CAJ | 학술논문

目的：比较不同糖代谢状态人群血清尿酸水平的差异，探讨尿酸与胰岛素抵抗的关系，并对尿酸影响因素进行筛查。方法：依据OGTT的结果和既往病史将研究对象分为正常糖代谢组（NGT）99例、糖耐量异常组（IGT）76例和糖尿病组（T2DM）72例。通过检测血清尿酸、血糖及胰岛素、血清醛固酮（SAC）、血浆肾素活性（PRA）、血电解质，比较不同糖代谢状态患者尿酸水平的差异，分析尿酸与空腹胰岛素、糖负荷后胰岛素及HOMA-IR的相关性。通过多重线性回归分析，筛选高尿酸的影响因素。结果：NGT、IGT和T2DM患者的尿酸水平逐渐升高，其中，NGT与T2DM两组比较差异有统计学意义（P＜0．05）。尿酸与空腹胰岛素、糖负荷后2 h 胰岛素及 Log-HOMA-IR 均呈正相关，相关系数分别为0．28（P＜0．01），0．222（P＜0．01）和0．242（P＜0．01）。通过多重线性回归分析结果显示PRA、BMI、肌酐和血钠均是高尿酸的危险因素，β值分别为0．167（P＜0．05），0．314（P＜0．01），0．175（P＜0．01）和0．161（P＜0．05）。结论：2型糖尿病患者尿酸水平升高，尿酸与胰岛素抵抗存在显著相关性；尿酸升高的危险因素包括PRA、BMI、肌酐和血钠。
목적：비교불동당대사상태인군혈청뇨산수평적차이，탐토뇨산여이도소저항적관계，병대뇨산영향인소진행사사。방법：의거OGTT적결과화기왕병사장연구대상분위정상당대사조（NGT）99례、당내량이상조（IGT）76례화당뇨병조（T2DM）72례。통과검측혈청뇨산、혈당급이도소、혈청철고동（SAC）、혈장신소활성（PRA）、혈전해질，비교불동당대사상태환자뇨산수평적차이，분석뇨산여공복이도소、당부하후이도소급HOMA-IR적상관성。통과다중선성회귀분석，사선고뇨산적영향인소。결과：NGT、IGT화T2DM환자적뇨산수평축점승고，기중，NGT여T2DM량조비교차이유통계학의의（P＜0．05）。뇨산여공복이도소、당부하후2 h 이도소급 Log-HOMA-IR 균정정상관，상관계수분별위0．28（P＜0．01），0．222（P＜0．01）화0．242（P＜0．01）。통과다중선성회귀분석결과현시PRA、BMI、기항화혈납균시고뇨산적위험인소，β치분별위0．167（P＜0．05），0．314（P＜0．01），0．175（P＜0．01）화0．161（P＜0．05）。결론：2형당뇨병환자뇨산수평승고，뇨산여이도소저항존재현저상관성；뇨산승고적위험인소포괄PRA、BMI、기항화혈납。
Objective To compare the levels of serum uric acid in three groups of patients with different glucose tolerance status, and to investigate the relationships between serum uric acid and insulin resistance and to screen the risk factors for high serum uric acid in patients. Methods 99 patients with normal glucose tolerance (NGT group), 76 patients with impaired of glucose tolerance (IGT group) and 72 patients with T2DM (T2DM group) were enrolled in this study. Levels of serum aldosterone, serum uric acid concentration and plasma renin activity (PRA) were determined in all patients. Fasting plasma glucose concentration and plasma glucose concentration after glucose load, fasting serum insulin concentration and serum insulin concentration after glucose load were determined in 132 participants. The levels of serum uric acid concentration were compared among the three groups of patients. Correlation coefficients between serum uric acid concentration and serum insulin concentration as well as HOMA-IR were studied according to the Pearson analysis. The affecting factors for high serum uric acid concentration were screened by multiple liner regression analysis. Results The levels of serum uric acid concentration were higher in the T2DM group than those in the NGT group, with no statistical difference with those in the IGT group. Serum uric acid concentration was positively correlated with serum insulin level, including fasting and after glucose lord, and Log-HOMA-IR, with the correlation coefficient index 0.28 (P < 0.01), 0.222 (P < 0.01) and 0.242 (P < 0.01), respectively. The affecting factors for high serum uric acid concentration were PRA, BMI, creatinine and serum sodium concentration with the β value 0.167 (P < 0.05), 0.314 (P < 0.01), 0.175 (P<0.01) and 0.161 (P<0.05), respectively. Conclusions The level of serum uric acid increased in the patients with type 2 diabetes is positively correlated with insulin resistance. The risk factors for high serum uric acid are PRA, BMI, serum creatinine concentration and serum sodium concentration.