Objective: To investigate the relationship between serum uric acid (SUA) levels and high sensitive C-reactive protein (hs-CRP) in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 400 patients who were hospitalized in the Department of Endocrinology and Metabolism of Jinshan Branch, Shanghai Sixth People's Hospital between April 2014 and December 2015 were divided into normouricemia (NUA, n=319) group and hyperuricemia (HUA, n=81) group according to the presence of HUA. Clinical features of the two groups were compared. Patients were further stratified into quartiles based on SUA levels, and then association between hs-CRP and SUA was analyzed. Results: Compared to the NUA group, the patients with HUA had higher hs-CRP concentration [2.12 (1.15, 6.73) mg/L vs 1.14 (0.52, 3.44) mg/L, P<0.001], erythrocyte sedimentation rate (ESR) [19.0 (10.5, 29.5) mm/h vs 12.0 (8.0, 17.0) mm/h, P<0.001], body mass index (BMI) [(25.2±3.6) kg/m(2) vs (23.6±3.6) kg/m(2,) P<0.001], and homeostasis model assessment-2 of insulin resistance (HOMA2-IR) index [1.88 (1.11, 2.94) vs 1.27 (0.77, 2.00), P<0.001]. After adjusting for age, the median level of hs-CRP of female with HUA was higher than that of male, female with NUA, and male with NUA (2.59, 1.94, 1.25 and 1.09 mg/L, respectively, P<0.001). There was significant difference in the prevalence of HUA among the patients with underweight, normal weight, overweight, and obesity (0, 12.3%, 21.6% and 25.8%, respectively, P=0.002). After adjusting for age and gender, duration of diabetes, BMI, serum lipids, level of SUA was still correlated with hs-CRP, HOMA2-IR, fasting C-peptide, blood urea nitrogen, serum creatinine, Cystatin C, microalbuminuria, respectively(all P<0.05). The level of SUA was positively associated with the increase of hs-CRP level (P=0.001). Multiple linear regression analysis showed that there was an independent and positive association between SUA and hs-CRP levels. Conclusion: SUA was independently associated with hs-CRP in T2DM patients, which suggested that chronic inflammation exists in HUA patients.
目的： 探讨2型糖尿病(T2DM)患者血尿酸水平与超敏C反应蛋白(hs－CRP)的关系。 方法： 选取2014年4月至2015年12月在上海市第六人民医院金山分院内分泌代谢科住院的T2DM患者400例。根据是否患高尿酸血症分为正常尿酸(NUA，n＝319)组及高尿酸血症(HUA，n＝81)组，比较两组患者临床特征。再根据血尿酸四分位水平将患者分成4组，分析血尿酸水平与hs－CRP的关系。 结果： HUA组较NUA组有较高的hs－CRP[2.12(1.15，6.73)mg/L比1.14(0.52，3.44)mg/L，P<0.001]、红细胞沉降率[19.0(10.5，29.5) mm/h比12.0(8.0，17.0)mm/h，P<0.001]、体质指数(BMI)[(25.2±3.6) kg/m(2)比(23.6±3.6) kg/m(2)，P<0.001]、稳态模型评估的胰岛素抵抗指数(HOMA2－IR) [1.88(1.11，2.94)比1.27(0.77，2.00)，P<0.001]。校正年龄后HUA组女性的hs－CRP中位数水平(2.59 mg/L)较HUA组男性(1.94 mg/L)、NUA组女性(1.25 mg/L)、NUA组男性(1.09 mg/L)显著升高(P<0.001)。低体重、正常体重、超重、肥胖者HUA患病率分别0、12.3%、21.6%、25.8%，四组间差异有统计学意义(P＝0.002)。相关性分析结果显示，校正性别、年龄、糖尿病病程、BMI、血脂后，血尿酸仍与hs－CRP、HOMA2－IR、空腹C肽、尿素氮、血肌酐、胱抑素C、尿微量白蛋白呈正相关(均P<0.05)。趋势性检验结果显示，随血尿酸水平升高，hs－CRP水平呈升高趋势(P＝0.001)。多重线性回归分析结果显示，血尿酸与hs－CRP水平呈独立正相关(P<0.001)。 结论： 2型糖尿病患者血尿酸与hs－CRP水平独立相关，提示HUA患者存在着慢性炎症状态。.
Keywords: C-reactive protein; Diabetes mellitus, type 2; Uric acid.