Relationship between Serum Uric Acid Levels and Kidney Arteriole Resistance in Patients with Type 2 Diabetes Associated with Hypertension

摘要

Objectives To investigate the relationship between serum uric acid levels and arteriole resistance detected with the color Doppler energy imaging (CDEI) and to explore the risks of impaired regulation of vascular tone by uric acid in kidneys of hypertension patients. Methods In 12 healthy control cases, 28 non-diabetic hypertension(nNIDDM+H) cases and 25 type 2 diabetic hypertension (NIDDM+H) cases, uric acid (UA) levels were measured with uricase-peroxidase method.Arteriole resistance index (RI) and pulsate index (PI) in separate sections of renal artery included MAR,SRA, IRA were detected using CDEI with 2.1-4.2Hz Doppler transducer in kidneys. Results In comparison,UA was significantly higher in non-diabetic hypertension group and diabetic hypertension group than in control group (P<0.01, separately). UA levels was also significantly higher in NIDDM+H group than in nNIDDM+H, P<0.029. RI in separate sections of renal artery was significantly higher in nNIDDM+H, or NIDDM+H group than in control group (all P<0.01),and it was significantly higher in NIDDM +H that nNIDDM+H groups (P<0.05 and P<0.01). In nNIDDM +H and NIDDM +H groups UA levels and RA-RI could be elevated significantly following with the impaired heart function being aggravated (x^2=13.028, P=0.005, x^2=13.29, P=0.004); the dosage of HCT being increased (x^2=14.216, P=0.001, x^2=14.661, P=0.001); the levels of GHbA1 being excessed unnormally (P=0.000). The correlation between UA and IRA-RI in both hypertension groups were directly related, in nNIDDM+H group r=0.842, P=0.000, in NIDDM+H group, r=0.797, P=0.000. Conclusions Uric acid levels and IRA-RI in hyper-tension patients were directly related. Uric acid levels and IRA-RI could be partly dependent on the severity of heart dysfunction, diuretic dose, and serum glucose status of diabete patients in long-term. Uric acid and the xanthine oxidase metabolic pathway may contribute to impaired regulation of arteriole tone in hypertension patients.