·糖尿病临床研究·

      【摘要】 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24 hUAlb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、2 hPG、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、24 hUAlb、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。

　　【关键词】 儿童;糖尿病，2型：高尿酸血症;胰岛素抵抗;血脂

　　Association study of children type 2 diabetes mellitus with hyperuricemia and insulin resistance，lipid LIANG Xue-jun，GONG Chun-xiu，LIU Ying，et al. Beijing Children’s Hosipital，Capital Medical University，Beijing 100045，China

　　Corresponding auther：GONG Chun-xin，E-mail：chunxiugong@sina.com

　　【Abstract】 Objective To investigate the relationship of T2DM with hyperuricemia in children with insulin resistance and lipid metabolism disorders. Methods A total of 135 children of type 2 diabetes mellitus were selected and divided into two groups：T2DM+HUA group (n=31) and T2DM group(n=104). The relationship of uric acid level with clinical parameters of glycometabolism and lipid metabolism was evaluated. Results (1)The prevalence of hyperuricemia(HUA) in children with T2DM was 23.0%. (2) There was no significant difference in age，duration of disease，systolic and diastolic blood pressure，serum creatinine and 24 hours urinary protein quantitative between the two groups(P>0.05). BMI[(24.55±4.19) vs (29.12±6.17)kg/m2]，the incidence of nigricans acanthosis[22(70.97%) vs 38(36.54%)] and non-alcoholic fatty liver disease [23(71.19%) vs 50(48.08%)] were significantly higher in T2DM+HUA group than in T2DM group (P=0.000，0.001，0.01，respectively).(3) FPG，2 hPG，FIns，FC-P、SUA and TG were significantly higher in T2DM+HUA group than in T2DM group (P=0.003，0.019，0.002，0.000，0.000，0.001，respectively). However，HbA1c，HOMA-IR，HOMA-β，Scr，24 hUAlb，TC，LDL-C and HDL-C were similar in both groups (P>0.05). (4) The uric acid levels in T2DM+HUA group were significantly decreased after 2 weeks treatment of insulin and low purine diet(P=0.001). But the other glucose and lipid metabolism disorders were not significantly improved(P>0.05). Conclusion Children T2DM with HUA have higher insulin resistance and dyslipidemia. The incidence of nigricans acanthosis and non-alcoholic fatty liver disease were significantly higher in T2DM+HUA group than in T2DM group. SUA is decreased after treatment of children T2DM.

　　【Key words】 Children;Diabetes mellitus，type 2;Hyperuricemia;Insulin resistance(IR);Lipid