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目的:探讨基线血尿酸(SUA)水平对糖尿病人群新发心脑血管事件以及全因死亡的预测价值。方法:采用前瞻性队列研究方法,以参加2006年7月至2007年10月健康查体的101 510名开滦集团职工中空腹血糖≥7.0 mmol/L或<7.0 mmol/L但已确诊为糖尿病,正在使用降糖药物的人群(8 306例)作为观察对象,随访1~53(47.38±5.12)个月,随访期间每半年收集1次新发心脑血管事件情况。按基线SUA水平分为高尿酸血症组及非高尿酸组,分析基线SUA水平对糖尿病人群新发心脑血管事件的影响。结果:(1)高尿酸血症组患者心脑血管死亡事件发生率、全因死亡发生率较非高尿酸组增加,差异有统计学意义;(2)多变量COX比例风险回归分析表明校正年龄、性别、TC、TG、HDL-C、SBP、DBP、BMI及吸烟史后,基线水平高尿酸血症组发生心脑血管死亡事件、全因死亡事件的风险分别是非高尿酸组的2.46倍(95%CI:1.40~4.33,P<0.05)和1.72倍(95%CI:1.19~2.50,P<0.05)。结论 :基线SUA水平可预测糖尿病人群发生心脑血管死亡事件及全因死亡事件;SUA水平较高者发生上述事件的危险增加。
Objective: To investigate the predictive value of baseline serum uric acid (SUA) level in new-onset cardiovascular events and all-cause mortality in diabetic population. Methods: A prospective cohort study was conducted in 101 510 Kailuan workers who participated in the health checkup from July 2006 to October 2007 with fasting blood glucose ≥7.0 mmol / L or <7.0 mmol / L but had been diagnosed with diabetes (8,306 cases) who were taking hypoglycemic drugs were enrolled in this study. Patients were followed up for 1 ~ 53 (47.38 ± 5.12) months. New cardiovascular and cerebrovascular events were collected every six months during the follow-up period. According to baseline SUA level, patients were divided into hyperuricemia group and non-hyperuricemia group, and the effect of baseline SUA level on new-onset cardiovascular and cerebrovascular events in diabetic population was analyzed. Results: (1) The incidence of cardiovascular death and all-cause mortality in patients with hyperuricemia were significantly higher than those in patients without hyperuricemia (2) Multivariate COX proportional hazards regression analysis showed that the adjusted age , Risk of all-cause deaths were 2.46-fold higher than those in non-hyperuricemia patients (P <0.05), and gender, TC, TG, HDL-C, SBP, DBP, BMI and smoking history 95% CI: 1.40-4.33, P <0.05) and 1.72-fold (95% CI: 1.19-2.50, P <0.05). CONCLUSIONS: Baseline SUA levels predict cardiovascular events and all-cause mortality in diabetic subjects; higher SUA levels are associated with an increased risk of these events.