| With the development of economy, the improvement of life quality andthe change of the lifestyle, the prevalence of diabetes mellitus （DM） isincreasing year by year. A survey on the prevalence of diabetes mellitus inChina practiced by Chinese Medical Association Diabetology Branch in2010shew that the incidence of diabetes mellitus among Chinese who were over20years old was9.7%. Furthermore, the incidence of impaired glucose tolerancewas15.5%.One of the prime reasons of death in patients with type2diabetesis macroangiopathy （cardiovascular, cerebrovascular and peripheral vasculardiseases）.The pathogenic mechanism is complex and undefined.Hyperuricemia is a metabolic disease. It is a risk factor and marker ofcardiovascular, metabolic syndrome and diabetes mellitus. Studies have shownthat hyperuricemia is related to the occurrence and the development of themacroangiopathy of type2diabetes mellitus. The incrassation of Intimamedia thickness （IMT） appears earlier than the formation of artery plaque andit is the prior evidence during the process of atherosclerosis and formation ofplaque. IMT has been recognized as a determination index of peripheral arteryatherosclerosis disease.Objective: By means of analyzing the relationship between differentlevels of serum uric acid and carotid intima media thickness in patients withtype2diabetes, discussing the role of uric acid played in the early formationof atherosclerosis and whether there is diversity in patients with differentgender. That can provide guidance for the early detection and prevention oftype2diabetes mellitus.Methods: We collect the patients’ clinical data and information who werediagnosed as T2DM according to the standard of T2DM established by WHO in1999and accepted hospitalization from February2012to February2013.All patients had been taken carotid ultrasound and had complete information.Meanwhile, all patients were excluded the occurrence of acute complicationsin nearly1month and the appearance of glomerular filtration rate （GFR）＜60ml/min. Patients who suffering from other diseases that affect the blood uricacid level, drinking and having high-purine diet recently, using drugs thataffect uric acid metabolism in nearly1month, having serious cardiovascularand cerebrovascular diseases and lung disease were also excluded.（1） Wecollect all patients’general clinical data, including gender, age, duration ofT2DM, past medical history, family history, smoking,alcohol consumping,eating habits, medication history, height, weight, systolic blood pressure,diastolic blood pressure, calculate body mass index（BMI）.（2） Collect allpatients’ fasting blood glucose（FPG）, triglycerides （TG）, total cholesterol （TC）,high density lipoprotein cholesterol （HDL-C）, low-density lipoproteincholesterol （LDL-C）, glycosylated hemoglobin （HbA1C）, serum urea（SUREA）, serum creatinine （SCr） and serum uric acid （SUA）.（3） All patientsaccepted the ultrasound examination of carotid artery by thespecially-assigned person in department of Ultrasound with the same machine.Patients were divided into three groups based on IMT: group A IMT≤0.9mm；group B0.9mm＜IMT＜1.3mm; group C IMT≥1.3mm or the formationof carotid plaque. SPSS17.0was used to analysis the statistics. Measurementdata were expressed as mean number±standard deviation. T test was usedwhen the data followed normal distribution. Meanwhile, the data didn’t follownormal distribution were analyzed by Mann-Whitney rank sum test. Countdata was expressed as percentages （%）, and compared by chi-square test. Usethe univariate logistic regression analysis to screen risk factors of carotidatherosclerosis. p＜0.05meant statistical significance.Results:1105cases were enrolled,49male patients, accounting for46.7%, and56female patients, accounting for53.3%.The mean age of male was56±14years old, mean HDL-C was1.02±0.26mmol/L, ratio of smoking was71%. The mean age of female was64±13years old, mean HDL-C was1.19±0.28mmol/L, ratio of smoking was1.8%. The comparisons of three indicators hadstatistical significance. p＜0.05.2Male patients were divided into groups based on IMT. Age, duration ofgroup B and group C were significantly higher than the control group. Thedifference was statistically significant, p＜0.05. Group C, HDL-C, diastolicblood pressure were lower than the control group, The difference wasstatistically significant, p＜0.05. There was no significant difference amonggroups A, B, C in serum uric acid levels, p＞0.05.3Female patients were divided into groups based on IMT. Age, durationof group B and group C were significantly higher than group A. The differencewas statistically significant, p＜0.05.Meanwhile, uric acid level of group Band group C were significantly higher than group A. The difference wasstatistically significant, p=0.025.4Logistic regression analysis of all patients. Results showed that thecarotid artery lesions （group B and group C as carotid artery lesions） wereassociated with age, course of diseases. Logistic regression analysis of malepatients. Results showed that the carotid artery lesions （group B and group Cas carotid artery lesions） were associated with age, course of disease andsmoking time. Logistic regression analysis of female patients, the carotidartery lesions （group B and group C as carotid artery lesions） were associatedwith age, HbA1C and blood uric acid. Logistic regression analysis further towomen with IMT, Carotid artery IMT is associated with blood uric acid.Conclusion: In the early stage of carotid atherosclerotic lesions （thecarotid intimal thickening stage）, Women with type2diabetes appearedelevated blood uric acid level. In carotid artery plaque formation period, theblood level of uric acid of female patients with type2diabetes significantlyincreased. Such correlation was not found in male patients. Blood uric acidwas an independent risk factor for carotid artery lesions in female patients,prompting blood uric acid levels can be used as a predictive index ofperipheral vascular diseases for female patients with type2diabetes. |
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