| BackgroundWith the prolongation of type 2 diabetes,patients may be accompanied by chronic microvascular complications.Diabetic retinopathy(DR)is one of the common microvascular diseases of diabetes and the main cause of blindness in the working population.Previous studies have found that the course of disease,blood glucose,blood pressure,and lipids are risk factors for diabetic retinopathy,and it is important to find other risk factors that may cause diabetic retinopathy and to conduct intervention treatment.Studies have shown that serum uric acid is closely related to diabetes and its chronic complications.In recent years,the research on diabetic retinopathy and uric acid has also attracted much attention.ObjectiveTo investigate the correlation between retinopathy and serum uric acid levels in patients with type 2 diabetes.MethodsA retrospective analysis of 680 patients with type 2 diabetes admitted to the Endocrinology Department of the Third Affiliated Hospital of Southern Medical University from January 2018 to May 2019.All included subjects underwent fundus photographic examination and laboratory examination.According to the results of fundus photography,patients were divided into diabetic retinopathy group(DR group)and non-diabetic retinopathy group(NDR group).The biochemical parameters and the prevalence of hyperuricemia were compared between the two groups.The risk factors of DR were analyzed by univariate and multivariate Logistic regression.According to the uric acid level,the patients were divided into ?,?,?,and ?groups according to the quartile method.The prevalence of DR in the four groups was compared.Logistic regression analysis was performed with different levels of serum uric acid,further analysis of the influence of different uric acid levels in the DR.The receiver operating characteristic curve(ROC)analysis was used to predict the critical value of uric acid.ResultsPatients in the DR group had higher uric acid,age,course of disease,SBP,BUN and Scr than those in the NDR group,while eGFR was lower than that in the NDR group,with statistically significant differences(P<0.001).There were no statistical differences in DBP,BMI,total cholesterol,triglycerides,HDL,LDL,HbAlc,fasting C peptide,and fasting blood glucose between the two groups of patients(P>0.05).The prevalence of hyperuricemia(HUA)in the DR group was 31.8%,and the prevalence of HUA in the NDR group was 4.6%.The difference in the prevalence of HUA between the two groups was statistically significant,P<0.001.and the difference between the DR group and the NDR group was statistically significant(P<0.001).The overall prevalence of DR in serum uric acid group ??? was statistically significant(P<0.001).With the increase of serum uric acid level,the prevalence of diabetic retinopathy in T2DM patients increased(P<0.001).There was a difference in the overall prevalence of diabetic retinopathy of different severity in the four groups,P=0.03.The trend test showed that the severity of DR increased with the increase of serum uric acid level(P<0.001).Multivariate Logistic regression analysis showed that uric acid,disease course and systolic blood pressure were risk factors for DR in T2DM patients.Logistic regression analysis was conducted with different SUA levels,and it was found that different uric acid levels had different effects on DR.When SUA>was 328?mol/L;it began to have an effect on DR(OR,3.073,95%CI 1.614-5.850,P<0.01),and the risk of DR increased with the increase of SUA level.ROC analysis found that the area under the curve of serum uric acid prediction DR was 0.746(95%CI 0.711-0.778,P<0.0001).When the patient's serum uric acid was>374?mol/L,will increase the risk of diabetic retinopathy.ConclusionsIn this study,serum uric acid levels in patients with type 2 diabetes were associated with diabetic retinopathy,a risk factor for diabetic retinopathy. |
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