2 型糖尿病合并高血压的非痛风患者血尿酸水平 与重度冠脉狭窄的相关性研究.

Objective To analyze the clinical characteristics of severe coronary stenosis (SCS) and the relationship between serum uric acid level and the risk of SCS in non-gout patients with type 2 diabetes mellitus (T2DM) and hypertension. To explore the appropriate intervention point for asymptomatic hyperuricemia (HUA) patients with multiple cardiovascular high-risk factors. Methods From Jan 2015 to Dec 2020, 1 417 non-gout patients with T2DM and hypertension who were hospitalized in Zhongshan Hospital, Fudan University and completed coronary computed tomography angiography (CTA) wereretrospectively enrolled. The characteristics of SCS patients and the relationship between serum uric acid level and the prevalence of SCS were analyzed. Results Patients with SCS had higher male proportions, smoking prevalence, systolic blood pressure, and older age. Serum uric acid, glycosylated hemoglobin, triglycerides, low-density cholesterol, erythrocyte sedimentation rate, C-reactive protein, homocysteine acid, and peripheral white blood cell count were all higher. However, there were no significant differences in BMI, fasting blood glucose, and diastolic blood pressure compared with patients without SCS. After adjusting for factors such as age, gender, BMI, systolic blood pressure, glycosylated hemoglobin, triglyceride, low-density cholesterol, and smoking history, the prevalence of SCS was significantly increased when serum uric acid≥430 μmol/L (OR=1.586, P=0.039). The level of serum uric acid was positively correlated with traditional cardiovascular risk factors such as BMI, triacylglycerol and homocysteine. Conclusion Elevated serum uric acid level is associated with increased risk of SCS in non-gout patients with T2DM and hypertension. The control of serum uric acid level in asymptomatic HUA patients need to be stratified according to risk factors, and patients with multiple high-risk factors may require intervention earlier than the current Chinese guidelines recommend (480 μmol/L). More prospective studies are needed to establish the benefits of uric acid-lowering interventions. [ABSTRACT FROM AUTHOR]