The Research On Relationship Between Hyperuricemia And Metabolic Disorders As Well As Related Diseases Of Type2Diabetes Mellitus

Objective:The research is designed to further understand the prevalence of hyperuricemia(HUA) in patients with type2diabetes mellitus (T2DM), explore the correlationbetween HUA and T2DM metabolic disorders as well as related diseases, and analyserisk factors for T2DM complicated with HUA.Methods:According to inclusive and exclusive criteria, in this study we selected threehundred and nine Medicare patients definitely diagnosed with T2DM who were undertreatment in endocrinology department of the Chinese people’s liberation army202thhospital between January2013and December2013. Then a detailed medical historyand numerous observation indexes of every selected patient were collected anddetermined, mainly including age, gender, duration, present medical history, previousmedical history, menstrual history, body mass index (BMI), fasting plasma glucose(FPG), hemoglobin A1c (HbA1c), fasting c-peptide (FC-P),2hour postprandialc-peptide (2hPC-P), homeostasis model assessment-insulin resistance index(HOMA-IR), serum lipid (TC, TG, LDL-C, HDL-C), serum uric acid (SUA), andurinary albumin to creatinine ratio (UACR), etc. Furthermore, the whole chosensubjects were divided into HUA group and NUA group on the basis of SUA levels.Eventually, we conducted a statistic analysis of clinical data of all the selected patients,and meanwhile made a comparative analysis of indexes related to metabolism and the morbidity of other related diseases ofpatients in HUAgroup and NUA group.Results:1. Among three hundred and nine selected Medicare inpatients with T2DM,sixty-nine patients were diagnosed with HUA, accounting for22.33%, and malepatients had a significantly higher incidence rate of HUA than female patients (27.89%verus13.45%, P<0.01). Of one hundred and nineteen female patients, twenty-threewere premenopausal while ninety-six were post-menopausal, respectively accountingfor19.33%and80.67%. The morbidity of HUA in post-menopausal female patientswas slightly higher than that in premenopausal ones, but without statistical significance(13.54%verus13.04%, P>0.05).2. Inpatients with T2DM often suffered from a variety of other diseases. Amongthem, the prevalence rate of diabetic peripheral neuropathy (DPN) was the highest, upto65.70%, and separately the incidence rate of hyperlipidemia, fatty liver,hypertension, coronary heart disease (CHD), diabetic nephropathy (DN), diabeticretinopathy (DR) and cerebral infarction (CI) was58.58%,53.07%,47.57%,29.77%,27.83%,28.16%and8.09%. Furthermore, the incidence rate of hypertension grade3,DN Ⅲ stage and DRⅠstage was30.42%,19.09%and15.21%, respectively, and all ofthem were the highest among different degree or stage of hypertension, DN and DR.3. Compared with NUA group, TG, UACR as well as the prevalence rate ofhyperlipidemia and hypertension of inpatients with T2DM in HUA group were allsignificantly increased while HDL-C was significantly decreased (P<0.01); BMI, FC-P,2hPC-P, TC and the incidence rate of DN were also increased but FPG with HbA1c wasdecreased (P<0.05). Moreover, the risk of hyperlipidemia, hypertension and DN inT2DM patients with HUA was3.554,2.752and1.814times larger than that in T2DMpatients with NUA, respectively. Patients with T2DM in HUA group compared withNUA group, although no significant difference was observed in their age, duration,HOMA-IR, LDL-C as well as the morbidity of fatty liver, CHD, DPN, DR and CI(P>0.05), all of them were still increased except for duration.4. Results of unconditioned logistic regression analysis suggested gender, TG, UACR and history of hypertension was recognized as risk factors for T2DMcomplicated with HUA whereas FPG as a protective factor, which was based on theadjustment of age, BMI, HbA1c, serum lipid (TC, LDL-C, HDL-C), presence of otherdiseases, and other related factors.Conclusion:1. There is a relatively high incidence rate of HUA in inpatients with T2DM. Andthe incidence rate of HUA in male patients is significantly higher than that in femaleones.2. The impacts of HUA on metabolic disorders of T2DM are complicated. Thecorrelation between HUA and lipid metabolic disorders of T2DM is positive while theassociation between HUAand glycemic control situation of T2DM is negative.3. HUA is a risk factor for hypertension and DN in inpatients with T2DM.4. Based on the adjustment of age, duration, BMI, and other related factors, gender,TG, UACR and history of hypertension is identified as risk factors for T2DMcomplicated with HUA, whereas FPG as a protective factor.