Relationship Between Serum Uric Acid And Carotid Intima-media Thickness In Patients With Type 2 Diabetes Mellitus

Objectives:We are aimed at investigate the relationship between serum uric acid and mean carotid intima-media thickness and evaluate the effect of serum uric acid/creatinine ratio on carotid intima-media thickness in patients with type 2 diabetes mellitus.Methods:A retrospective collection of 344 patients with type 2 diabetes mellitus from the Department of Endocrinology and Metabolism,Tianjin Medical University General Hospital from May 2017 to June 2018,including 207 males and 137 females,collected the basic information such as the age,height,weight,smoking and drinking history and biochemical indicators such as serum uric acid,creatinine,total cholesterol,triglyceride.We also collected carotid intima-media thickness detected by carotid ultrasound.Spearman rank correlation and unitary linear regression analysis were used to compare the correlation and causality among the indicators.Results:1..In this study,a total of 344 patients had an average age of 56.2±12.1 years,an average serum uric acid level of 313.1±82.4umol/L,an average serum uric acid/creatinine ratio 5.1±1.5,an average carotid intima-media thickness of 1.0±0.2mm.Male serum uric acid,creatinine,blood urea nitrogen and triglyceride were higher than female,while female total cholesterol and very low density lipoprotein were higher than males,the difference was statistically significant((P<0.05).2.There was no correlation and causal relationship between UA and CIMT in total type 2 diabetes mellitus(P>0.05),while there was a correlation and negative causal relationship between UA/Cr and CIMT(P<0.05).3.UA was not associated with CIMT in male type 2 diabetes mellitus(P>0.05),while UA/Cr was associated with CIMT(P<0.05).The patients were divided into four groups according to uric acid:69 patients with UA≤300umol/L;59 patients with UA 300-350 umol/L;58 patients with UA 350-420 umol/L;21 patients with UA ≥420 umol/L.UA was correlated with CIMT when UA≤300umol/L(P<0.05).UA had a negative causal relationship with CIMT when UA≤300umol/L and UA≥420umol/L.UA/Cr was correlated with CIMT when UA/Cr=3.88±0.82 and UA/Cr=6.52±1.48(P<0.05).UA/Cr and CIMT has negative causality When UA/Cr=3.88±0.82 and UA/Cr=4.79±0.9 and UA/Cr=6.52±1.48(P<0.05).4.There was no correlation between UA,UA/Cr and CIMT in female type 2 diabetes.The patients were divided into four groups according to uric acid:44 patients with UA≤250umol/L;35 patients with UA 250-300 umol/L;35 patients with UA 300-360 umol/L;23patients with UA ≥ 360 umol/L.When UA/Cr=6.16±1.68,UA/Cr was correlated with CIMT(P<0.05).UA and CIMT still have no relationship.There was no causal relationship between UA,UA/Cr and CIMT.Conclusions:1.In patients with type 2 diabetes mellitus,the physiological range of uric acid levels have an antioxidant effect and may be a protective factor for atherosclerosis.2.Male serum uric acid,creatinine,urea nitrogen are higher than female,may be related to smoking and drinking.3.Female serum uric acid was not associated with carotid intima-media thickness,which may be related to female estrogen.The exact mechanism needs further study.4.The ratio of serum uric acid / serum creatinine reduced the effect of different creatinine levels between different individuals on uric acid excretion,can better reflect the relationship between uric acid itself and carotid intima-media thickness.