| Objective: To observe the correlation between different serum uric acid levels and left ventricular mass index in patients with type 2 diabetes mellitus,and to explore the relationship between serum uric acid levels and left ventricular hypertrophy.It is helpful for the early diagnosis and treatment of abnormal cardiac structure in patients with type 2 diabetes mellitus.Methods:This study was a single-center retrospective study.Adult patients with type 2 diabetes diagnosed in the first affiliated Hospital of Guangxi Medical University from January 2016 to December 2018 were collected.The general data of the patients included in this study and the clinical blood biochemical results 8 hours after admission were collected: sex,age,height,weight,smoking and drinking history,admission systolic blood pressure,admission diastolic blood pressure,admission heart rate,red.Cell,hemoglobin,total bilirubin,albumin,creatinine,cystatin C,homocysteine,serum uric acid,fasting and 2 hours after meal blood glucose,glycosylated hemoglobin,blood lipids and other related indexes.At the same time,the results of color Doppler echocardiography were collected: left ventricular end diastolic diameter,leftventricular end systolic diameter,end diastolic interventricular septum thickness,left ventricular posterior wall thickness,left atrial diameter and right ventricle measured by echocardiography in our hospital.Diameter,right ventricular outflow tract and other indicators,the left ventricular mass index was calculated.According to the level of uric acid,the patients were divided into three groups:low(103-319umol/L),medium(320-451umol/L)and high(452-903umol/L).The differences of various indexes among the three groups were compared,and the correlation confounding factors were adjusted by multivariate logistic regression analysis,and the relationship between different uric acid levels and left ventricular mass in three groups of patients with type 2 diabetes mellitus was analyzed and compared.Results1.In the three groups of type 2 diabetic patients with different uric acid levels,the comparison among the three groups showed that the left ventricular mass index in the high uric acid level group was lower than that in the middle uric acid level group,and the difference was statistically significant(P < 0.05).2.In the pairwise comparison,here was no significant difference in left atrial diameter,left ventricular systolic end diameter,EDV(end diastolic volume),right ventricular diameter,right ventricular outflow tract and EF between middle uric acid level group and low uric acid level group,but there was no significant difference between high uric acid level group and low uric acid level group,but there was no significant difference between high uric acid level group and low uric acid level group.The left atrial diameter,left ventricular systolic end diameter,EDV(end diastolic volume),right ventricular diameter and right ventricular outflow tract in the high uric acid group were significantly higher than those in the low and middle uric acid group,and theleft atrial diameter,left ventricular end systolic diameter,end diastolic volume,right ventricular outflow tract in the high uric acid group were significantly higher than those in the low and middle uric acid group.However,the EF value in the high uric acid level group was lower than that in the low and middle uric acid level group.3.Univariate analysis showed that age,BMI,systolic blood pressure,smoking,hemoglobin,creatinine,cystatin C,total bilirubin,albumin,high density lipoprotein cholesterol and low density lipoprotein cholesterol were found in patients with type 2 diabetes mellitus.The levels of alcohol,apolipoproteins AI,homocysteine and high uric acid were all correlated with left ventricular mass index(LVMI).4.Multivariate regression analysis showed that after adjusting for age,sex,BMI,smoking,admission systolic blood pressure,hemoglobin,creatinine,high density lipoprotein,low density lipoprotein and other confounding factors,in patients with type 2 diabetes,The high level uric acid group was still an independent risk factor for left ventricular mass index(P < 0.05).Conclusion1.The higher the level of serum uric acid,the larger the left atrial diameter,EDV(left ventricular end diastolic volume),left ventricular systolic end diameter,right ventricular diameter and right ventricular outflow tract in the cardiac structure of patients with type 2 diabetes mellitus.It is suggested that the level of high uric acid may be a risk factor affecting the structure of the heart.2.The higher the level of serum uric acid,the lower the ejection fraction of,EF(,suggesting that the level of serum uric acid may be a risk factor for the decrease of EF.3.The left ventricular mass index was lower in the high uric acid group and significantly higher in the middle uric acid group.after adjusting for various confounding factors,the increase of serum uric acid level was still independently correlated with the left ventricular mass index.It is suggested that the increase of uric acid may be an independent risk factor for left ventricular hypertrophy in patients with type 2 diabetes mellitus. |
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