吴晓丹, 郑裕彬, 刘小翠, 胡郁刚, 李帆. 代谢指标联合心脏彩超对糖尿病伴高尿酸血症的心脏功能受损评估及预后[J]. 心脏杂志, 2022, 34(5): 557-561, 572. DOI: 10.12125/j.chj.202111010
    引用本文: 吴晓丹, 郑裕彬, 刘小翠, 胡郁刚, 李帆. 代谢指标联合心脏彩超对糖尿病伴高尿酸血症的心脏功能受损评估及预后[J]. 心脏杂志, 2022, 34(5): 557-561, 572. DOI: 10.12125/j.chj.202111010
    Xiao-dan WU, Yu-bin ZHENG, Xiao-cui LIU, Yu-gang HU, Fan LI. Evaluation and prognosis of impaired cardiac functions in diabetic patients with hyperuricemia by metabolic index combined with cardiac color Doppler echocardiography[J]. Chinese Heart Journal, 2022, 34(5): 557-561, 572. DOI: 10.12125/j.chj.202111010
    Citation: Xiao-dan WU, Yu-bin ZHENG, Xiao-cui LIU, Yu-gang HU, Fan LI. Evaluation and prognosis of impaired cardiac functions in diabetic patients with hyperuricemia by metabolic index combined with cardiac color Doppler echocardiography[J]. Chinese Heart Journal, 2022, 34(5): 557-561, 572. DOI: 10.12125/j.chj.202111010

    代谢指标联合心脏彩超对糖尿病伴高尿酸血症的心脏功能受损评估及预后

    Evaluation and prognosis of impaired cardiac functions in diabetic patients with hyperuricemia by metabolic index combined with cardiac color Doppler echocardiography

    • 摘要:
        目的  探讨代谢指标联合心脏彩超对2型糖尿病(T2DM)伴高尿酸血症(HUA)的心脏功能受损及预后。
        方法  选择2019年2月~2021年9月广东省潮州市人民医院诊治的T2DM患者100例和T2DM合并HUA患者100例。分析两组间一般临床资料、代谢指标及心脏指标。采用多因素Logistic回归分析筛选影响糖尿病合并HUA及糖尿病并发症患者的相关危险因素,采用ROC曲线分析代谢指标及心脏指标对T2DM合并HUA的预测价值。
        结果  与T2MD组比较,T2DM合并HUA组体质量指数(BMI)(P<0.01)、收缩压(SBP)(P<0.01)、舒张压(DBP)(P<0.05)、三酰甘油(TG)(P<0.01)、低密度脂蛋白胆固醇(LDL-C)(P<0.05)、肌酐(SCr)(P<0.01)、尿酸(UA)(P<0.01)、尿素氮(BUN)(P<0.01)、尿白蛋白/肌酐比(UACR)(P<0.01)水平明显升高,高密度脂蛋白胆固醇(HDL-C)水平明显下降(P<0.01);与T2MD组比较,T2DM合并HUA组舒张期室间隔厚度(IVST)、左心室心肌重量(LVM)、左心室心肌重量指数(LVMI)、相对室壁厚度(RWT)值明显升高(P<0.01),左心室射血分数(LVEF)明显下降(P<0.01);多因素Logistic回归分析提示,BMI、TG、Scr、LVEF、LVM和LVMI是发生T2DM合并HUA患者的独立危险因素(P<0.05);ROC曲线分析,BMI、Scr、LVEF、LVM和LVMI对T2DM合并HUA具有诊断价值(P<0.05),其中LVM的诊断价值最大,曲线下面积(AUC)最大;多因素Logistic回归分析提示,BMI、TG、SCr、LVEF、LVM、LVMI是影响糖尿病白蛋白尿患者的独立危险因素(P<0.05);TG、UA、SCr和LVM是影响糖尿病周围神经病变的独立危险因素(P<0.05);TG、UA、SCr、LVM和LVMI是影响糖尿病视网膜病变的独立危险因素(P<0.05)。
        结论  血脂、肾功能等代谢指标和心室肥厚心脏指标异常与糖尿病合并HUA及糖尿病并发症相关,为该病的诊治提供重要参考依据。

       

      Abstract:
        AIM  To investigate the effect of metabolic indexes combined with color Doppler echocardiography on cardiac function impairment and prognosis in diabetic patients with hyperuricemia.
        METHODS  We selected 100 patients with T2DM and 100 patients with T2DM combined with HUA who were diagnosed and treated in the People's Hospital of Chaozhou City, Guangdong Province from February 2019 to September 2021. The general clinical data, metabolic indicators and cardiac indicators between the two groups were analyzed. Multivariate logistic regression analysis was used to find the risk factors in diabetic patients with HUA and complications, and ROC curve was used to analyze the predictive value of metabolic and cardiac indicators for T2DM with HUA
        RESULTS  Compared with those in T2MD group, the T2DM combining with HUA group had significantly higher body mass index (BMI) (P<0.01), systolic blood pressure (SBP) (P<0.01), diastolic blood pressure (DBP) (P<0.05), triglyceride (TG) (P<0.01), low density lipoprotein cholesterol (LDL-C) (P<0.05), creatinine (SCR) (P<0.01), uric acid (UA) (P<0.01), urea nitrogen (BUN) (P<0.01) and urinary albumin/creatinine ratio (UACR) (P<0.01) ,but lower high density lipoprotein cholesterol (HDL-C) (P<0.01). In addition, the T2DM combining with HUA group had significantly higher diastolic ventricular septal thickness (IVST), left ventricular myocardial mass (LVM), left ventricular myocardial mass index (LVMI) and relative wall thickness (RWT) in T2DM combined with Hua group increased significantly (P<0.01), and the left ventricular ejection fraction (LVEF) decreased significantly (P<0.01) compared to those in T2MD. Multivariate logistic regression analysis showed that BMI, TG, SCR, LVEF, LVM and LVMI were independent risk factors for T2DM patients with HUA(P<0.05). ROC curve analysis showed that BMI, SCR, LVEF, LVM and LVMI had diagnostic value for T2DM complicated with HUA (P<0.05). Multivariate Logistic regression analysis showed that BMI, TG, SCr, LVEF, LVM and LVMI were independent risk factors for diabetic albuminuria (P<0.05). TG, UA, SCr and LVM were independent risk factors for diabetic peripheral neuropathy (P<0.05). TG, UA, SCr, LVM and LVMI are independent risk factors for diabetic retinopathy (P<0.05).
        CONCLUSION  Abnormal metabolic indexes such as lipid and renal functions and abnormal cardiac indexes of ventricular hypertrophy are associated with diabetes complicated with HUA and diabetic complications, providing important reference for the diagnosis and treatment of this disease.

       

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