摘要
目的探讨三酰甘油高密度脂蛋白胆固醇比值(TG/HDL-C)、三酰甘油葡萄糖乘积指数(TyG)对2型糖尿病(T2DM)患者发生高尿酸血症(HUA)的预测价值。方法668例T2DM患者根据血尿酸水平分为HUA组(183例)和非高尿酸血症(NUA)组(485例)。采集患者基本信息、体格检查等资料,检测实验室相关指标。采用多因素Logistic回归分析TG/HDL-C(四分位数Q1~Q4组)、TyG指数(四分位数q1~q4组)与T2DM患者HUA发生风险的关系,及两者与血尿酸对糖尿病并发症的影响;采用受试者工作特征(ROC)曲线评估TG/HDL-C、TyG指数对T2DM患者伴发HUA的预测价值。结果多因素Logistic回归分析显示,在未校正及校正年龄、性别、收缩压(SBP)、舒张压(DBP)、体质量、体质量指数(BMI)、腰围(WC)、臀围后,TG/HDL-C、TyG指数第3、第4四分位数组发生HUA的风险高于第1四分位数组(P<0.05),第2四分位数组与第1四分位数组差异无统计学意义(P>0.05);校正三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、高血压史、吸烟史、饮酒史后,TG/HDL-C的第3、第4四分位数组发生HUA的风险仍高于第1四分位数组(P<0.05),而TyG指数此时与HUA的发病风险无关联(P>0.05)。TG/HDL-C、TyG指数、血尿酸均为糖尿病白蛋白尿的危险因素,TG/HDL-C是糖尿病周围神经病变的保护因素(P<0.05),而三者均与糖尿病视网膜病变无关联(P>0.05)。ROC曲线显示,TG/HDL-C曲线下面积为0.651(95%CI:0.604~0.697),TyG指数曲线下面积0.617(95%CI:0.570~0.665)。结论TG/HDL-C、TyG指数是T2DM合并HUA的独立危险因素,两者对HUA有一定预测价值;TG/HDL-C、TyG指数、血尿酸与糖尿病并发症密切相关,临床应严密关注。
Objective To investigate the predictive value of triacylglycerol high-density lipoprotein cholesterol ratio(TG/HDL-C)and triacylglycerol glucose product index(TyG)on the development of hyperuricemia(HUA)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 668 patients diagnosed with T2DM were selected and were divided into HUA group(n=183)and non-hyperuricemia(NUA)group(n=485)according to their serum uric acid levels.The basic information,physical examination and other data of patients were collected.The laboratory-related indicators were tested.Multivariate Logistic regression was used to explore the relationship of TG/HDL-C(quartiles Q1 to Q4 groups)and TyG index(quartiles q1 to q4 groups)with the development of HUA in patients with T2DM,and the effect of both with serum uric acid on diabetic complications.The subject working characteristic(ROC)curve was used to assess the predictive value of the TG/HDL-C and TyG index for HUA in T2DM patients.Results Multivariate Logistic regression analysis showed that after uncontrolled and controlled for age,sex,systolic blood pressure(SBP),diastolic blood pressure(DBP),body mass,body mass index(BMI),waist circumference(WC)and hip circumference,the risk of HUA was higher in quartiles 3 and 4 groups of the TG/HDL-C and TyG index than that in quartile 1 group(P<0.05),and there was no significant difference between quartile 2 group and quartile 1 group(P>0.05).After further control of triacylglycerol(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL C),history of hypertension,history of smoking,and history of alcohol consumption,the risk of HUA was still higher in quartiles 3 and 4 groups of TG/HDL-C than that in quartile 1 group(P<0.05),while TyG index was not associated with the risk of HUA at this time(P>0.05).TG/HDL-C,TyG index and serum uric acid were three risk factors for diabetic albuminuria,and TG/HDL-C was a protective factor for diabetic peripheral neuropathy(P<0.05),while all three were not associated with diabetic retinopathy(P>0.05)
作者
杨曦
柳怡莹
万沁
YANG Xi;LIU Yi-ying;WAN Qin(Department of Endocrinology,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,China)
出处
《天津医药》
CAS
北大核心
2021年第6期603-608,共6页
Tianjin Medical Journal
基金
国家重点研发计划项目(2016YFC0901200,2016YFC0901205)。
