CAJ | 학술논문

目的：分析糖尿病肾病（DKD）1～3期血清尿酸水平与肾小球滤过率估计值（eG-FR）的关系，探讨血清尿酸在诊断早期 DKD 的应用价值。方法纳入2型糖尿病患者中已确诊合并DKD 的239例患者（A 组）、正常健康人228名（B 组），2组受检者的 eGFR 均≥30 ml／（min·1.73 m2），并按 DKD 分期将 A 组分为 A1组（DKD 1期）96例、A2组（DKD 2期）101例、A3组（DKD 3期）42例。比较各组及各亚组间血清尿酸水平，分析 A、B 组各自血清尿酸水平与 eGFR 的相关性。结果A、B 组间 eGFR 比较差异无统计学意义（P ＞0.05），A 组血清尿酸水平高于 B 组（P ＜0.01）；A1～3组间血清尿酸比较差异有统计学意义（P ＜0.05），并且随 DKD 分期呈上升趋势（P ＜0.05）。A、B 组中，血清尿酸与 eGFR 均有良好相关性（P ＜0.01），多重线性回归显示，血清尿酸是DKD 患者 eGFR 下降的危险因素（P ＜0.01）。结论高血清尿酸与早期 DKD 的 eGFR 异常相关，是其危险因素之一，提示尿酸可能参与 DKD 早期肾损害的发生、发展。
목적：분석당뇨병신병（DKD）1～3기혈청뇨산수평여신소구려과솔고계치（eG-FR）적관계，탐토혈청뇨산재진단조기 DKD 적응용개치。방법납입2형당뇨병환자중이학진합병DKD 적239례환자（A 조）、정상건강인228명（B 조），2조수검자적 eGFR 균≥30 ml／（min·1.73 m2），병안 DKD 분기장 A 조분위 A1조（DKD 1기）96례、A2조（DKD 2기）101례、A3조（DKD 3기）42례。비교각조급각아조간혈청뇨산수평，분석 A、B 조각자혈청뇨산수평여 eGFR 적상관성。결과A、B 조간 eGFR 비교차이무통계학의의（P ＞0.05），A 조혈청뇨산수평고우 B 조（P ＜0.01）；A1～3조간혈청뇨산비교차이유통계학의의（P ＜0.05），병차수 DKD 분기정상승추세（P ＜0.05）。A、B 조중，혈청뇨산여 eGFR 균유량호상관성（P ＜0.01），다중선성회귀현시，혈청뇨산시DKD 환자 eGFR 하강적위험인소（P ＜0.01）。결론고혈청뇨산여조기 DKD 적 eGFR 이상상관，시기위험인소지일，제시뇨산가능삼여 DKD 조기신손해적발생、발전。
Objective To analyze the relationship between serum uric acid (SUA)and estimated glomerular filtration rate (eGFR)in type 2 diabetes mellitus (T2DM)patients with stages 1-3 of diabetic kid-ney disease (DKD)and evaluate the diagnostic value of SUA in early DKD.Methods In total,231 T2DM patients complicated with DKD were assigned into group A and 228 healthy controls in group B.All participants presented with eGFR ≥ 30 ml/(min·1.73 m2 ).Patients in group A were sub-grouped into A1 (stage DKD-1,n =96),A2 (stage DKD-2,n =101)and A3 (stage DKD-3,n =42)groups according to DKD stag-ing.The SUA levels were statistically compared and the correlation between SUA and eGFR was analyzed among different groups and sub-groups.Results eGFR did not significantly differ between groups A and B (P>0.05),whereas SUA level in group A was significantly higher compared with that in group B (P <0.01).The SUA levels significantly differed among subgroups A1,A2 and A3 (P <0.05)and were elevated along with DKD staging (P <0.05).In both groups A and B,SUA level was significantly correlated with eGFR (both P <0.01).Multiple linear regression analysis revealed that SUA was a risk factor for eGFR impairment in DKD patients (P <0.01).Conclusions SUA is related to the abnormity of eGFR during early DKD and acts as one of the independent risk factors,prompting that SUA probably participates in the incidence and de-velopment of renal damage during early stage of DKD.