尿酸與第二型糖尿病腎病變相關性探討

The Relationship between Uric Acid and Type II Diabetic Nephropathy

林佩靜(Pei-Ching Lin)

指導教授 ： 曾博修

中山醫學大學/醫學院/生化暨生物科技研究所/碩士(2011年)

摘要

糖尿病中以第二型糖尿病為最常見之類型，約佔全世界糖尿病之90%。當患者發現其罹患第二型糖尿病時，通常已有明顯蛋白尿現象，最終導致患者腎功能衰竭而須洗腎。洗腎病人不僅對其生活品質造成極大影響，亦消耗龐大的國家醫療資源。我們嘗試評估不同等級尿酸值之個體與第二型糖尿病腎病變之關係，希望在尿蛋白出現前，另尋可供為早期警訊的危險因子。本研究將慢性腎衰竭腎功能指標（BUN，Creatinine，GFR）、尿酸（UA）、尿液白蛋白alb(u)、受試者之性別、年齡，分別使用相關性、卡方檢定及線性迴歸分析等，探討尿酸與糖尿性腎病變之間的關連性。經皮爾森卡方檢定（Pearson chi-square）交叉分析結果發現，研究中發現腎功能指標(BUN，Creatinine，GFR)與尿酸具有相關性(P＜0.01)，再分別比對第二型糖尿病組與糖尿病洗腎組，也皆具有相同的情形，經由線性迴歸分析得知尿酸確實為糖尿病的危險因子。性別分組分析及尿酸與性別間之交互作用檢定發現，尿酸對糖尿病腎病變不論男女性皆有顯著影響。綜合分析結果，證實尿酸為糖尿病腎病變死亡之預測因子。

關鍵字

腎病變 ； 腎絲球過濾率 ； 尿酸 ； 糖尿病

並列摘要

Type 2 diabetes (T2D) is the most common type of diabetes, comprises 90% of diabetes patients all over the world. T2D patients usually accompany albuminuria when they are diagnosed and eventually lead to renal failure. Hemodialysis patients are not only great change in quality of life and consume a large amount of national medical resources. We try to estimate the relationship between different level of uric acid and nephropathy in T2D and discuss if the uric acid can be a predictor for early stage nephropathy in T2D before albuminuria. To evaluate the association between uric acid and diabetic nephropathy, the renal function index (BUN, creatinine and GFR), uric acid, alb (u), sex and age were analyzed by Pearson correlation coefficient, Pearson chi-square test and regression analysis in this study. The results of Pearson chi-square test indicate that the correlation between uric acid and renal function index (BUN, creatinine and GFR) are significant and the results are the same in the group of T2D and group of T2D with hemodialysis. The results of regression analysis indicate that uric acid is an independent risk factor for diabetes mellitus.Gender analysis and uric acid group and the interaction between gender test found that uric acid on diabetic nephropathy not significantly affect male and female.These results suggest that uric acid is an independent predictor for T2D.

並列關鍵字

nephropathy ； GFR ； uric acid ； Diabetes

參考文獻

diagnosis and classifycation of diabetes mellitus;

23.行政院衛生署，代謝症候群防治手冊，2007

30.行政院衛生署國民健康局，修正我國代謝症候群之判定標準，

Association between serum uric acid and some

38.蔡詩力，高尿酸血症與蛋白尿相關性的探討，2005。