| Background:Diabetes mellitus(DM)is a common chronic disease in clinic.With the development of the times and the continuous change of people’s living standards,the number of patients at home and abroad has increased sharply,and the prevalence rate has increased year by year,especially in patients with type 2 diabetes.With the progress of diabetes and the occurrence of chronic complications,it is related to more use of medical services,higher hospitalization rate,premature death and high cost of medical services.Is a global public health problem.Related literature studies have pointed out that hyperuricemia is closely related to the occurrence and development of diabetes,hypertension,coronary heart disease,ischemic cerebrovascular disease,chronic kidney disease and other diseases.Early prevention and treatment is very important.Objective:To study the relationship between clinical characteristics and the incidence of cardiovascular risk factors in patients with type 2 diabetes mellitus complicated with hyperuricemia,to explore the correlation with carotid intima-media thickness,and to clarify the predictive value of risk factors of carotid atherosclerosis.to provide reference for early clinical monitoring,prevention and health care.Method:1.A total of 350 patients with type 2 diabetes and 51 healthy outpatients were collected from the endocrinology department of our hospital from January 2019 to February 2020.According to the inclusion and exclusion criteria,350 patients with type 2 diabetes and 51 healthy outpatients were divided into high uric acid group(HUA group,n=136)and normal uric acid group(NUA group,n=214)according to the level of serum uric acid.2.The general data of the subjects,including age,sex and the course of diabetes,were recorded,height and weight were measured,and body mass index(Bodymassindex,BMI)=weight(kg)/height(m~2)was calculated.3.After fasting for 8-10 hours at night,the elbow venous blood was collected in the morning,and the serum was separated and determined by Hitachi7600 automatic biochemical analyzer:Fasting plasma glucose(FPG),serum uric acid(SUA),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),glycosylated hemoglobin(Hb A1C),homocysteine(HCY),Serum creatinine(SCr),Blood urea nitrogen(BUN)were collected.According to the results of color Doppler echocardiography,the IMT was measured by ultrasonic diagnostic apparatus in our hospital.According to the CIMT value of carotid intima-media thickness,the patients were divided into two groups:no carotid intima-media thickening group(CIMT<1.0mm)and carotid intima-media thickening group(CIMT≥1.0 mm).4.The data were processed by SPSS23.0 statistical software,and the measurement data were expressed by mean±standard deviation(x±S).Independent sample t-test was used for inter-group comparison,single-factor analysis of variance was used for multi-group comparison,and Pearson or Spearman analysis was used for related factors.The rate of counting data(%)showed that x2 test was used for comparison between groups,and Logistic stepwise regression method was used for multivariate analysis,and the difference was statistically significant when P<0.05.Result:1.350 eligible patients with type 2 diabetes mellitus were included in this study,Among them,the number of HUA group was 136(38.9%),the number of),NUA group was 214(61.1%).The results showed that compared with the NUA group,Age[(59.5±9.98)years VS(55.12±11.0)years]、Course of diabetes mellitus[(8.46±5.42)years VS(3.30±3.45)years]、BMI[(24.80±3.31)kg/m~2VS(23.32±3.68)kg/m~2]、TG[(2.58±1.70)mmol/L VS(2.01±1.41)mmol/L]、BUN[(6.40±2.71)mmol/L VS(5.01±1.75)mmol/L]、SCr[(101.71±50.73)umol/L VS(70.56±26.38)umol/L]、CIMT[(0.93±0.13)mm VS(0.65±0.15)mm]、HCY[(14.10±6.27)mmol/L VS(12.26±6.54)mmol/L]The levels were significantly increased(p<0.05 or 0.01),and the difference was statistically significant.meanwhile HDL-C[(0.95±0.25)mmol/L VS(1.16±0.36)mmol/L],The level of uric acid was lower than that of normal uric acid group(p<0.05).No difference was observed in FBG,TC,LDL-C,Hb A1C and sex between the two groups.In addition,compared with NUA group,the incidence of HUA increased with age and body weight(p<0.05).2.The analysis of the level and incidence of CIMT between the HUA group and the NUA group showed that compared with the NUA group,the average level of CIMT(0.93 mm vs 0.65 mm P<0.05),CIMT thickening rate(61%VS3.7%P<0.001),with the increase of SUA level,CIMT thickening showed an upward trend,the proportion was higher than that of the NUA group.3.Analysis of influencing factors between carotid intima-media thickness and clinical indexes,Results CIMT and age(r=0.395,p<0.001)、Course of diabetes mellitus(r=0.589,p<0.001)、BUN(r=0.289,p<0.001)、SCr(r=0.345,p<0.001)、TG(r=0.119,p<0.027)、SUA(r=0.565,p<0.001)、HCY(r=0.123,p<0.021)Positive correlation,Negative correlation with HDL-C(r=-0.181,p<0.001).No significant correlation was observed with female,BMI,TC,LDL-C,Hb A1c and FPG(P>0.05).4.In multivariate Logistic regression analysis,with or without carotid intima-media thickening as dependent variables,age,course of diabetes,TG,HDL-C,BUN,SCr,HCY,BMI and SUA were taken as independent variables to remove confounding factors.Result Age(β=1.245,OR=3.474,p<0.01)、Course of diabetes mellitus(β=1.616,OR=5.032,p<0.01)、SUA(β=3.287,OR=26.761,p<0.01),It is an independent risk factor for carotid intima-media thickening in patients with type 2 diabetes,that is,long-term course of diabetes,advanced age and hyperuricemia are increased risk of CIMT thickening in patients with T2DM.Conclusions:1.With the increase of age and uric acid level in patients with T2DM,the prevalence rate of CIMT increased.2.The thickness of CIMT in patients with T2DM was positively correlated with age,course of diabetes,HCY,TG,serum creatinine,blood urea nitrogen and SUA,and negatively correlated with HDL-C.3.Long-term course of diabetes,advanced age and hyperuricemia are independent risk factors for CIMT thickening in patients with T2DM. |
