Objective To investigate the relationship between serum uric acid ( UA ) level and carotid artery arteriosclerosis in patients with type 2 diabetes mellitus ( T2DM ). Methods Blood glucose, blood lipid, UA, hs - CRP and blood pressure of 347 T2DM patients ( male: 174, female: 173 ) were detected, and the BMI was calculated. High frequency ultrasound was used to detect IMT and plaques. The correlation between the level of UA and carotid artery disease was analyzed. Results ( 1 ) The serum UA levels in men were significantly higher than those in women ( P =0. 007 ). ( 2 ) The subjects of both male and female were divided into 3 groups respectively ( groups A, B and C ) according to carotid artery ultrasonometry IMT ( group A: IMT s; 0.09 mm; group B: 0.09 mm < IMT < 0. 13 mm; group C: IMT≥0. 13 mm or plaques formation). Inwomen, the serum UA levels of group B and group C were significantly higher than those of group A ( P <0. 05 ). But in men, there was no statistically significant difference in the 3 groups ( P > 0. 05 ). ( 3 ) After adjusting for age, duration of diabetes mellitus, HbA,c, smoking, LDL, systolic blood pressure, body mass index, total cholesterol, triglyceride and C -reactive protein ( CRP ), Logistic regression analysis showed that the serum UA level in women was an independent risk factor for carotid artherosclerosis and carotid artery IMT ( P =0.039 ). But in men, no relationship was found between serum UA and carotid artherosclerosis. ( 4 ) Spearman analysis showed that in women, serum UA was positively correlated with TG ( r =0. 390, P = 0. 000 ) and hs - CRP ( r =0. 159, P =0. 036 ), but was negatively correlated with HDL - C ( r = -0. 223 , P =0. 003 ). Serum UA was almost positively correlated with BMI ( r =0. 156, P =0. 051 ). Conclusion Serum UA level is a risk factor for carotid artherosclerosis in women with T2DM. Controlling body weight and improving lipids metabolism disorder may reduce the incidence of hyperuricemia in women.%目的 探讨2型糖尿病患者血尿酸水平与颈动脉硬化的关系.方法 对347例2型糖尿病患者(男174例,女173例)进行血糖、血脂、血尿酸、超敏C反应蛋白(hs-CRP)的测定,测量血压、计算体质指数(BMI);同时用高频超声检查颈动脉内膜中层厚度(IMT)及斑块形成情况,分析血尿酸水平与颈动脉血管病变的相关性.结果 (1)男性患者的血尿酸水平显著高于女性患者(P=0.007);(2)将男女患者分别根据颈动脉血管病变情况分为3组:A组:颈总动脉内膜正常,IMT≤0.09 mm;B组,0.09 mm＜IMT＜0.13 mm,颈动脉内膜增厚组;C组,IMT≥0.13 mm或有斑块形成,颈动脉斑块形成组.女性B、C组患者血尿酸水平显著高于A组(P＜0.05);而男性A、B、C组患者血尿酸水平间差异无统计学意义(P＞0.05).(3)Logistic回归分析显示,在校正年龄、糖尿病病程、糖化血红蛋白、吸烟、低密度脂蛋白等因素后,女性2型糖尿病患者尿酸水平是颈动脉硬化及颈动脉IMT增厚的危险因素;男性尿酸水平与颈动脉硬化无相关性.(4)Spearman相关分析显示,女性患者的血尿酸水平与三酰甘油、hs-CRP呈正相关(P＜0.05),与高密度脂蛋白胆固醇呈负相关(P＜0.01);与BMI相关性接近统计学意义(P=0.051).结论 血尿酸水平是女性2型糖尿病患者颈动脉硬化病变的危险因素.控制体质量和改善脂代谢紊乱,可能会减少女性患者高尿酸血症的发病.
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