上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2019, Vol. 39 ›› Issue (7): 754-.doi: 10.3969/j.issn.1674-8115.2019.07.011

• 论著·临床研究 • 上一篇    下一篇

血清高尿酸水平与住院糖尿病患者白蛋白尿短期进展的关系研究

王婷婷 1, 2，李明杰 1，林宁 1，钮忆欣 1，简蔚霞 1，苏青 1   

  1. 1. 上海交通大学医学院附属新华医院内分泌科，上海 200092；2. 上海大华医院急诊科，上海 200231
  • 出版日期:2019-07-28 发布日期:2019-08-26
  • 通讯作者: 简蔚霞，电子信箱：jianweixia@xinhuamed.com.cn。
  • 作者简介:王婷婷（1982—），女，主治医师，硕士生；电子信箱： wangtt_dahua@sina.com。
  • 基金资助:
    国家自然科学基金面上项目（81670746）

Relationship between high serum uric acid level and short-term progression of albuminuria in hospitalized diabetic patients

WANG Ting-ting1, 2, LI Ming-jie1, LIN Ning1, NIU Yi-xin1, JIAN Wei-xia1, SU Qing1   

  1. 1. Department of Endocrinology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China; 2. Department of Emergency, Shanghai Dahua Hospital, Shanghai 200231, China
  • Online:2019-07-28 Published:2019-08-26
  • Supported by:
    National Natural Science Foundation of China，81670746

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摘要： 目的 ·探讨 2型糖尿病（ type 2 diabetes mellitus，T2DM）患者白蛋白尿短期进展的相关危险因素。方法 ·采用回顾性队列研究设计，连续收集 2010年 4月— 2015年 4月 210例符合入选标准的 T2DM住院患者，其中男性 102例，女性 108例。分别收集患者 2次住院（分别作为基线和随访资料）的一般资料、生化检测结果和用药情况。通过多因素 Logistic回归分析探讨患者基线白蛋白尿以及白蛋白尿短期进展的潜在危险因素。结果 ·基线资料中，大量白蛋白尿组（≥ 300 mg/24 h）血清尿酸水平显著高于无白蛋白尿组（<30 mg/24 h）（P0.002）。207例患者（剔除 3例数据有缺失的样本）第 2次住院时，有 51例白蛋白尿有进展（ 24.6%），156例无进展（ 75.4%）。白蛋白尿进展组血清尿酸水平显著高于白蛋白尿非进展组（ P0.009）。多因素 Logistic回归分析结果显示，血清尿酸水平是 T2DM患者白蛋白尿短期进展的独立危险因素（ OR1.349，95% CI 1.014～ 1.793，P0.040）。结论 · T2DM患者中，血清高尿酸水平可能是 T2DM患者白蛋白尿短期进展的独立危险因素，对高尿酸进行早期干预可能会延缓糖尿病肾病的发展。

关键词: 2型糖尿病, 糖尿病肾病, 血清尿酸, 白蛋白尿

Abstract:

Objective · To explore the risk factors associated with short-term progression of albuminuria in the patients with type 2 diabetes mellitus (T2DM). Methods · The retrospective cohort study design was performed to consecutively recruit 210 hospitalized T2DM patients who met the inclusion criteria, including 102 males and 108 females April 2010 to April 2015. The data of the patients twice in hospital (as baseline and follow-up information, respectively), including general data, biochemical examinations and medication were collected. Multivariate Logistic analysis was used to explore the potential risk factors for baseline albuminuria and short-term progression of albuminuria. Results · Serum uric acid levels were significantly higher in the patients with macroalbuminuria ( ≥ 300 mg/24 h) than those in the patients without albuminuria (< 30 mg/24 h) at baseline (P0.002). Among the 207 patients (excluding 3 samples with missing data) during the second hospitalization, 51 patients (24.6%) had progress in albuminuria and 156 patients (75.4%) had none. Serum uric acid levels were significantly higher in the progression group than those in the non-progression group (P0.009). Multivariate Logistic regression analysis showed that high serum uric acid level was an independent risk factor for progression of albuminuria in T2DM patients (OR1.349, 95%CI 1.014-1.793, P0.040). Conclusion · The high serum uric acid level may be an independent risk factor for short-term progression of albuminuria, and early intervention with hyperuricemia might delay the progression of diabetic kidney disease in T2DM patients.

Key words: type 2 diabetes mellitus (T2DM), diabetic kidney disease (DKD), serum uric acid, albuminuria

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