| Objective:To explore the risk factors of gout in patients with type 2 diabetes mellitus and screen metabolic markers of gout and hyperuricemia in type 2 diabetes mellitus by metabolomic analysis,so as to achieve the goal of early prevention,early detection and early treatment.Method:Patients with type 2 diabetes mellitus,type 2 diabetes mellitus with hyperuricemia and type 2 diabetes mellitus with gout hospitalized in the Department of Endocrinology and Metabolism,Bethune First Hospital,Jilin University,from January 2018 to August 2018 were selected.All patients met the diagnostic criteria of diabetes put forward by WHO in 1999,gout and hyperuricemia developed by American Rheumatology Society in 1977.All subjects were divided into three groups.There are 33 patients of type 2 diabetes mellitus with gout,31 patients of type 2 diabetes mellitus with hyperuricemia and 33 patients of type 2 diabetes mellitus(control group).A total of 97 subjects recorded their age,sex,smoking history,drinking history,hypertension,hyperlipidemia history,course of diabetes mellitus and treatment plan,and calculated BMI,WHR and other related physical examination data.Fasting blood glucose,C-peptide 0,glycosylated hemoglobin,aspartate aminotransferase,alanine aminotransferase,BUN,creatinine,cystatin C,retinol binding protein,uric acid,CO2 binding capacity,LDL,HDL,TG,cholesterol,apolipoprotein a1,apolipoprotein b,small lipoprotein a,white blood cells,,absolute value of monocytes,thyrotropin,FT3,FT4,high-sensitivity Creactive protein,sugar chain antigen 125,cytokeratin 19 fragment,24-hour urinary protein,24-hour urinary microalbumin,24-hour uric acid and other laboratory indicators were sent for metabolomics detection.The final data were analyzed by SPSS22.0 software.Result:(1)There were 32 male patients and 1 female patient in gout group.There were 26 males and 5 females with hyperuricemia.There were significant differences in sex between gout group and hyperuricemia group compared with the control group(P < 0.05).Male was the dominant group and postmenopausal female was the dominant group.(2)The duration of diabetes mellitus in gout group was shorter than that in control group and hyperuricemia group(P < 0.05),the proportion of smoking history was higher in gout group than that in control group(P < 0.05),and the proportion of drinking history was higher in gout group than that in control group(P < 0.05).(3)The absolute value of creatinine,monocyte,uric acid,C-peptide 0 in gout group and hyperuricemia group were higher than those in control group(P < 0.05).The levels of triglyceride,cystatin C,r-Glutamyltransferase and apolipoprotein B in gout group were higher than those in control group(P < 0.05).The differences of leukocyte and alkaline phosphatase between hyperuricemia group and control group were systematic(P < 0.05).Academic significance(P < 0.05).(4)Cytokeratin 19 was lower in gout group than in simple hyperuricemia group(P < 0.05),and sugar chain antigen 125 was higher in gout group than in simple hyperuricemia group and control group(P < 0.05).(5)C2 was significant difference between the gout group and the control group(P < 0.05),which could be used as a diagnostic index and had a low positive correlation with uric acid;Orn/Cit in the simple hyperuric acid group had a significant difference compared with the control group(P < 0.05),and had a low negative correlation with uric acid;The difference of C14:1/C16 between gout group and simple hyperuricemia group was significant(P < 0.05).Conclusion:(1)Alkaline phosphatase,absolute value of monocytes,ornithine/citrulline may be associated with hyperuricemia in type 2 diabetic patients;CA125 may be associated with gout in type 2 diabetic patients;CA125 and HOMA-IR may be associated with gout in type 2 diabetic patients with hyperuricemia.(2)Acetyl carnitine(C2),myristenyl carnitine/palmitoyl carnitine(C14:1/C16)may be used as diagnostic indicators for type 2 diabetes mellitus with gout. |
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