CAJ | 학술논문

目的：探讨儿童T2DM合并高尿酸血症（HUA）与IR、脂代谢异常的关系。方法选取T2DM患儿135例，根据血尿酸（SUA ）水平分为 T2DM 合并 HUA 组（T2DM ＋ HUA ）31例和单纯T2DM组（T2DM ）104例，比较两组的临床资料，分析 SUA 水平与糖、脂参数的关系。结果（1） T2DM患儿中，HUA的患病率为23.0％。（2）两组年龄、病程、SBP、DBP、Scr和24 hUAlb比较，差异无统计学意义（P均＞0.05），T2DM＋ HUA组BMI[（24.55±4.19） vs （29.12±6.17） kg／m2]、黑色棘皮病发生率[22（70.97％） vs 38（36.54％）]及非酒精性脂肪性肝病（NAFLD）发生率[23（71.19％） vs 50（48.08％）]均高于 T2DM 组（P＝0.000、0.001、0.01）。（3）T2DM＋ HUA 组 FPG、2 hPG、FIns、FC‐P、SUA及TG均高于T2DM组（P＝0.003、0.019、0.002、0.000、0.000、0.001）。但 HbA1c、胰岛β细胞功能指数（HOMA‐β）、胰岛素抵抗指数（HOMA‐IR）、Scr、24 hUAlb、TC、HDL‐C和LDL‐C比较，差异无统计学意义（P＞0.05）。（4）通过2周胰岛素降糖和低嘌呤饮食治疗后，T2DM＋ HUA组SUA水平较治疗前下降（P＝0.001），而其他糖、脂代谢参数虽比治疗前好转，但差异无统计学意义（P＞0.05）。结论与单纯T2DM患儿相比，伴 HUA的T2DM患儿IR、血脂异常更显著，发生NAFLD和黑色棘皮病概率更高；T2DM患儿治疗后SUA降低。
목적：탐토인동T2DM합병고뇨산혈증（HUA）여IR、지대사이상적관계。방법선취T2DM환인135례，근거혈뇨산（SUA ）수평분위 T2DM 합병 HUA 조（T2DM ＋ HUA ）31례화단순T2DM조（T2DM ）104례，비교량조적림상자료，분석 SUA 수평여당、지삼수적관계。결과（1） T2DM환인중，HUA적환병솔위23.0％。（2）량조년령、병정、SBP、DBP、Scr화24 hUAlb비교，차이무통계학의의（P균＞0.05），T2DM＋ HUA조BMI[（24.55±4.19） vs （29.12±6.17） kg／m2]、흑색극피병발생솔[22（70.97％） vs 38（36.54％）]급비주정성지방성간병（NAFLD）발생솔[23（71.19％） vs 50（48.08％）]균고우 T2DM 조（P＝0.000、0.001、0.01）。（3）T2DM＋ HUA 조 FPG、2 hPG、FIns、FC‐P、SUA급TG균고우T2DM조（P＝0.003、0.019、0.002、0.000、0.000、0.001）。단 HbA1c、이도β세포공능지수（HOMA‐β）、이도소저항지수（HOMA‐IR）、Scr、24 hUAlb、TC、HDL‐C화LDL‐C비교，차이무통계학의의（P＞0.05）。（4）통과2주이도소강당화저표령음식치료후，T2DM＋ HUA조SUA수평교치료전하강（P＝0.001），이기타당、지대사삼수수비치료전호전，단차이무통계학의의（P＞0.05）。결론여단순T2DM환인상비，반 HUA적T2DM환인IR、혈지이상경현저，발생NAFLD화흑색극피병개솔경고；T2DM환인치료후SUA강저。
Objective To investigate the relationship of T2DM with hyperuricemia in children with insulin resistance and lipid metabolism disorders. Methods A total of 135 children of type 2 diabetes mellitus were selected and divided into two groups:T2DM + HUA group (n= 31) and T2DM group(n=104). The relationship of uric acid level with clinical parameters of glycometabolism and lipid metabolism was evaluated. Results (1)The prevalence of hyperuricemia(HUA) in children with T2DM was 23.0%. (2) There was no significant difference in age ,duration of disease ,systolic and diastolic blood pressure ,serum creatinine and 24 hours urinary protein quantitative between the two groups(P>0.05). BMI[(24.55 ± 4.19) vs (29.12 ± 6.17)kg/m2 ] ,the incidence of nigricans acanthosis[22(70.97% ) vs 38 (36.54% )] and non‐alcoholic fatty liver disease [23(71.19% ) vs 50(48.08% )] were significantly higher in T2DM+ HUA group than in T2DM group (P= 0.000 ,0.001 ,0.01 ,respectively). (3) FPG ,2 hPG , FIns ,FC‐P、SUA and TG were significantly higher in T2DM + HUA group than in T2DM group (P=0.003 ,0.019 ,0.002 ,0.000 ,0.000 ,0.001 ,respectively). However ,HbA1c ,HOMA‐IR ,HOMA‐β,Scr ,24 hUAlb ,TC ,LDL‐C and HDL‐C were similar in both groups (P>0.05). (4) The uric acid levels in T2DM+ HUA group were significantly decreased after 2 weeks treatment of insulin and low purine diet(P=0.001). But the other glucose and lipid metabolism disorders were not significantly improved(P>0.05) . Conclusion Children T2DM with HUA have higher insulin resistance and dyslipidemia. The incidence of nigricans acanthosis and non‐alcoholic fatty liver disease were significantly higher in T2DM+ HUA group than in T2DM group. SUA is decreased after treatment of children T2DM.