| Objective: To study the relationship between serum uric acid concentration and carotid intima-media thickness in type 2 diabetic patients,to explore the effect of different levels of uric acid on the formation of early carotid artery lesions,and to elucidate the predictive value of the risk factors of carotid artery disease,in order to find the early detection of carotid atherosclerosis in patients with type 2 diabete s mellitus,Guidance for diagnosis and prevention.Methods: The type 2 diabetic patients who were hospitalized in the endocrine division of our hospital in January 2016 and June 2017 were collected and analyze d in 473 cases of type 2 diabetes mellitus in strict accordance with the inclusion e xclusion criteria.Record the patient's sex,age,the results of diabetes course,smoki ng and drinking history,dietary habits,past medical history,medication history,hei ght,weight,blood pressure,blood glucose and blood lipid,glycosylated hemoglobin(HbA1c),renal function,serum uric acid(SUA)and carotid artery ultrasonography were measured according to the CIMT value of carotid intima-media thickness,Th e patients were divided into carotid vascular lesion Group(cimt<1.0mm)and caroti d artery lesion Group(cimt?1.0mm).Results processing using SPSS21.0 statistical software,the statistical methods mainly have independent sample t test,single factor variance analysis or nonparametric rank and test to compare the general clinical da ta and CIMT level of each group;the difference of the incidence of carotid artery lesions among different groups was compared by using the card-square test.Single Factor Correlation analysis(Pearson or Spearman)analysis of the related influencin g factors of CIMT;After correcting the confounding factors,the risk factors of carotid artery lesions were screened by logistic regression model,and the p<0.05 differ ence was statistically significant.Results: 1,473 patients with type 2 diabetes who would be included in the st udy were divided into uric acid <251 umol/l,251-298 umol/l,298-348.5 umol/l,?348.5 umol/l four groups according to the four-digit spacing of their blood UA lev el.With the increase of blood UA level,the proportion of men and drinkers in eac h group increased gradually,while diastolic pressure,BMI,TG,urea nitrogen and c reatinine level increased with the increase of blood UA,while FPG,HbA1 C,hdl-c,EGFR level decreased progressively,The differences between the four groups were statistically significant(p<0.05).There was no statistically significant difference in age,diabetes course,proportion of smokers,systolic pressure,TC,ldl-c level among four groups(p>0.05).2,The female CIMT level was slightly lower than that of men,but compared between the two groups,there was no significant difference between the CIMT le vels(p>0.05).The CIMT level increased with age and uric acid level,and the diff erence between groups was statistically significant(p<0.05).In addition,with the in crease of diabetic course,the CIMT level showed a higher trend,but there was no statistically significant difference between groups(p>0.05).3,In the study of 473 patients with type 2 diabetes mellitus,there were 149 c ases of carotid intima-media thickening.It was found that the incidence of carotid artery lesions was statistically significant(p<0.05)among different genders,different age groups,different diabetes course and different levels of uric acid.The incidenc e of carotid artery lesions in males is higher than that of women,and the higher t he age,the longer the course of diabetes and the more uric acid level,the greater the risk of carotid artery disease.4,Single-factor correlation analysis of serum uric acid and carotid intima-media thickness showed that serum UA level was positively correlated with CIMT(r=0.219,p<0.01).In addition,age,diabetes course,systolic pressure,CRP,urea nitrogen,creatinine,and glutathione were also positively correlated with CIMT,while EGFR was negatively correlated with CIMT and had statistically significant(p<0.05).5,In multivariate logistic regression analysis,after adjusting the age,diabetes c ourse,systolic pressure,CRP,urea nitrogen,creatinine,eG FR,and glutathione confo unding factors,the results showed that elevated uric acid was an independent risk f actor for carotid artery disease(or=1.004,95 %ci:1.001-1.008,p =0.006).Conclusion: In patients with type 2 diabetes,the level of serum uric acid is p ositively correlated with carotid intima-media thickness,and elevated uric acid is an independent risk factor for carotid artery lesions,which may be a biochemical ind ex for predicting early peripheral vascular lesions in patients with type 2 diabetes mellitus. |
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