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目的:探讨2型糖尿病患者血尿酸水平和肾脏白蛋白排泄率的关系。方法:检测316例2型糖尿病患者血尿酸、晨尿微量白蛋白/肌酐、尿酸排泄分数,根据尿微量白蛋白/肌酐水平分为正常组、微量白蛋白组和大量白蛋白组,根据血尿酸水平分为尿酸正常组(血尿酸<360μmol/L)和高尿酸血症组(血尿酸≥360μmol/L),将患者血尿酸水平从低到高排序,等分为4组,使用SPSS 13.0软件包进行分析。结果:(1)高尿酸血症组体质量指数、腰臀比、平均动脉压、三酰甘油及尿微量白蛋白/肌酐较尿酸正常组高(P<0.05)。(2)正常组、微量白蛋白组、大量白蛋白组血尿酸水平分别为(285.3±76.8)μmol/L、(300.1±101.3)μmol/L、(342.4±103.8)μmol/L,组间比较差异有统计学意义(P<0.05);血尿酸值等分4组的异常尿白蛋白患病率分别是19.4%,20.0%,22.5%,34.8%。(3)以尿微量白蛋白/肌酐为因变量进行多元逐步线性回归,血尿酸、尿酸排泄分数及平均动脉压进入方程,以尿微量白蛋白/肌酐分级为因变量进行二元logistic回归,结果显示血尿酸的相对危险度为1.158,P=0.008。结论:2型糖尿病患者血尿酸与肾脏白蛋白排泄率独立相关,可反映肾脏的早期病变。
Objective: To investigate the relationship between serum uric acid level and renal albumin excretion rate in type 2 diabetic patients. Methods: Serum uric acid and morning urine microalbumin / creatinine and uric acid excretion were measured in 316 patients with type 2 diabetes mellitus. According to the level of urine microalbumin / creatinine, they were divided into normal group, microalbumin group and a large amount of albumin group. The levels of uric acid were divided into four groups according to the level of serum uric acid in normal group (serum uric acid <360μmol / L) and hyperuricemia group (serum uric acid≥360μmol / L). SPSS 13.0 software Package for analysis. Results: (1) Body mass index, waist-hip ratio, mean arterial pressure, triglyceride and urinary albumin / creatinine in hyperuricemia group were higher than those in normal uric acid group (P <0.05). (2) Serum uric acid levels were (285.3 ± 76.8) μmol / L, (300.1 ± 101.3) μmol / L and (342.4 ± 103.8) μmol / L respectively in normal group, microalbumin group and large albumin group) The difference was statistically significant (P <0.05). The prevalences of abnormal urinary albumin in 4 groups were 19.4%, 20.0%, 22.5% and 34.8%, respectively. (3) The multiple linear regression of urine microalbumin / creatinine was taken as the dependent variable. The serum uric acid, uric acid excretion score and mean arterial pressure were entered into the equation. Binary logistic regression was performed using urinary albumin / creatinine as the dependent variable. The relative risk of displaying uric acid was 1.158, P = 0.008. Conclusion: Serum uric acid and renal albumin excretion rate are independently correlated in patients with type 2 diabetes mellitus, which can reflect the early lesions of the kidney.