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目的探讨儿童T2DM合并高尿酸血症(HUA)与IR、脂代谢异常的关系。方法选取T2DM患儿135例,根据血尿酸(SUA)水平分为T2DM合并HUA组(T2DM+HUA)31例和单纯T2DM组(T2DM)104例,比较两组的临床资料,分析SUA水平与糖、脂参数的关系。结果 (1)T2DM患儿中,HUA的患病率为23.0%。(2)两组年龄、病程、SBP、DBP、Scr和24hUAlb比较,差异无统计学意义(P均>0.05),T2DM+HUA组BMI[(24.55±4.19)vs(29.12±6.17)kg/m2]、黑色棘皮病发生率[22(70.97%)vs 38(36.54%)]及非酒精性脂肪性肝病(NAFLD)发生率[23(71.19%)vs 50(48.08%)]均高于T2DM组(P=0.000、0.001、0.01)。(3)T2DM+HUA组FPG、2hPG、FIns、FC-P、SUA及TG均高于T2DM组(P=0.003、0.019、0.002、0.000、0.000、0.001)。但HbA1c、胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)、Scr、24hUAlb、TC、HDL-C和LDL-C比较,差异无统计学意义(P>0.05)。(4)通过2周胰岛素降糖和低嘌呤饮食治疗后,T2DM+HUA组SUA水平较治疗前下降(P=0.001),而其他糖、脂代谢参数虽比治疗前好转,但差异无统计学意义(P>0.05)。结论与单纯T2DM患儿相比,伴HUA的T2DM患儿IR、血脂异常更显著,发生NAFLD和黑色棘皮病概率更高;T2DM患儿治疗后SUA降低。
Objective To explore the relationship between T2DM with hyperuricemia (HUA) and abnormal IR and lipid metabolism in children. Methods Totally 135 T2DM children were enrolled in this study. According to the level of serum uric acid (SUA), 31 patients with T2DM complicated with T2DM complicated with HUA (T2DM + HUA) and 104 patients with simple T2DM (T2DM) were selected. The clinical data of two groups were compared. , The relationship between fat parameters. Results (1) The prevalence of HUA in T2DM children was 23.0%. (2) There was no significant difference in age, course of disease, SBP, DBP, Scr and 24hUAlb between the two groups (all P> 0.05). The BMI in the T2DM + HUA group was (24.55 ± 4.19) vs (29.12 ± 6.17) kg / ], The incidence of black acanthosis [22 (70.97%) vs 38 (36.54%) and non-alcoholic fatty liver disease (NAFLD), 23 (71.19% vs 50%, 48.08% (P = 0.000, 0.001, 0.01). (3) The levels of FPG, 2hPG, FIns, FC-P, SUA and TG in T2DM + HUA group were higher than those in T2DM group (P = 0.003,0.019,0.002,0.000,0.000,0.001). There were no significant differences in HbA1c, HOMA-β, HOMA-IR, Scr, 24hUAlb, TC, HDL-C and LDL-C between the two groups (P> 0.05). (4) After two weeks of insulin hypoglycemic and hypoglycemic diet, the level of SUA in T2DM + HUA group was lower than that before treatment (P = 0.001), while the other parameters of glucose and lipid metabolism were better than those before treatment, but the difference was not statistically significant Significance (P> 0.05). Conclusion Compared with T2DM children, T2DM children with HUA had more abnormal IR and dyslipidemia, and had a higher probability of developing NAFLD and black acanthosis. T2DM children had lower SUA after treatment.