0.002,95％ CI:0.0010 -0.0030,P＜0.01)、ACPR(ββ =0.001,95％ CI:0.0002—0.0020,P=0.02)、胰島素AUC( β=0.002,95％ CI:0.0004～0.0030,P＜0.01)及C肽AUC(β=0.003,95％ CI:0.0020～0.0030,P＜0.01)獨立相關.結論 血尿痠水平可能是預測女性2型糖尿病患者胰島β細胞功能的獨立危險因素.
목적 연구녀성2형당뇨병환자혈뇨산수평여이도β세포공능적상관성.방법 2007년1월지2008년12월재상해중산의원내분비과주원533례녀성2형당뇨병환자위연구대상,측정인체삼수、상관생화지표급정안산자격적이도β세포일상이도소분비공능(AIR)화일상C태분비공능(ACPR).기중262례환자행75 g구복포도당내량시험병계산이도소곡선하면적(AUC)화C태AUC.이혈뇨산＞360 μmol/L위고뇨산혈증.결과 고뇨산조(86례)여정상뇨산조(447례)적혈뇨산수평분별위(430±8)화(248 ±3) μmol/L.고뇨산조적AIR、ACPR、AUC급C태AUC균고우정상뇨산조(균P＜0.01).단인소상관분석발현혈뇨산수평분별여AIR(r=0.194,P＜0.01)、ACPR(r=0.146,P＜0.01)、이도소AUC(r=0.307,P＜0.01)급C태AUC(r=0.420,P＜0.01)정정상관.안AIR삼분위분조적혈뇨산수평분별위(260±7)、(264±8)、(302±7)μmoL/L；안ACPR삼분위분조적혈뇨산수평분별위(263±8)、(271±7)、(296±7) μmol/L;안이도소AUC 삼분위분조적혈뇨산수평분별위(241±10)、(279±10)、(301±8)μmol/L；안C태AUCe삼분위분조적혈뇨산수평분별위(229±8)、(265±9)、(326±10) μmol/L,차이균유통계학의의(균P＜0.01).다원선성회귀분석현시재교정료다개상관위험인소후,혈뇨산수평분별여AIR(β=0.002,95％ CI:0.0010 -0.0030,P＜0.01)、ACPR(ββ =0.001,95％ CI:0.0002—0.0020,P=0.02)、이도소AUC( β=0.002,95％ CI:0.0004～0.0030,P＜0.01)급C태AUC(β=0.003,95％ CI:0.0020～0.0030,P＜0.01)독립상관.결론 혈뇨산수평가능시예측녀성2형당뇨병환자이도β세포공능적독립위험인소.
Objective To examine the correlation of serum uric acid and islet beta cell functions in female type 2 diabetics.Methods A total of 533 female type 2 diabetics were recruited. And their clinicobiochemical parameters were measured.The levels of acute insulin response (AIR) and acute Cpoptide response (ACPR) were measured by a stimulation of arginine.Among them,262 patients received the examinations of OGTT (oral glucose tolerance test),area under the curve of insulin (AUC-insulin) and C peptide (AUC-C peptide).Serum uric acid ＞ 360 μmol/L was defined as hyperuricemia.Results The serum uric acid levels of the hyperuricemia and control groups were (430 + 8) and ( 248 + 3 ) μmol/Lrespectively.The AIR,ACPR,AUC-insulin and AUC-C peptide levels were significantly higher in the hyperuricemia group than those in the control group (P ＜ 0.01 ).There was a significant positive correlation between serum uric acid and AIR,ACPR,AUC-insulin and AUC-C peptide (r =0.194,P ＜ 0.01; r =0.146,P ＜ 0.01 ; r =0.307,P ＜ 0.01 and r =0.420,P ＜ 0.01 ).The serum levels of uric acid were significantly different between tertile groups of AIR (260 +_ 7 ),(264 + 8 ),( 302 + 7 ) μmol/L,ACPR ((263_+8),( 271 +7),(296+7) μmo]/L),AUC-insulin ((241 +10),(279 +10),(301 +8) μmol/L)and AUC-C peptide ( ( 229 + 8 ),( 265 ± 9 ),( 326 ± 10 ) μmol/L,P ＜ 0.01 ).Multivariate linear regression demonstrated that the serum level of uric acid were associated with AIR (β =0.002,95％ CI0.0010 - 0.0030,P ＜ 0.01 ),ACPR ( α =0.001,95％ CI 0.0002 - 0.0020,P =0.02 ),AUC-insulin ( β =0.002,95 ％ CI 0.0004 - 0.0030,P ＜ 0.01 ) and AUC-C peptide ( α =0.003,95 ％ CI 0.0020 -0.0030,P ＜ 0.01 ) after an adjustment of related risk factors.Conclusion The serum level of uric acid is significantly correlated with AIR,ACPR,AUC-insulin and AUC-C peptide in female type 2 diabetics.And it may be an independent risk factor of predicting islet beta cell functions in female type 2 diabetics.
