Correlation Between Serum Uric Acid Levels And Epicardial Fat Thickness In T2DM Patients

ObjectiveTo study the correlation between different levels of serum uric acid?SUA?)and epicardial adipose tissue?EAT?thickness in patients with type 2 diabetes mellitus?T2DM?,the effects of different levels of SUA on the formation of early thickness of EAT were explored,and its predictive value as a risk factor for thickness lesions of EAT was expounded,with a view to providing theoretical guidance for the early detection,diagnosis and prevention of thickness lesions in T2DM patients clinically.MethodT2DM patients who were admitted to the Department of Endocrinology in the First Affiliated Hospital of Xi'an Medical College from February 2018 to December 2019 were collected.In strict accordance with the criteria of inclusion and exclusion,a total of 491patients with complete data and measuring EAT thickness were included and conducted a retrospective analysis,recording their age,gender,duration of diabetes,weight,body mass index?BMI?,blood pressure,glycosylated hemoglobin?HbA1c?,glucose tolerance test,insulin+C peptide release test,blood lipid,liver function,renal function,EAT thickness ultrasound results and other test indicators.?1?Analyze the collected cases and compare the basic characteristics of male and female patients;?2?According to the EAT thickness values,male and female patients were divided into normal EAT thickness groups?EAT?3.0mm?and increasing EAT thickness groups?EAT>3.0mm?,and compared the differences of SUA and other indicators between the two groups;?3?According to the level of SUA,The 2019 edition of the guidelines for the diagnosis and treatment of hyperuricemia and gout proposes that regardless of male and female hyperuricemia SUA>420umol/L^[1],so patients of different genders were divided into male low SUA group?U1?,normal SUA group?U2?,high SUA group?U3?,and female low SUA group?U4?,normal SUA groups?U5?,high SUA group?U6?,compared the differences in indicators,such as EAT thickness,among three groups of different SUA genders;?4?Pearson or Spearman correlation analysis and Logistic regression analysis further clarified the correlation between the SUA level and EAT thickness in T2DM patients;?5?The ROC receiver working curve was used to determine the threshold levels of SUA for predicting EAT thickness in different genders.ResultThe analysis of the 491 T2DM patients included the following results;1.The general data of male and female patients showed that:?1?male weight?SUA?fasting C peptide?blood urea nitrogen?BUN??serum creatinin?Scr??and triglyceride?TG?were higher than women?P<0.05?;?2?Male's age?duration of disease?2 hours postprandial blood glucose?insulin?and C peptide?globulin?GLOB??total cholesterol?TC?)?high density lipoprotein?HDL??low density lipoprotein?LDL?were lower than female?P<0.05?;?3?Body mass index?BMI?for men and women?systolic blood pressure?SBP??diastolic blood pressure?DBP??EAT?HbA1c?fasting blood-glucose?FPG??fasting insulin?FINS??aspartate aminotransferase?AST??alanine aminotransferase?ALT??and albumin?Albumin,ALB??P>0.05?were no statistically significant difference between the two groups.2.According to SUA level,male and female patients were divided into three groups.?1?Comparison of clinical data between different SUA levels of male showed that weight and EAT thickness gradually increased with the increase of SUA level?P<0.05?.Fasting C peptides was different in between the U1 and U3 groups?U2 and U3 groups,ALB?BUN?Scr showed differences between the U2 and U3 groups?P<0.05?;?2?Comparison of clinical data between different SUA levels of female showed that:EAT thickness,fasting C peptide,BUN,Scr,and TG levels gradually increased with the increase of SUA level?P<0.05?,BMI was different between U5 and U6 groups,and HDL was different between U4 and U6,U5 and U6 groups?P<0.05?;?3?Regardless of male and female,the thickness of EAT is increased with the increase of SUA.3.According to EAT level,male and female patients were divided into two groups.?1?Comparison of clinical data between men with different EAT thickness levels showed that age?SUA?and FINS levels is gradually increased with the increase in EAT thickness?P<0.05?.?2?Comparison of clinical data between female with different EAT thickness levels showed that age and SUA levels is gradually increase with increasing EAT thickness?P<0.05?,and ALB levels is gradually decrease with increasing EAT thickness?P<0.05?.4.Analysis of the correlation between EAT thickness and clinical indicators on male and female patients:?1?male EAT thickness and SUA?r=0.259?,FINS?r=0.302?,GLOB?r=0.143?was a positive correlation?P<0.05?,and a negative correlation with 2 hours postprandial C peptide?r=-0.176?,and ALB?r=-0.187?;?2?According to the correlation analysis of the thickness of female EAT and each clinical indicators,EAT thickness and age?r=0.336?,course of disease?r=0.150?,weight?r=0.182?,BMI?r=0.247?,SBP?r=0.185?,SUA?r=0.295?,HbA1c?r=0.155?,2 hour postprandial blood glucose?r=0.142?,FINS?r=0.245?,2 hour postprandial insulin?r=0.187?,and TG?r=0.220?showed positive correlation?P<0.05?.5.Binary logistic regression analysis of risk factors for EAT thickness was performed on different gender patients.?1?Binary logistic regression analysis of risk factors for EAT thickness on male showed statistically significant differences in age,blood SUA,and FINS?P<0.05?;?2?female EAT binary logistic regression analysis of thickness risk factors showed statistically significant differences in age,SUA,and ALB?P<0.05?.6.The prediction analysis of EAT thickness at different SUA levels showed that male and female SUA levels have predictive value for EAT thickness,that is,when the SUA level corresponding to male is 301umol/L and female is 306umol/L,it has predictive value for the formation of early EAT thickness.Conclusion1.There is a positive correlation between the level of SUA and the thickness of epicardial fat in T2DM patients.2.Increased age and SUA levels are risk factors for thickening of epicardial adipose tissue.3.The SUA level has a certain predictive value for EAT thickness.A slightly higher SUA level in the normal range is helpful for the clinical evaluation of EAT thickness increase in T2DM patients.