| Objective: To explore the correlation between serum uric acid(SUA)level and left ventricular hypertrophy(LVH)in patients with type 2 diabetic nephropathy(T2DN),so as to further clarify the relationship between SUA and cardiovascular complications.In order to provide a theoretical basis for the early prevention and treatment of complications and the improvement of prognosis in patients with T2 DN.Methods: This study was a single-center retrospective study.The clinical data of202 T2 DN patients hospitalized in Northern Jiangsu People’s Hospital from November2019 to November 2020 were analyzed.The left ventricular myocardial mass index(LVMI)of the patients was calculated first,and the patients were divided into the non LVH group and the LVH groups according to the LVMI results.The general data,biochemical parameters as well as the prevalence of hyperuricemia(HUA)were compared between the two group,and the risk factors for LVH were analyzed by multivariate logistic regression.Then we divided the patients into four groups(I,II,III and IV)according to SUA level using the quartile method,and compared the differences of each indicator of cardiac color ultrasound among the four groups which suggested cardiac structure.And to analyze the effect of different SUA levels on the risk of developing LVH,to further determine the effect of SUA level on LVH.Finally,the receiver operating characteristic curve(ROC)was used to analyze the diagnostic value of SUA level for the development of LVH in patients with T2 DN,and to predict the critical value of SUA when LVH occurred.Results: 1.Comparison of general data,biochemical parameters,and the prevalence of HUA between the non LVH group and the LVH group in 202 T2 DN patients.The average admission systolic blood pressure,SUA,serum creatinine,blood urea nitrogen and cystatin C of the LVH group were higher than those of the non LVH group,while the average admission heart rate,hemoglobin and estimated glomerular filtration rate(e GFR)of the LVH group were lower than those of the non LVH group,with statistical significance(P < 0.05).Meanwhile,compared with the non LVH group,the proportion of female patients in the LVH group and the prevalence of hypertension were higher,with statistical significance(P < 0.05).The prevalence of HUA in the LVH group was 54.55%,and that in the non LVH group was 27.22%.The LVH group had a significantly higher prevalence of HUA than the non LVH group,with statistically significant differences between groups(P = 0.002).2.Multivariate logistic regression analysis suggested that high admission systolic blood pressure and high SUA level were risk factors for the development of LVH in T2 DN patients,and high e GFR level was protective factor for LVH.3.According to SUA level,the patients were divided into four groups by quartile method,and the echocardiographic indexes of different SUA level groups were compared.The average LVMI of the four groups were 79.90 ± 14.04 g/m2,89.14 ±17.20 g/m2,94.81 ± 15.78 g/m2,96.83 ± 17.45 g/m2,respectively.With the increase of SUA level,the average LVMI of the four groups showed a significant upward trend,with significant differences.Meanwhile,with the increase of SUA level,the left atrial diameter(LAD),left ventricular end diastolic diameter(LVDD),left ventricular end systolic diameter(LVSD),interventricular septum thickness(IVST),left ventricular posterior wall thickness(PWT)and aortic root diameter(AAO)also showed an increasing trend,while the left ventricular ejection fraction(LVEF)showed a decreasing trend,with statistical significance between the groups(P < 0.05).4.Risk analysis of different SUA levels on LVH: SUA<284 umol/L was used as the control group.Compared with the control group,the risk of LVH in SUA > 439 umol / L group(OR=5.162,95% CI 1.284-20.762,P=0.021)was 5.162 times higher than that in the control group(P < 0.05).When SUA was between 352-439 umol/L,compared with the control group,patients tended to develop LVH(OR=2.66,95%CI0.639-11.071),but at this time,P value was not significant(P=0.179).The risk of LVH increased with the increase of SUA level.5.ROC analysis showed that the area under the curve(AUC)of SUA predicting LVH was 0.685(P = 0.001).SUA had a certain value in predicting the occurrence of LVH.When SUA was greater than 361.65umol/l,the risk of LVH would increase.Conclusions: There was a correlation between serum uric acid level and left ventricular hypertrophy in patients with type 2 diabetic nephropathy.High level of uric acid was an independent risk factor for left ventricular hypertrophy.Serum uric acid may directly participate in the pathophysiological process of ventricular remodeling and then cause left ventricular hypertrophy. |
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