| ObjectiveWith the development of modern economy and changes of people' s dietary patterns and life style,population of hyperuricemia rised constantly,morbidity of gouty arthritis,gout stones and gouty nephropathy incidence increased year by year caused by high uric acid,which made hugeness harm to the human health.In recent years,study found that hyperuricemia was closely related with high serum glucose,hypertension,high lipids and other metabolic diseases,and became one of the important components of metabolic syndrome.Research have shown that hyperuricemia is an independent risk factor for cardiovascular disease.A series of inflammatory factors and adipokines may be an important link in the metabolic disorder of hyperuricemia.This study intends to observe the changes of serum APN?NO and MCP-1?TNF-??IL-6 levels in hyperuricemia patients and effect of compound Tufuling granules(CGT)on it,try to discuss the pathogenesis of hyperuricemia and the mechanism of CGT from the perspetive of adipokines and inflammatory factors,so as to provide theoretical basis for the prevention and treatment of hyperuricemia,and to provide a new way whether uric acid lowering therapy can prevent metabolic syndrome and related components.MethodsPart 1:Select 60 patients with hyperuricemia and 36 people with non hyperuricemia from the health examination center.Clinical data of two groups were collected,the serum levels of APN,MCP-1,IL-6 and TNF-a were detected by ELISA in two groups,Serum NO level was detected by nitrate reductase method.The changes of the two groups were compared,the influence factor of hyperuricemia and the correlation between SUA and each index and the correlation between serum APN,MCP-1 and NO were analyzed.Part 2:60 patients with hyperuricemia were randomly divided into experimental group and control group(n = 30).The control group was given health education and low purine diet;While the experimental group were given CGT with 10g,2 times a day on the base of control group.A total of 3 months of treatment.The changes of SUA,APN,MCP-1,NO,IL-6,TNF-a and metabolic indexes were compared between the two groups before and after treatment.ResultsPart 1:1.Relationship between hyperuricemia and metabolic syndrome.Compared with non high uric acid group,hyperuricemia group BMI,WC,WHTR,TG,TC levels were significantly increased(P<0.05 or P<0.01),The proportion of hyperuricemia combining with high blood lipid,hypertension,central obesity and diabetes increased significantly(P<0.05 or P<0.01).Univariate analysis showed that SUA was significantly correlated with BMI,WHTR,TG,HT,central obesity,the difference was statistically significant(P<0.05 or P<0.01).Two classification and regression analysis showed that hyperuricemia was closely related to central obesity,hypertension,high blood lipid,and high blood sugar,the risk coefficient of hyperuricemia who suffer from thoses dieases is 4.466,3.365,2.373,3.719 times.2.Relationship between SUA and serum APN.Compared with non high uric acid group,the serum APN expression in hyperuricemia group was significantly lower,the difference was statistically significant(P<0.01);multiple regression analysis showed that serum APN was negatively correlated with SUA(P<0.01),which may be an important factor affecting SUA.3.Relationship between inflammatory factors MCP-1,TNF-a,IL-6,NO and hyperuricemia.The serum levels of MCP-1,IL-6 and TNF-a in patients with hyperuricemia were higher than those in non hyperuricemia group,The serum levels of NO was lower than that in non hyperuricemia group,the difference was statistically significant(P<0.01 or P<0.05);Univariate analysis showed that MCP-1,TNF-a and SUA were positively correlated(?=0.645,0.217,P<0.01 or P<0.05),NO was negatively correlated with SUA(?=-0.218,P<0.01);Multiple regression analysis showed that MCP-1,NO are important factors in the incidence of hyperuricemia(?=0.594,-0.297,P<0.05).4.Correlation between APN,MCP-1,NO,TNF-and IL-6.Correlation analysis showed that APN were negatively related to MCP-1,TNF-a(P<O.05 or P<0.01),was positively correlated with NO(P<0.01);MCP-1 was negatively correlated with NO(P<0.05)while positively correlated with TNF-a(P<0.05);TNF-a was positively correlated with IL-6(P<0.05).5.Relationship between hyperuricemia and renal function.Compared with non hyperuricemia group,the hyperuricemia group Cys C levels were significantly increased(P<0.01).Two groups of CREA,BUN did not show significant difference(P>0.05).Univariate analysis showed that Cys C was positively correlated with SUA(P<0.01).Part 2:1.Comparison of SUA levels in two groups after treatment.SUA levels in the two groups were lower than those before treatment(P<0.05 or P<0.01),the level of SUA in the experimental group was significantly lower than that in the control group(P<0.01).2.Effect of CGT on serum APN.Compared with before treatment,the experimental group after treatment,APN was significantly increased(P<0.01),the control group did not find significant changes,APN increased significantly in the experimental group than the control group after treatment(P<0.01).3.Effects of CGT on MCP-1,TNF-a,IL-6,NO.Compared with before treatment,the expression of MCP-1,TNF-a and IL-6 in the experimental group were significantly decreased,the expression of NO was significantly increased(P<0.05 or P<0.01),MCP-1 and TNF-a level of the control group have a downward trend,but no statistical difference;Compared with the control group,MCP-1?TNF-a and IL-6 were significantly decreased in the experimental group,NO level was significantly increased(P<0.05 or P<0.01).4.Effect of CGT on lipid metabolism.Compared with before treatment,the experimental group TG,TC decreased significantly after treatment(P<0.05 or P<0.01),HDL-C significantly increased(P<0.01),LDL-C no significant change(P>0.05).The level of TG in experimental group was significantly lower than that of control group(P<0.05),and the level of HDL-C was significantly higher(P<0.05).5.Effect of CGT on renal function.After treatment,the experimental group Cys C level dropped significantly,compared with before this treatment,compared with the control group were statistically significant(P<0.01).There was no significant difference between the two groups before and after treatment with CREA and BUN(P>0.05).Conclusions1.Hyperuricemia is closely related to the components of metabolic syndrome.There is a disorder of glucose and lipid metabolism in patients with hyperuricemia,The risk of hyperuricemia associated with central obesity was significantly higher than that of other metabolic factors.2.APN may be directly or indirectly involved in the occurrence and development of hyperuricemia,it is a protective factor for uric acid and other energy metabolism.It may be the intermediate link between hyperuricemia and central obesity.3.Hyperuricemia is closely related to inflammatory factors MCP-1,TNF-a,IL-6 and NO.MCP-1,TNF-a,IL-6 may be involved in the oxidative stress induced by uric acid,the decrease of NO level is a protective factor of uric acid metabolism disorder.It is suggested that hyperuricemia is a chronic low-grade inflammatory disease.As a link between various kinds of metabolic diseases,inflammatory factors play an important role in the pathogenesis of hyperuricemia and metabolic diseases.4.Cys C may be a sensitive indicator of early renal damage in uric acid associated nephropathy,inflammatory factors may play an important role in it.5.CGT has obvious effect of reducing uric acid,which can directly or indirectly increase the level of serum APN and NO in patients with hyperuricemia,reduce the level of MCP-1,TNF-? and IL-6,improve glucose and lipid metabolism disorder,has anti-inflammatory and anti oxidative stress effects.CGT has a good advantage in the primary prevention of patients with hyperuricemia and metabolic syndrome.The increase of adiponectin level may be one of the mechanisms of reducing blood uric acid and preventing metabolic diseases of CGT.6.The protective effect of CGT on renal function could be proved by reducing the expression of Cys C. |
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