| Objective: This study investigated the expression of uric acid(UA)in primary hepatocellular carcinoma(PHC),type 2 diabetes(T2DM),and primary hepatocellular cancer combined with type 2diabetes,and further analyzed the role of UA in it and its biochemistry.The relationship between indicators and tumor markers,so as to provide a basis for the diagnosis and treatment of patients with PHC,T2 DM and PHC combined with T2 DM.Methods: 1.Patients admitted to the physical examination department of our hospital from September2016 to September 2019 were enrolled.2.Divided into four groups according to the history of T2 DM and the history of newly diagnosed PHC: control group,PHC group,T2 DM group,and PHC combined with T2 DM group.3.Collect and record the age,sex,height,weight,and past disease history of the study subjects,and calculate the BMI.4.Roche automatic biochemical analyzer was used to measure blood uric acid(SUA)levels in different groups;Fasting plasma glucose(FPG),fructosamine(FMN)and other glucose metabolism indicators;Liver function indicators such as alanine aminotransferase(ALT)and glutamyl transferase(GGT);Renal function indicators such as blood urea nitrogen(BUN)and creatinine(CR);Total cholesterol(TC)and triglycerides(TG)Isometric lipid metabolism indicators;Full-automatic electrochemiluminescence assay for tumor markers such as alpha-fetoprotein(AFP)and carcinoembryonic antigen(CEA).5.Data processing was performed using SPSS 23.0 software;Comparison of measurement data between groups was performed using analysis of variance;Correlation analysis was performed using Pearson correlation analysis;Influencing factor analysis was performed using logistic regression analysis.Results:1.A total of 200 subjects were included in the subject,including 50 patients with PHC(33/17 male to female ratio),50 patients with T2DM(35/15 male to female ratio),and 50 patients(35/15 male to female)with PHC + T2 DM,50 healthy controls(male to female ratio 24/26).There was no significant difference in sex ratio between the four groups.Compared with the healthy control group,the PHC group was older(52.58 ± 10.763,59.22 ± 10.674)(P <0.001);The BMI of the PHC + T2 DM group and the simple PHC group was lower(27.59 ± 2.61,24.31 ± 2.67,23.74 ± 3.77)(P <0.001).2.Comparison of glucose and lipid metabolism indexes between the four groups: Compared with the control group,the FPG in the combined group and the T2 DM group was higher(4.810.88,8.043.34,8.34 ± 2.63)(P <0.001),higher FMN(192.42±30.73,261.96±92.89,305.68±59.87)(P <0.001),higher TG in the T2 DM group(1.26 ± 0.50,2.40 ± 1.94)(P <0.001),TC in PHC group was lower(4.33 ± 0.81,3.69 ± 0.87),LDL-C was lower(3.69 ±0.87,2.62 ± 0.67)(P <0.05).3.Comparison of liver and kidney function indexes between the four groups:Compared with the control group,ALT in the combined group and PHC group was higher(21.34 ± 17.96,39.42 ± 48.23,39.80 ± 26.30)(P <0.05);AST was higher(17.48 ± 5.70,55.60 ± 64.16,66.08 ± 61.04)(P<0.05).GGT was higher(27.40 ± 24.07,146.90 ± 210.01,147.52 ± 193.46)(P <0.05).Compared with the control group,the ALB of the PHC group and the combined group was lower(41.82 ± 3.39,36.55 ± 5.91,34.89 ± 7.18)(P <0.001);T-Bil was higher(13.11 ± 6.59,21.09 ± 19.73,24.69 ± 17.06)(P <0.05);D-Bil was higher(3.89 ± 1.67,10.16 ± 13.71,12.18 ± 11.48)(P <0.05).I-Bil in PHC group was higher(9.23± 5.10,12.50 ± 7.61)(P <0.05);CO2CP in T2 DM group was lower(25.28 ± 2.23,23.83 ± 2.38)(P<0.05),and BUN in combined group was higher(5.04 ± 1.29,6.67 ± 5.14)(P <0.05);CO2CP in the combined group and PHC group was higher than that in T2 DM group(26.10 ± 3.90,26.40 ± 2.84,25.28 ± 2.23)(P <0.001).4.Comparison of tumor markers between the four groups: Compared with the control group,the AFP in the combined group and the PHC group was higher(2.96 ± 1.42,260.53 ±407.59,414.17 ± 499.14)(P <0.001);And the liver cancer group AFP was higher than the combined group(414.17 ± 499.14,260.53 ± 407.59)(P <0.05).Compared with the control group,the CEA in the PHC group was higher(2.00 ± 2.57,7.76 ± 15.72)(P <0.05),and the CA125 was higher(11.1 ±4.40,54.95 ± 99.17)(P <0.05).CA199 in the combined group was higher(8.57 ± 5.18,147.25 ±274.77)(P <0.05);CA199 in the T2 DM group and PHC group was lower than the combined group(15.99± 10.78,63.41 ± 111.27,147.25 ± 274.77)(P <0.05).5.After eliminating the differences in age and BMI by covariance analysis,the results of covariance analysis of uric acid index between groups showed that compared with the control group,the UA value was higher in the T2 DM group(285.02 ± 75.69,332.06 ± 77.63)(P <0.001),and the PHC group The UA value was lower(285.02 ± 75.69,230.9 ±57.39)(P <0.001);The UA value of the T2 DM group and the PHC combined T2 DM group were higher than the PHC group(332.06 ± 77.63,298.66 ± 153.22,230.9 ± 57.39)(P <0.05)).6.In the T2 DM group,uric acid was positively correlated with FPG,BUN,and CR(r = 0.306,P <0.05;r = 0.281,P <0.05;r = 0.4,P <0.05);In the PHC group,uric acid and BUN And CR were positively correlated(r = 0.373,P<0.05;r = 0.328,P <0.05);Negatively correlated with FPG(r =-0.410,P <0.05);In the PHC combined T2 DM group,uric acid was correlated with BUN and CR And CA125 showed a significant positive correlation(r = 0.650,P <0.001;r = 0.506,P <0.001;r = 0.795,P <0.001).There was a positive correlation with age,TC,and CA124(r = 0.342,P <0.05;r = 0.389,P <0.05;r = 0.447,P <0.05);And a negative correlation with FPG(r =-0.323,P <0.05).7.The results of univariate logistic regression analysis showed that the increase in UA value is a risk factor for T2 DM,and the decrease in UA value is a risk factor for PHC;the increase in gender and FPG is a risk factor for T2 DM,and the increase in age,T-Bil and D-Bil is simple PHC Risk factors,age,T-Bil,D-Bil,BUN,FPG increase are risk factors for PHC combined with T2DM;ALB decline is a risk factor for PHC and PHC combined with T2 DM.8.The results of multivariate logistic regression analysis show that: increased UA is a risk factor for T2 DM,and decreased UA is a risk factor for PHC.The increase of age and T-Bil are the risk factors of PHC and PHC combined with T2 DM,while the decline of ALB is the risk factor of PHC and PHC combined with T2 DM.Conclusion:1.UA increases in T2 DM and decreases in PHC,and its increase may be a risk factor for T2 DM.2.In patients with T2 DM or PHC,it is recommended to detect UA at the same time as blood glucose and tumor markers. |
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