| Objective:The objective of this study was to investigate the prevalence of hyperuricemia,the prevalence and incidence of type 2 diabetes mellitus in the middle-aged and elderly population in Nanning,Guangxi,to explore the relationship between hyperuricemia and type 2 diabetes mellitus.Methods:(1)From April 2011 and January 2012,10039 permanent residents aged40 and over were selected from several communities in Nanning and surrounding areas.All residents conducted lifestyle questionnaires,physical examination and blood biochemistry.Excluding the data lack of blood uric acid,fasting blood glucose,2h postprandial blood glucose,finally 8057 people were retained.Then we calculate the prevalence of hyperuricemia and type 2diabetes mellitus,compare the clinical features of hyperuricemia and non-hyperuricemia,and to explore the relationship between hyperuricemia and the prevalence of type 2 diabetes mellitus.(2)From September 2014 to June 2016,a return visit was conducted to thebaseline population with blood biochemical tests.A total of 8,000 people accepted the second survey,and 4476 of them finally completed the blood biochemical examination.The baseline patients with diabetes were further excluded,2645 people were in inclusion at last.Then we calculated the incidence of new-onset type 2 diabetes in the population,and compared the new cases of diabetes between the groups of hyperuricemia,obesity,central obesity,hypertension and dyslipidemia.Besides,we calculated the population attributable risk between the type 2 diabetes and various types of risk factors such as obesity,centrality,hypertension and so on,and analyzed the relationship between hyperuricemia and the onset of type 2 diabetes.Results:1?In the sample survey from April 2011 to January 2012:(1)The prevalence of hyperuricemia in the population over 40 years old in Nanning,Guangxi was 39.1%,the standardized prevalence rate was 38.2%,and the prevalence rate of male standardization was higher than that of females(46.1% vs 33.5%,P<0.001).The prevalence of type 2 diabetes mellitus was19.2%,the standardized prevalence rate was 18.1%,and the prevalence of male standardization was higher than that of females(20.6% vs 16.7%,P <0.001).With the increase of age,the prevalence of hyperuricemia and type 2 diabetes mellitus were gradually increased.(2)The hyperuricemia group had higher fasting insulin,fasting blood glucose,2h postprandial blood glucose,glycosylated hemoglobin and diabetes prevalence than non-hyperuricemia group(P<0.05).(3)In the glucose metabolism group,the blood uric acid level was the lowest in the normal blood glucose group(P<0.05),but there was no significantdifference in the blood uric acid level between the glucose tolerance group and the type 2 diabetes mellitus group(P>0.05).(4)In the Spearman correlation analysis,the blood uric acid in the diabetic group was negatively correlated with fasting blood glucose and 2 h postprandial blood glucose(r=-0.084?-0.051,P<0.05),positively correlated with insulin(r=0.195,P<0.05),and had no significant correlation with glycated hemoglobin(r=-0.038,P>0.05).(5)In the multivariate logistic regression analysis,hyperuricemia was not significantly associated with type 2 diabetes(OR=1.07,P>0.05).In the multivariate logistic regression analysis of hyperuricemia and abnormal glucose metabolism,hyperuricemia was an independent risk factor for abnormal glucose metabolism(OR=1.364,P<0.05).2?In the follow-up survey from September 2014 to June 2016:(1)After an average follow-up of 3.5 years,the cumulative number of diabetes mellitus in 2645 people was 282,the incidence density was 28.9/1000person-years,the male incidence density was 32.8/1000 person-years,and the female incidence density was 27.0/1000 people.There was no significant difference in the incidence between males and females(P>0.05).The incidence of diabetes was higher in older age,lower education,hyperuricemia,obesity,central obesity,dyslipidemia,hypertension,and impaired glucose regulation(HR=1.19,P<0.05).(2)In the single factor COX regression analysis,hyperuricemia was a risk factor for type 2 diabetes(HR=1.35,P<0.05).However,after adjusting for confounding factors,hyperuricemia was not associated with type 2 diabetes(HR=1.19,P>0.05).The main risk factors for diabetes were obesity(HR=1.60,PAR=7.5%),central obesity(HR=1.50,PAR=14.9%)and hypertension(HR=1.89,PAR=23.7%).Conclusion:(1)In 2011,the standardized prevalence of hyperuricemia in the population aged 40 and over in Guangxi Nanning was 38.2%,and the standardized prevalence of type 2 diabetes was 18.1%.(2)From 2011 to 2016,the incidence density of type 2 diabetes in people aged 40 and over in Guangxi Nanning was 28.9/1000 person-years.(3)Hyperuricemia was an independent risk factor for impaired glucose regulation.Hyperuricemia may be associated with type 2 diabetes,but in hyperglycemia,it may mask true blood uric acid levels.(4)The effect of hyperuricemia on the onset of diabetes may be less severe than other influencing factors,but for patients with hyperuricemia,intervention should be performed as soon as possible.(5)The risk factors for type 2 diabetes are obesity,central obesity,and hypertension.If these risk factors are removed,7.5%,14.9%,and 23.7% of diabetes can be prevented. |
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