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題名 | 第二型糖尿病老年患者血清尿酸與代謝參數、腎功能及發炎指標之相關性=Correlation of Serum Uric Acid with Metabolic Parameters, Renal Function, and Inflammatory Markers in Older Adults with Type 2 Diabetes |
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作者 | 黃瑞華; 盧義發; 陳甫州; 李寧遠; 蔡麗卿; Huang, Jui-hua; Lu, Yi-fa; Cheng, Fu-chou; Lee, Ning-yuean; Tsai, Leih-ching; |
期刊 | 臺灣老年醫學暨老年學雜誌 |
出版日期 | 20120800 |
卷期 | 7:3 2012.08[民101.08] |
頁次 | 頁175-193 |
分類號 | 417.7937 |
語文 | chi |
關鍵詞 | 糖尿病; 尿酸; 代謝參數; 腎功能; 發炎; Diabetes; Uric acid; Metabolic parameters; Renal function; Inflammatory; |
中文摘要 | 目的:許多研究顯示血清尿酸與代謝症候群、腎病變及發炎的發展有關聯, 然而,第2 型糖尿病人血清尿酸與代謝控制、腎病變及發炎之間的關聯仍不明確, 本研究探討第2 型糖尿病老人血清尿酸與代謝控制、腎功能及發炎指標的相關性。 方法:本研究採用橫斷面研究,包括210 位年齡65 歲(含)以上之老年糖尿病 患者,臨床變數測量包括體位測量、血壓及血液與尿液之生化測定,以一般線性 模式分析其血清尿酸與代謝控制、腎功能及發炎指標的關聯性。 結果:在210 位第2 型糖尿病老年患者中,25.2%的患者有高尿酸血症,其中, 女性高尿酸血症盛行率顯著高於男性(31.3% vs. 18.4%),有高三酸甘油酯,中央型 肥胖,高身體質量指數、慢性腎臟疾病、高血清肌酸酐及高血尿素氮的患者,會 有顯著高的血清尿酸值及高尿酸血症盛行率(p<0.05)。此外,具有高敏感性C-反應 蛋白且心血管疾病中至高危險者的高尿酸血症盛行率更高於低危險者(p<0.05)。白 血球計數高的患者,其高尿酸血症盛行率亦較高。經調整干擾因子後,三酸甘油 酯,腰圍,身體指量指數、肌酸酐、尿素氮及高敏感性C-反應蛋白隨著血清尿酸 四分位數的增加而升高(p<0.05)。另外,白血球計數隨著血清尿酸四分位數的增加 而升高(p=0.056)。糖化血色素及估計的腎絲球過濾率隨著血清尿酸四分位數的增 加而較低(p<0.05)。 結論:本研究顯示第2 型糖尿老年病患者血清尿酸與代謝控制、腎功能及發 炎指標有密切關聯,而血清尿酸值上升似可以作為預測糖尿病老年患者肥胖、血 脂異常、心血管疾病及腎功能衰退的生化指標,目前研究已顯示血清尿酸值上升 可能有益於血糖控制,但是機轉不明,尚待進一步探討。 |
英文摘要 | Objective: The present study was to investigate relationships among uric acid, metabolic control, renal function, and inflammatory markers in older adults with type 2 diabetes.Research design and methods: The cross-sectional study was used and included 210 type 2 diabetes patients aged 65 years and above. Clinical variables included anthropometric measurements, blood pressure, and biochemical determinations of blood and urine samples. General linear model was applied to determine the relationships between serum uric acid with metabolic control, and renal function, and inflammatory markers.Results: The high prevalence of hyperuricemia were found in elderly type 2 diabetes patients, in which patients with high triglyceride, central obesity, high body mass index, chronic kidney disease, high serum creatinine, and high blood urea nitrogen had high uric acid levels and hyperuricemia (p<0.05). For high-sensitivity C-reactive protein (hsCRP) levels, the moderate and high risk of patients revealed higher percentage of hyperuricemia than those of the low risk group (p<0.05). Patients with higher white blood cell counts showed significantly higher serum uric acid level and percentage of hyperuricemia than those of lower white blood cell counts (p<0.05). After adjusting confounding factor, triglycerides, waist circumference, body mass index, creatinine, blood urea nitrogen, and hsCRP were significantly higher with increasing quartile of serum uric acid (p<0.05). In addition, white blood cell counts were marginal higher with increasing quartile of serum uric acid (p=0.056). Glycated hemoglobin and estimated glomerular filtration rate were significantly lower with increase quartile ofserum uric acid (p<0.05).Conclusions: Serum uric acid was highly associated with metabolic control, nephropathy, and inflammatory markers in elderly type 2 diabetes patients. In addition, serum uric acid may serve as a potential biomarker for blood dyslipidemia, obesity, cardiovascular disease risk, and renal function decline in elderly type 2 diabetes patients. Although elevated serum uric acid may benefit glycemic control, the mechanisms remain unclear. |
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