| Objective:1.This study was performed to clear the basic clinical characteristics and the level of surum uric acid(SUA)as well as the incidence of macroangiopathy(including carotid artery lesion(LLAL)and lower limb atherosclerotic lesions and albumin urine in hospitalized patients with type 2 diabetes mellitus(T2DM).2.SUA levels in patients with T2DM were analyzed according to the groups ofhaemoglobin A1c(HbA1C)and body mass index(BMI),the relationship between SUA and blood glucose control and BMI were also analyzed in this study.3.Further analysis was performed to study the effects of SUA on the incidence of macroangiopathy and albuminuria in patients with T2DM.4.The risk factors for the development of hyperuricemia(HUA)were also analyzed in this study.Methods:1.Retrospectively analyzed the demographic data,medical history and related test and examination reports of 2002 patients with T2DM(T2DM group)and 233 patients with normal fasting blood glucose from the health examination center of the Third Affiliated Hospital of Anhui Medical University from July 2012 to December 2017.2.Group Information(1)Patients with T2DM were divided into four groups according to HbA1C,from low to high respectively:G1:<7.0%,G2 7.0%-7.0%,G3:9.0%-9.0%,G4?11.(2)Patients with T2DM were divided into four groups according to BMI,from low to high respectively:B1<18.5 kg/m~2,B2:18.5 kg/m~2-23.9 kg/m~2,B3:24 kg/m~2-27.9 kg/m~2,B4?28 kg/m~2?(3)Patients with T2DM were divided into four groups according to SUA,from low to high respectively:Q1?245.0umol/L,Q2:245.1umol/L-295.5 umol/L,Q3:295.6 umol/L-353.0 umol/L,Q4?353.1 umol/L?Results:1.The basic clinical characteristics of patients of T2DM:Systolic blood pressure(SBP),diastolic blood pressure(DBP),HbA1C,gamma-glutamyl transpeptidase(GGT),triglycerides(TG),total cholesterol(TCH),low-density lipoprotein cholesterol(LDL-C),blood urea nitrogen(BUN)and the incidence of fatty liver was significantly higher in patients with T2DM than those in the NC group.SUA and high-density lipoprotein cholesterol(HDL-C)was lower in T2DM group than that in NC group(P<0.05).Age,duration of diabetes,TCH,LDL-C,HDL-C in male patients with T2DM was lower than that in female(P<0.05).BMI,DBP,C-peptide,GGT,creatinine(CRE),BUN,TG and the incidence of smoking in males patients with T2DM was higher than those in females(P<0.05).2.The level of SUA in T2DM patients:The SUA level in T2DM group was lower than that in NC group(P<0.05).Patients with T2DM has a higher incidence of HUA than NC group(P<0.05).The level of SUA and the incidence of HUA in females were lower than those in males(P<0.05).(1)SUA of patients with T2DM were classified according to HbA1C.The SUA level and HUA prevalence were highest in G1 group and lowest in G4 group,respectively(P<0.05),SUA level and HUA incidence decreased from G1 group to G4 group(P<0.05)?Pearson correlation coefficient analysis showed that SUA was negatively correlated with HbA1C(r=-0.237,P=0.046)in G1group;whether or not confounding factors were adjusted,there was no correlation between SUA and HbA1C in G2 group(P>0.05);after adjustment for age,gender,blood pressure,blood lipid,BMI,the duration of T2DM,SUA was negatively correlated with HbA1C(r=-0.183,P=0.042)both in group 3 and 4.(2)SUA level and HUA incidence were lowest in B1 group and highest in B4 group(P<0.05).SUA level and HUA incidence increased from B1 group to B4 group(P<0.05).Pearson correlation coefficient analysis results showed that after adjustment for age,gender,blood pressure,blood lipid,BMI,the duration of T2DM,SUA was positively correlated with BMI in every group.3.Clinical characteristics of patients with T2DM according to SUA:BMI,C-peptide,GGT,CRE,BUN,cystatin C,retinol binding protein(RBP),TG,TCH,DBP,smoking,hypertension(HBP)and the incidence of fatty liver were lowest in Q1 group,and were highest in Q4 group(P<0.05).These indexes increased from Q1 group to Q4group in turn(P<0.05).Age and HDL-C were highest in Q1 group and were lowest in Q4 group(P<0.05).These indexes decreased from Q1 group to Q4 group in turn(P<0.05).4.Incidence of macroangiopathy in patients with T2DM:Carotid intima media thickness(CIMT)and the incidences of carotid artery lesion,carotid plaque and LLAL in T2DM group were higher than those in NC group(P<0.05).5.Relationship between SUA and macroangiopathy as well as albuminuria in patients with T2DM:(1)The incidences of carotid artery lesion,carotid plaque and LLAL in Q1 group and Q4 group were significantly higher than those in Q2 group and Q3 group(P<0.05).There was no statistical difference in CIMT among the four groups(P>0.05).There was no statistical difference in the incidences of carotid artery lesion,carotid plaque and LLAL between Q1 group and Q4 group(P>0.05);There was also no statistical difference in the incidences of carotid artery lesion,carotid plaque and LLAL between Q2 group and Q3 group(P>0.05).(2)Urinary albumin-creatinin ration(UACR)and the incidence of albumin urine were lowest in Q1 group and were highest in Q4 group(P<0.05).The indexes increased from Q1 group to Q4 group in turn(P<0.05).6.Correlation between SUA and other parameters in T2DM patients:after adjustment for age and gender,partial correlation analysis exhibited that SUA was positive to BMI,SBP,DBP,GGT,C-peptide,TG,TCH,CRE,BUN,RBP,cystatin-C,and was negative correlated to HbA1C and HDL-C(P<0.05).7.Logistic regression was performed to find the independent risk factors of HUA,which showed that gender,DBP,BMI,HDL-C,hypertension and smoking history were risk factors of HUA.Conclusions:1.The control of blood glucose is seriously poor and the prevalence of HUA,carotid artery lesion,carotid plaque as well as LLAL are high in hospitalized patients with T2DM.2.The SUA level of T2DM patients is affected by the blood glucose level,and the relationship between SUA and HbA1C is not consistent with different blood glucose control levels.3.A“U”-shaped curve was presented between SUA level and the incidence of macroangiopathy.Patients with low SUA level and high SUA level have higher incidence of macroangiopathy,while,patients with intermediate SUA level have lower incidence of macroangiopathy.High uric acid level is a risk factor for albuminuria in patients with T2DM.Therefore,reasonable control of SUA level may reduce the occurrence of macroangiopathy and albuminuria in T2DM patients. |
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