| Background and ObjectiveWith the improvement of living standards,people's diet customs and life stles have changed in recent years,and this leads to an increasing number of people suffering from diabetes mellitus.The number of people with dibetes mellitus has reached more than 450 million at present,and it has a tendency torise in the future.It is expected that the number will increase by about 200 million in the next 20 years.Aging is becoming more and more serious nowadays,with the elderly accounting for an increasing proportion of the population,the number of elderly people with diabetes mellitus also has an increase.Type 2 diabetes mellitus accounts for 90% of total diabetes,and it is a chronic disease which leads to chronic complications involving various blood vessels.Diabetic macrovascular disease involving cardiovascular and cerebrovascular,easily leads to critical events such as acute myocardial infarction and acute cerebralinfarction.Type 2 diabetes mellitus is based on the pathological basis of atherosclerosis and vessels,such as aorta,coronary artery,cerebralartery,renal artery are involved.Hypeluricemia is acted as an important risk factor for the fourth cardiovascular disease after hypertension,hyperlipidemia,and hyperglycemia.Serum uric acid and urinary microalbumin is an indicator of early renal dysfunction.Studies have shown that uric acid,urinary albumin can be used as an independent risk factor for cardiovascular events in recent years.Uric acid acting as an endogenous antioxidant takes part in the formation of atherosclerosis.By facilitating lipid oxidation,increasing oxygen free radicals and blood platelet,uric acid can promote the process of atherosclerosis.A study by Bickel showed that The mortality rate of coronary heart disease were increased with the uric acid levels.The increased uric acid levels are still predictive factors of coronary heart disease even in the absence of traditional risk factors for this disease.American Diabetes Association recommends urinary albumin/creatinine ratio as an indicator of screening for microalbuminuria.Urinary protein in the body shows a wide range of endothelial dysfunction.KIM,University of Gartou,Korea,made a prospective study in 2015,and the results showed that in the exclusion of age,gender,hypertension and mellitus history,BMI,smoking status,and blood lipids,urinary albumin was still an independent risk factor for cardiovascular.It was also an independent predictor of allcause mortality.But there are still some studies which suggest that uric acid,urinary microalbumin are not independent risk factors for cardiovascular events.In our study,We make a retrospective analysis of these materials to investigate the correlation between serumuric acid,urinary albumin levels and diabetic macroangiopathy.Also,this study provides early predictive indicators for the prevention of diabetic macrovasculardiseases.Methods87 patients with T2 DM were recruited from the first affiliated hospital of Zhengzhou University,both of which were more 60 years old.50 males and 37 females were included among these patients.They were divided into two groups: patients with macrovascular disease were divided into group A,22 males and 12 females(n=34);patients without macrovascular disease were divided into group B,28 males and 25 females(n=53).Certainly,we selected 32 healthy elderly which were more 60 years old in the same period as a control group C,18 males and 14 females(n=32).Collected general information about these subjects,such as age,sex,duration of diabetes,history of smoking,and hypertension.Measured the systolic blood pressure,diastolic blood pressure,body mass index.The biochemical indexes of glycosylated hemoglobin,total cholesterol,triglyceride,low density lipoprotein,high density lipoprotein,creatinine,uric acid,fasting plasma glucose and 24 hours urine microalbumin were also measured by the biochemical analyzer in our hospital.Analyzed the datas among three groups.ResultsComparison of general information:There were no significant differences in age,sex and diastolic blood pressure among the three groups(P>0.05).But there were significant differences in smoking,BMI,duration of diabetes mellitus and systolic blood pressure among the three groups(P<0.05).The number of smokers in group A was more than that in group B and group C;the duration of diabetes mellitus in group A was longer than that in group B and group C and systolic blood pressure in group A was higher than that in group B and group C.Comparison of Biochemical Indexes:There were no significant differences in total cholesterol,blood urea nitrogen and creatinine among the three groups.But there were significant differences in glycosylated hemoglobin?fasting palsma glucose,low density lipoprotein,triglycerides,uric acid,urine microalbumin among the three groups(P<0.05).And also these indicators in group A were higher than that in group B and group C.For high density lipoprotein,there was also a significant difference among the three groups(P<0.05),and group A was lower than that in group B and group C.Pearson correlation analysis showed: ACR and UA?LDL?HbA1c?FPG ?diabetes course were positively correlated(r=0.28?0.377?0.185?0.415?0.472,P<0.05).UA?HbA1c?diabetes course were were risk factors for ACR(Standardized regression coefficient was 0.214,0.307,0.252,P<0.05).From the binary stepwise logistic regression analysis,we concluded that uric acid,urinemicroalbumin,low density lipoprotein were risk factors for diabetic macrovascular disease(P<0.05).OR values were :1.481?5.161?0.001?1.017;95%CI were:(1.014,2.164)?(1.57,16.971)?(0.000,0.261)?(1.003,1.032).Conclusions1.UA and ACR are higher in elderly patients with type 2 diabetes mellitus;2.UA is a risk factor for senile type 2 diabetic macrovascular disease,and urinary microalbumin can indirectly affect the elderly type 2 diabetic macrovascular disease,both of them can be used as detection indices of early diabetic macroangiopathy. |
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