高尿酸血症对糖尿病肾病患者β细胞功能、肾功能和脂质组的影响:一项基于性别的回顾性研究

Prateek Rajkarnikar, Yancheng Xu, Arun Bhattarai
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The Spearman rank correlation test was used to evaluate the correlation between SUA and other clinical variables. Finally, stepwise multinomial logistic regression test was performed to identify the factors that are independently associated with HUA. Results: A total of 492 patients were included in this study. The regression analysis showed that there was a significant association between HUA and decreased estimated glomerular filtration rate (eGFR) in both male and female patients (odds ratio (OR) [95% confidence interval (CI)] = 4.73 [2.19–10.24], p value ≤0.01 in male patients and OR [95% CI] = 3.07 [], p value = 0.04 in female patients). FBG, 2hPBG, and HbA1c were negatively correlated with SUA in male patients (r = −0.182, p value ≤0.01; r = −0.168, p value ≤0.01; and r = −0.187, p value ≤0.01, respectively), whereas fasting insulin was positively correlated in male patients (r = 0.131, p value = 0.023) and female patients (r = 0.192, p value = 0.041). The atherogenic index of plasma was significantly high in patients with HUA (OR [95% CI] = 5.75 [2.32–14.23], p value ≤0.01 in male patients and OR [95% CI] = 8.37 [1.96–35.78], p value ≤0.01 in female patients). Other indices of lipid profile such as lipoprotein combine index, atherosclerosis index, and triglyceride/high-density lipoprotein ratio were also independently associated with HUA in both male and female patients. Conclusion: SUA can affect various clinical parameters in patients with DKD. There is a significant association between HUA and decline in eGFR in both male and female patients. 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引用次数: 1

摘要

目的:血清尿酸(SUA)与糖尿病肾病(DKD)的发生和进展有关。在这项研究中,我们打算比较高尿酸血症(HUA)对DKD患者β细胞功能、肾功能和脂质面板的影响。方法:选取492例DKD患者进行资料收集和分析。男性和女性的标准SUA水平不同;因此,我们分别对这两组进行分析。正常尿酸血症(NUA)男性(n = 253)≤428 μmol/L,女性(n = 83)≤357 μmol/L, HUA男性(n = 94) >428 μmol/L,女性(n = 62) >357 μmol/L。根据不同性别的NUA和HUA分析患者的临床特征。采用Spearman秩相关检验评价SUA与其他临床变量的相关性。最后进行逐步多项逻辑回归检验,以确定与HUA独立相关的因素。结果:本研究共纳入492例患者。回归分析显示,HUA与男性和女性患者肾小球滤过率(eGFR)降低之间存在显著相关性(优势比(OR)[95%可信区间(CI)] = 4.73[2.19-10.24],男性患者p值≤0.01;OR [95% CI] = 3.07[],女性患者p值= 0.04)。男性患者FBG、2hPBG、HbA1c与SUA呈负相关(r = - 0.182, p值≤0.01;R =−0.168,p值≤0.01;r = - 0.187, p值≤0.01),而男性患者(r = 0.131, p值= 0.023)和女性患者(r = 0.192, p值= 0.041)与空腹胰岛素呈正相关。HUA患者血浆动脉粥样硬化指数显著升高(OR [95% CI] = 5.75[2.32-14.23],男性患者p值≤0.01;OR [95% CI] = 8.37[1.96-35.78],女性患者p值≤0.01)。其他血脂指标如脂蛋白联合指数、动脉粥样硬化指数、甘油三酯/高密度脂蛋白比值也与男性和女性患者的HUA独立相关。结论:SUA可影响DKD患者的各项临床参数。在男性和女性患者中,HUA与eGFR下降之间存在显著关联。HUA还与DKD患者的血脂异常有关,增加心脏并发症和死亡率的风险。
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Effects of Hyperuricemia on Beta-Cell Function, Renal Function, and Lipid Panels of Patients with Diabetic Kidney Disease: A Gender-Based Retrospective Study
Objective: Serum uric acid (SUA) has been linked with development and progression of diabetic kidney disease (DKD). In this study, we intend to compare the effects of hyperuricemia (HUA) on beta-cell function, renal function, and lipid panels of patients with DKD. Methods: A total of 492 patients with DKD were included for data collection and analysis. Males and females have different standard SUA levels; thus, we analyzed these 2 groups separately. Normouricemia (NUA) for men (n = 253) was ≤428 μmol/L and for women (n = 83) was ≤357 μmol/L, whereas HUA for men (n = 94) was >428 μmol/L and for women (n = 62) was >357 μmol/L. Clinical characteristics of patients were analyzed based on gender-specific NUA and HUA. The Spearman rank correlation test was used to evaluate the correlation between SUA and other clinical variables. Finally, stepwise multinomial logistic regression test was performed to identify the factors that are independently associated with HUA. Results: A total of 492 patients were included in this study. The regression analysis showed that there was a significant association between HUA and decreased estimated glomerular filtration rate (eGFR) in both male and female patients (odds ratio (OR) [95% confidence interval (CI)] = 4.73 [2.19–10.24], p value ≤0.01 in male patients and OR [95% CI] = 3.07 [], p value = 0.04 in female patients). FBG, 2hPBG, and HbA1c were negatively correlated with SUA in male patients (r = −0.182, p value ≤0.01; r = −0.168, p value ≤0.01; and r = −0.187, p value ≤0.01, respectively), whereas fasting insulin was positively correlated in male patients (r = 0.131, p value = 0.023) and female patients (r = 0.192, p value = 0.041). The atherogenic index of plasma was significantly high in patients with HUA (OR [95% CI] = 5.75 [2.32–14.23], p value ≤0.01 in male patients and OR [95% CI] = 8.37 [1.96–35.78], p value ≤0.01 in female patients). Other indices of lipid profile such as lipoprotein combine index, atherosclerosis index, and triglyceride/high-density lipoprotein ratio were also independently associated with HUA in both male and female patients. Conclusion: SUA can affect various clinical parameters in patients with DKD. There is a significant association between HUA and decline in eGFR in both male and female patients. HUA is also associated with dyslipidemia in DKD, increasing the risk of cardiac complications and mortality.
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