摘要
目的探讨血清尿酸(SUA)对糖尿病肾病(DKD)的早期诊断价值。方法回顾性分析2019年1月至12月在西安医学院第一附属医院内分泌科住院的491例2型糖尿病患者的临床资料。根据尿白蛋白与肌酐比值(UACR)将患者分为非DKD组与DKD组。DKD组依据UACR的不同程度分为微量白蛋白尿组与大量白蛋白尿组。比较非DKD组、DKD组的临床资料,微量白蛋白尿组、大量白蛋白尿组的临床资料;采用Spearman相关性分析SUA水平与非DKD组、DKD组中各指标间的相关性。结果DKD组的糖尿病病程长于非DKD组,收缩压、SUA、UACR水平高于非DKD组,肾小球滤过率(eGFR)低于非DKD组,差异具有统计学意义(P<0.05)。大量白蛋白尿组的糖尿病病程长于微量白蛋白尿组,收缩压、SUA、UACR水平高于微量白蛋白尿组,eGFR低于微量白蛋白尿组,差异具有统计学意义(P<0.05)。Spearman相关性分析结果显示,SUA水平与非DKD组中的年龄、高密度脂蛋白胆固醇(HDL-C)呈负相关,与身体质量指数(BMI)、甘油三酯(TG)、前白蛋白(PA)呈正相关(P<0.05)。SUA水平与DKD组中的年龄、BMI、UACR、TG、PA呈正相关,与糖化血红蛋白(HbA1c)、eGFR、HDL-C呈负相关(P<0.05);调整年龄、BMI、TG、HDL-C、PA后,SUA水平仍与UACR呈正相关,与eGFR呈负相关(P<0.05)。线性回归分析结果显示,在DKD组中SUA水平是UACR、eGFR的影响因素,高UACR、低eGFR的DKD患者的SUA水平更高。结论SUA水平与DKD具有相关性,其是DKD患者UACR、eGFR的影响因素,与DKD尿蛋白严重程度相关,可为DKD的早期诊断、疾病严重程度评估提供依据。
Objective To explore the value of serum uric acid(SUA)in the early diagnosis of diabetes kidney disease(DKD).Methods The clinical data of 491 type 2 diabetes patients hospitalized in the endocrine department of the First Affiliated Hospital of Xi'an Medical University from January to December 2019 was retrospectively analyzed.The patients were divided into non DKD group and DKD group according to the urinary albumin to creatinine ratio(UACR).DKD group was divided into microalbuminuria group and massive albuminuria group according to different degrees of UACR.The clinical data of non DKD group,DKD group,microalbuminuria group and massive albuminuria group were compared;Spearman correlation was used to analyze the correlation between SUA level and various indicators in non DKD group and DKD group.Results The course of diabetes in the DKD group was longer than that in the non DKD group,the systolic blood pressure,SUA and UACR levels were higher than those in the non DKD group,the glomerular filtration rate(eGFR)was lower than that in the non DKD group,and the differences were statistically significant(P<0.05).The course of diabetes in the massive albuminuria group was longer than that in the microalbuminuria group,the systolic blood pressure,SUA and UACR levels were higher than those in the microalbuminuria group,the eGFR was lower than that in the microalbuminuria group,and the differences were statistically significant(P<0.05).Spearman correlation analysis results showed that SUA level was negatively correlated with age and high-density lipoprotein cholesterol(HDL-C)in the non DKD group,and positively correlated with body mass index(BMI),triglyceride(TG)and prealbumin(PA)(P<0.05).SUA level was positively correlated with age,BMI,UACR,TG,PA in the DKD group,and negatively correlated with glycosylated hemoglobin(HbA1c),eGFR,HDL-C(P<0.05);after adjusting for age,BMI,TG,HDL-C and PA,SUA level was still positively correlated with UACR and negatively correlated with eGFR(P<0.05).Linear regression analysis results showed
作者
谢传庆
马卫国
王芬芬
白姣
霍媛媛
邵小娟
李亚
XIE Chuanqing;MA Weiguo;WANG Fenfen;BAI Jiao;HUO Yuanyuan;SHAO Xiaojuan;LI Ya(Endocrine Department,the First Affiliated Hospital of Xi'an Medical University,Xi'an 710077,China)
出处
《临床医学研究与实践》
2022年第23期15-18,共4页
Clinical Research and Practice
基金
西安市科技厅自然科学基金[No.201805094YX2SF28(12)]。
关键词
血清尿酸
糖尿病肾病
尿白蛋白/肌酐比值
肾小球滤过率
serum uric acid
diabetes kidney disease
urinary albumin to creatinine ratio
glomerular filtration rate
