Investigation On The Correlation Between Type 2 Diabetes Combined With Hyperuricemia And Visceral Fat Area And Treatment Status

Objective(s):The purpose of this study was to clarify the correlation between type 2 diabetes mellitus complicated with hyperuricemia and visceral fat area,and to provide a theoretical basis for the role of visceral fat in the development of hyperuricemia in patients with type 2 diabetes mellitus..The treatment of T2DM patients with HUA was investigated.Methods:A total of 4173 male and female patients(18-80 years old)with type 2 diabetes were enrolled by the National Center for Standardized Metabolic Disease Management,Yunnan First People’s Hospital Branch(MMC)(1999 WHO diagnostic criteria).visceral fat area(visceral fat area)was measured using a dual bioelectrical impedance analyzer(Omron DUALSCANHDS2000 device)according to 0≤VFA<50cm~2,50≤VFA<100cm~2,100≤VFA<150cm~2and VFA≥150cm~2were divided into A,B,C and D.Gender,age,height,weight,waist circumference,VFA,serum uric acid(SUA),blood uric acid and triglycerides were collected.TG),total cholesterol(TC),low density lipoprotein(LDL-C),high density lipoprotein(high density lipoprotein,HDL-C),glycosylated hemoglobin by hemoglobin,Hb A1c,body mass index(BMI)and homeostasis model assessment of insulin resistance(HOMA-IR)were calculated for observation.The correlation between hyperuricemia and visceral fat area in type 2 diabetes patients was analyzed by comparing the general data and clinical indicators of the above four groups.To analyze whether VFA was an independent risk factor for T2DM with HUA,the patients were grouped according to whether they had HUA.The uric acid lowering treatment of T2DM patients with HUA was investigated,and the changes of uric acid before and after entering MMC for 1year were compared.Results:1.There was statistical significance in whether group A,group B,group C and group D were complicated with hyperuricemia(P<0.05)further pairwise comparison showed that there were statistical differences in whether group A,B,C and D4 were complicated with hyperuricemia.In this study,854 patients with hyperuricemia were enrolled in a total of 3330 patients,and the prevalence rate was 25.6%.With the increase of visceral fat area,the prevalence rate of the four groups increased successively,which were 12.60%,22.60%,31.10%and 42.70%,respectively.2.Taking VFA as the dependent variable,gender,age,waist circumference,BMI,SFA,TG,TC,HDL-C,HOMA-IR,alcohol consumption and hyperuricemia were included in the multiple stepwise linear regression equation.The results showed as follows:Age,waist circumference,BMI,SFA,TG,HDL-C,HOMA-IR,and hyperuricemia were significantly positively correlated with VFA(P<0.05).3.The VFA value of HUA group was 106.04±42.18cm2,which was higher than that of non-Hua group 88.01±40.79,and the difference was statistically significant(P<0.05).4.With whether suffering from hyperuricemia as the dependent variable,binary Logistic regression analysis was performed on the statistically significant difference in clinical data between the two groups as the independent variable.The variable screening method was stepwise forward selection method,and the results showed:VFA[Odds ratio(OR):1.003,(Confidence interval,95%CI):1.000～1.006)],SFA(OR:1.003,95%CI:1.001～1.005),waist circumference(OR:1.021,95%CI:1.007～1.036),TG(OR:1.077,95%CI:1.050～1.105),male(OR:1.988,95%CI:1.638-2.413)were independent risk factors for HUA disease(P<0.05),age(OR:0.988,95%CI:0.980～0.996),Hb A1c(OR:0.905,95%CI:0.872～0.939)were negatively correlated with HUA(P<0.05),is a protective factor for HUA disease.5.With VFA as the test variable and HUA as the state variable,ROC curve analysis results showed that the area under the curve predicted by VFA in male T2DM patients with HUA was0.617(95%CI:0.592～0.643).In male patients with T2DM,the optimal cut-off value of VFA was 96.25cm~2,the specificity was 0.604,and the sensitivity was 0.573.The area under the curve predicted by VFA in women with T2DM and HUA was 0.621(95%CI:0.579～0.663).In female T2DM patients,the optimal cut-off value of VFA was 88.8cm~2,the specificity was 0.590,and the sensitivity was 0.602.6.In this study,among 854 patients with hyperuricemia,only 133 patients were treated with first-line urico-lowering drugs such as allopurinol,febuxotec and benbromarone,accounting for15.5%of the patients with hyperuricemia.SUA of T2DM patients with HUA was491.77±73.26μmol/L before MMC management,and 448.63±88.11μmol/L after 1 year of MMC management,the difference was statistically significant(P<0.05).Conclusion(s):1.There is a significant positive correlation between visceral fat area and hyperuricemia in patients with type 2 diabetes mellitus.Visceral fat area is an independent risk factor for hyperuricemia in patients with type 2 diabetes mellitus.2.The risk cut-off point for VFA was 96.25cm~2in male type 2 diabetes patients with hyperuricemia and 88.8cm~2in female type 2 diabetes patients with hyperuricemia.3.Only 15.5%of T2DM patients with HUA were treated with first-line uric acid.One year after admission to the MMC center,uric acid decreased,but still did not decrease to normal.