Correlation Research About Serum Uric Acid In Patients With Type 2 Diabetes And Diabetic Kidney Disease

Objective:The main research direction is the correlation between serum uric acid (SUA) level and type 2 diabetic kidney disease (DKD) in progression, determine whether SUA to conduct an independent pathogenic factor for type 2 DKD, while exploring related prevention and treatment methods.Methods:Collected 86 subjects from september 2013 to september 2014 at the First Hospital of Lanzhou University Nephrology inpatient treatment, and fully comply with the trial inclusion criteria,50 males and 36 females, the clinical diagnosis of all primary type 2 diabetes (T2DM). Urinary albumin excretion rate (UAER) and (or) 24-hour urine protein (PRO) for grouping criteria, the subjects were divided into 3 groups in accordance with the standards. Normal albuminuria group (NAU), enrolled 34 patients (19 men,15 women); microalbuminuria group (MAU), enrolled 32 patients (18 men,14 women); macroalbuminuria group (MAAU), enrolled 20 patients (13 men,7 women). The subgroup grouping criteria according to whether SUA and glomerular filtration rate (eGFR) in normal, detail recorded and verified the necessary test information, all subjects performed physical examination, telled them the correct sampling methods, followed the steps for the collection and inspection of blood and urine samples; maked data consolidation and statistical analysis for clinical and laboratory test results, explored the relationship about SUA level and proteinuria occur, eGFR level in type 2 DKD patients.Results:1. Compared difference among the 3 groups, only gender variable is not statistically significant (χ2=0.505, P>0.05), all other variables have statistically difference(P<0.05); clinical parameters compared in 3 groups patients, with the increase of UAER, age, diabetes duration (DD), duration of hypertension (DH), body mass index (BMI), systolic Wood pressure (SBP), diastolic blood pressure (DBP) also upward (P<0.01), laboratory testing indicators of SUA, serum creatinine (Scr), β2-microglobulin (β2-MG), fasting plasma glucose (FPG), mashing hemoglobin (HbA1c), high-sensitivity C-reactive protein (CRP), triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL) and the indicator of UAER are positively correlated (P<0.01), hemoglobin (Hb), albumin (Alb), high density lipoprotein (HDL), eGFR and UAER are negatively correlated (P<0.01). SUA lowest in the NAU group, highest in the MAAU group (P<0.01); eGFR in contrast of 3 groups (P<0.01); the proportion of hyperuricemia (HUA) in 3 groups is inconsistent, MAAU group and MAU group are significantly higher proportion than NAU group (respectively 80% VS 17.6%,53.1% VS 17.6%, all P<0.01).2. On the basis of whether SUA level and eGFR in normal range make parameters compare between subgroups, high uric acid subgroup and eGFR declined subgroup generally show SBP and DBP higher, DD and DH longer, age and BMI higher (P<0.01); SUA, FPG, HbA1c, CRP, TG etc in high uric acid subgroups and eGFR declined subgroup higher (P<0.01), Hb, eGFR etc lower (P<0.01); among the 3 groups with the elevated level of urinary protein, UAER difference increase (5.52<11.02<36.82).3. Significant variables include in the NAU group and MAU group, UAER as the dependent variable, the results of multiple linear regression reveal SUA, TG, CRP, Hb and DBP are influence factors for UAER; meaningful variables select in 2 category Logistic regression, the result of independent risk factors for the appearance of microalbuminuria are SUA and DD in type 2 DKD patients.4. Significant variables include in the NAU group and MAU group, eGFR as the dependent variable, the results of multiple linear regression reveal FPG and SBP are influence factors for eGFR; meaningful variables select in 2 category Logistic regression, the result of independent risk factors for the induce of renal function decline are SUA, TG and HbA1c in type 2 DKD patients.Conclusions:1. SUA and DD are the independent risk factors for the appearance of microalbuminuria in type 2 DKD patients; SUA, TG and HbAjc are the independent risk factors for the induce of renal function decline in type 2 DKD patients;2. Comprehensive analysis consider SUA as an independent pathogenic factor of the type 2 DKD course. Clinical work should strengthen the prevention of the above risk factors, in order to slow the progression of DKD, making the greatest degree of preservation the renal function.