Study On The Related Factors Of Type 2 Diabetes Mellitus Complicated With Hyperuricemia And Distribution Pattern Of TCM Syndrome Types

Objective:Through a retrospective analysis of hospitalized medical records of type 2 diabetes patients with hyperuricemia,the related factors affecting the incidence of hyperuricemia in type 2 diabetes were summarized,providing a reference for the prevention and treatment of this disease.Meanwhile,the distribution rule of TCM Syndromes of type 2 diabetes with hyperuricemia and the relationship between blood stasis syndrome and platelet parameters were discussed,in order to provide scientific evidence for TCM differentiation of the disease.Method:The medical records of type 2 diabetes patients hospitalized in the Endocrinology Department of Hubei Provincial Hospital of integrated Chinese and Western Medicine from November 2019 to November 2021 were collected.According to the acceptance criteria,231 patients with complete clinical data were selected,including 77 cases in the hyperuricemia group and 154 cases in the normal uric acid group.The general conditions（age,gender,duration of diabetes,blood pressure）,laboratory indicators（blood sugar,blood lipids,renal function,platelet parameters,uric acid）,accompanying disease（hypertension,hyperlipidemia,fatty liver）,chronic diabetic complications and TCM syndrome types of the two groups were compared and analyzed.To explore the influencing factors of type 2 diabetes with hyperuricemia,the distribution of TCM Syndrome Types and the relationship between blood stasis syndrome and platelet parameters.Result:（1）The total rate of type 2 diabetes with hyperuricemia was 33.33%,of which the male was higher than that of female（P<0.05）.（2）Compared with the normal uric acid group,the age,high-density lipoprotein cholesterol and glomerular filtration rate of the hyperuricemia acid group were lower（P<0.05）,while the triglyceride,serum creatinine,serum uric acid,average platelet volume and platelet distribution width were higher than those in the normal uric acid group（P<0.05）.There was no significant difference between the two groups in duration of diabetes,systolic blood pressure,diastolic blood pressure,glycosylated hemoglobin,fasting blood glucose,total cholesterol,low density lipoprotein cholesterol,urine uric acid,total platelet count and platelet volume（P>0.05）.The incidence of hypertension,hyperlipidemia and fatty liver in hyperuricemia group was higher than that in normal uric acid group（P<0.05）.The incidence rate of diabetic nephropathy,retinopathy and peripheral vascular disease in hyperuricemia group was significantly higher than that in normal uric acid group（P<0.05）,but there was no statistical significance in diabetic peripheral neuropathy and foot disease between the 2groups.（P>0.05）.（3）Spearman correlation analysis showed that serum uric acid was positively correlated with male,triglycerides,serum creatinine,platelet distribution width and history of hypertension,and negatively correlated with high-density lipoprotein cholesterol and glomerular filtration rate.Multivariate logistic regression analysis showed that the distribution of male,triglyceride,blood creatinine and platelet were the risk factors for hyperuricemia（P<0.05）.（4）Among the main syndromes,the prevalence rates of Qi Yin deficiency syndrome and liver stomach stagnation heat syndrome in the high uric acid group were significantly higher than those in the normal uric acid group（P<0.05）,and the gastrointestinal excess heat syndrome and Yin Yang deficiency syndrome were significantly lower than those in the normal uric acid group（P<0.05）.And there was no significant difference in the other main syndromes between the two groups（P>0.05）.（5）In hyperuricemia group,the platelet distribution width of patients with blood stasis syndrome was higher than that of patients without blood stasis syndrome（P<0.05）,and there was no significant difference in total platelet count,average platelet volume and platelet hematocrit（P>0.05）.Conclusion:（1）The incidence of hyperuricemia in type 2 diabetes mellitus may be related to age,gender,triglyceride,high density lipoprotein cholesterol,serum creatinine,blood uric acid,glomerular filtration rate,mean platelet volume and platelet distribution width.And among them,male,triglyceride,serum creatinine and platelet distribution width may be the risk factors of the disease.（2）The incidence of hypertension,hyperlipidemia and fatty liver may be higher in type 2 diabetic patients with hyperuricemia than those with normal uric acid.At the same time,the incidence of diabetic nephropathy,retinopathy and peripheral vascular disease may also be higher.（3）Patients with type 2 diabetes and hyperuricemia have significantly increased platelet activation,especially those with blood stasis syndrome.Therefore,it is necessary to pay attention to antiplatelet therapy for primary,secondary and tertiary prevention of cardiovascular and cerebrovascular diseases.（4）Type 2 diabetes with hyperuricemia is mainly manifested by Qi Yin,deficiency syndrome,and blood stasis syndrome is more than phlegm dampness syndrome in TCM Syndromes of type 2diabetes.Therefore,the treatments mainly focus on Supplementing Qi and nourishing yin and activating blood circulation to dissipate blood stasis.