CAJ | 학술논문

目的探讨血糖稳定的2型糖尿病患者血尿酸水平与糖尿病肾病发生及进展的关系.方法选择郑州大学第一附属医院门诊及住院患者中30例单纯2型糖尿病患者为糖尿病(DM)组,30例单纯高尿酸血症患者为高尿酸血症(HUA)组,30例2型糖尿病合并高尿酸血症患者为糖尿病合并高尿酸血症(DM-HUA)组,另选取30例体检科健康体检者作为正常对照(NC)组,分别检测四组的尿白蛋白血肌酐比值(ACR)、血尿酸(UA)、血肌酐(Cr)、血尿素氮(BUN)、血β2微球蛋白、血浆总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平,计算体质量指数(BMI),进行相关的统计学分析.结果 DM-HUA组的血TC、TG、LDL-C及尿ACR较其余三组均显著升高,HDL-C较其余三组降低,BMI较NC组及DM组均升高；DM组及HUA组TC、TG、HDL-C、LDL-C比较差异无统计学意义(P＞0.05),两组血TC、LDL-C、β2微球蛋白及BMI均较NC组升高,HUA组的血BUN及血Cr较NC组增高(P＜0.05).多元线性回归表明血尿酸是ACR的主要影响因素(R2=0.5027,P＜0.01).结论 ①高尿酸血症与血脂异常及体质量超标明显相关；②血尿酸是尿白蛋白肌酐比值的主要影响因素；③2型糖尿病合并高尿酸血症患者更容易出现糖尿病肾脏损害,高尿酸血症促进2型糖尿病肾病的发生及进展.
목적 탐토혈당은정적2형당뇨병환자혈뇨산수평여당뇨병신병발생급진전적관계.방법 선택정주대학제일부속의원문진급주원환자중30례단순2형당뇨병환자위당뇨병(DM)조,30례단순고뇨산혈증환자위고뇨산혈증(HUA)조,30례2형당뇨병합병고뇨산혈증환자위당뇨병합병고뇨산혈증(DM-HUA)조,령선취30례체검과건강체검자작위정상대조(NC)조,분별검측사조적뇨백단백혈기항비치(ACR)、혈뇨산(UA)、혈기항(Cr)、혈뇨소담(BUN)、혈β2미구단백、혈장총담고순(TC)、삼선감유(TG)、고밀도지단백담고순(HDL-C)、저밀도지단백담고순(LDL-C)수평,계산체질량지수(BMI),진행상관적통계학분석.결과 DM-HUA조적혈TC、TG、LDL-C급뇨ACR교기여삼조균현저승고,HDL-C교기여삼조강저,BMI교NC조급DM조균승고；DM조급HUA조TC、TG、HDL-C、LDL-C비교차이무통계학의의(P＞0.05),량조혈TC、LDL-C、β2미구단백급BMI균교NC조승고,HUA조적혈BUN급혈Cr교NC조증고(P＜0.05).다원선성회귀표명혈뇨산시ACR적주요영향인소(R2=0.5027,P＜0.01).결론 ①고뇨산혈증여혈지이상급체질량초표명현상관；②혈뇨산시뇨백단백기항비치적주요영향인소；③2형당뇨병합병고뇨산혈증환자경용역출현당뇨병신장손해,고뇨산혈증촉진2형당뇨병신병적발생급진전.
Objective To investigate the relationship between the level of serum uric acid and the happening and progression of type 2 diabetic nephropathy with stable blood glucose.Methods Thirty cases of simple type 2 diabetes mellitus patients were choosed as the diabetes mellitus (DM) group,30 cases of simple hyperuricemia patients were choosed as the hyperuricemia(HUA) group,30 cases of type 2 diabetes mellitus conbined with hyperuricemia patients were choosed as the diabetes mellitus combined with hyperuricemia(DM-HUA) group,and the other 30 patients of the healthy physical examination department were choosed as normal control (NC) group from the first affiliated hospital of Zhengzhou university.The blood concentration of the creatinine (Cr),blood urea nitrogen(BUN),β2 microglobulin,serum uric acid(SUA),total cholesterol(TC),triglyceride(TG),HDL-C,LDL-C and the urinary albumin to creatinine ratio(ACR) were detected,meanwhile the body mass index(BMI) was calculated,and the statistical analysis was made.Results The DM-HUA group had the higher level of TC,TG,LDL-C,ACR and lower HDL-C than the other three groups,and higher BMI than NC and DM group (P ＜0.05) ; The difference of TC,TG,HDL-C,LDL-C had no significant between the DM and HUA group (P ＞0.05),but had the higher level ofTC,LDL-C,BMI than NC group(P ＜0.05) ; The HUA group had higher concentration of BUN and Cr than NC group (P ＜ 0.05).The multiple linear regression analysis showed that serum uric acid (UA) was the main influence factor of ACR (R2 =0.5027,P ＜0.01).Conclusions ①Hyperuricemia is highly correlated with the dyslipidemia and overweight of the patients; ②Serum uric acid is the main influence factor of ACR.③T2DM with hyperuricemia patients are easier to get diabetic nephropathy,hyperuricemia can promote the happening and progression of the diabetic nephropathy.