The Correlation Between Uric Acid And The Prevalence Of Type 2 Diabetes Mellitus In Patients With Hypertension

BackgroundUric acid(UA)is the end product of purine metabolism.With the improvement of living standards,the incidence of hyperuricemia(HUA)is increasing.HUA is closely related to hypertension(HTN)and diabetes mellitus and plays an important role in the pathogenesis of HTN and diabetes mellitus.HUA is a risk factor for HTN but it is not clear whether and what effect it has on glucose metabolism in patients with HTN.Therefore,it is necessary to study the correlation between UA and the prevalence of HTN with diabetes mellitus.ObjectivesTo study the effect of different UA levels in HTN patients on the prevalence or risk of type 2 diabetes mellitus(T2DM)and analyze their correlation.MethodsHTN patients who were treated in the Department of Cardiology,the second affiliated Hospital of Guangzhou Medical University from January 2018 to December 2019 were selected.The basic data,clinical history and clinical examination data of patients with HTN were collected and analyzed retrospectively.Including UA,sex,age,smoking,T2 DM,T2DM course,HTN course,gout,abdominal circumference,hip circumference,waist-to-hip ratio(WHR),height,weight,body mass index(BMI),heart rate,systolic blood pressure(SBP),diastolic blood pressure(DBP),pulse pressure(PP),mean arterial pressure(MAP),alanine transaminase(ALT),total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL),fasting blood glucose(FBG),serum creatinine(Scr),glomerular filtration rate(GFR).According to whether the combination of hyperuricemia,the patients were divided into hypertension with hyperuricemia group(HUA group)and hypertension with non-hyperuricemia group(non-HUA group);And uric acid were divided into four groups(UA1 group,UA2 group,UA3 group,UA4 group)according to the uric acid quartile for comparison.SPSS22.0 statistical software and GraphEditV10.0 were used to analyze clinical data and draw histograms.The normality of the measurement data was tested by Shapiro-Wilk method,and P>0.05 indicated that the data conform to normal distribution.The measurement data conforming to normal distribution were analyzed by independent sample T test and it used for comparison between groups,which was expressed as mean±standard(`x±s).Mann Whitney U test or chi-square test were used for comparison of measurement data or counting data sets that did not conform to normal distribution and the measurement data of non-normal distribution were expressed by quartile spacing(P25,P75),and the dichotomous variables were expressed by percentage(%).Binary Logistic regression analysis was used to analyze risk factors.Box-Tidwell method was used to test the linear relationship between independent variables and dependent variables.Pearson correlation analysis was used to analyze the correlation of continuous variables with normal distribution,and Spearman correlation analysis was used to analyze continuous variables and classified variables that did not accord with normal distribution and P<0.05 was statistically significant.In the verification of multicollinearity between independent variables,the variance expansion factor(VIF)< 10 or Tolerance > 0.01 indicated that there was no multicollinearity.Results(1)Mann-WhitneyU test showed that there were significant differences in UA,T2 DM,gout,HTN course,abdominal circumference,hip circumference,WHR,body weight,BMI,ALT,TG,Scr and GFR between HUA group and non-HUA group(P<0.05).(2)There was significant difference in the prevalence of HTN with T2 DM between the HUA group and the non-HUA group(c2 = 10.648 P=0.001);there was no significant difference between the UA1 group and the UA2 group(c2=1.796,P=0.18);between the UA1 group and the UA3 group there was a statistically significant difference(c2=8.92,P=0.003);there was a statistically significant difference between the UA1 group and the UA4 group(c2=14.96,P<0.001).There was no significant difference between UA2 group and UA3 group(c2=2.783,P=0.095),but there was significant difference between UA2 group and UA4 group(c2=6.309,P=0.012).There was no significant difference between the UA3 group and the UA4 group(c2=0.705,P=0.401).(3)Binary Logistic regression analysis showed that HUA was a risk factor for HTN with T2 DM and for every 1?mol/L increase in UA,the risk of T2 DM increases by 1.006 times(P=0.010).Regression analysis in the quartile of UA showed that the risk of HTN with T2 DM in UA3 group was 2.408 times higher than that in UA1 group(P = 0.043)and the risk of HTN with T2 DM in UA4 group was 3.097 times higher than that in UA1 group(P=0.038).(4)Spearman correlation analysis showed that UA,the course of HTN,hip circumference,WHR,FBG,abdominal circumference,BMI,TC,sex and the UA of UA4 group were positively correlated with HTN with T2DM(P<0.05)and he higher level of UA,the greater correlation coefficient.UA was positively correlated with WHR,BMI,TG,metabolic syndrome(MS)and T2DM(P<0.05).(5)There was significant difference in the prevalence of T2 DM between HUA group and non-HUA group in MS patients(c2=36.816,P<0.001).Conclusion(1)In HTN patients,UA had a significant influence on the prevalence of T2 DM,which gradually increased with the increase of UA level.(2)HUA is a risk factor for T2 DM in HTN patients and the risk of T2 DM increases with the increase of UA level.There was no statistically significant difference in the risk of T2 DM in HTN patients with normal UA level.