Relationship between serum uric acid level and Framingham 10-year risk of coronary heart disease in patients with type 2 diabetes mellitus

doi:10.3877/cma.j.issn.2095-655X.2022.03.001

Abstract

Abstract:

Objective

To investigate the relationship and significance of serum uric acid (UA) level and the Framingham 10-year risk of coronary heart disease in patients with type 2 diabetes mellitus (T2DM).

Methods

904 patients with T2DM who were admitted to the Department of Endocrinology, Ninth People′s Hospital (North Hospital) , Shanghai Jiaotong University School of Medicine, from August 2015 to December 2017 were chosen, the serum UA levels and Framingham 10-year risk of coronary heart disease between men and women with T2DM were compared. Patients were divided into 4 groups based on quantiles of serum UA level, Framingham 10-year risk of coronary heart disease, and other indicators were compared. T2DM patients were divided into low-risk group, medium-risk group and high-risk group based on their Framingham risk scores for 10-year coronary heart disease, and serum UA levels and other indicators in each group were compared and analyzed. The risk factors for coronary heart disease in the Framingham 10-year were investigated using Logistic regression.

Results

Men with T2DM had higher serum UA levels [340.00(287.00, 393.00)μmol/L] and a higher Framingham 10-year coronary heart disease risk [20(13, 31)%] than women [305.00(255.00, 365.50)μmol/L, 15(10, 20)%], and the differences were statistically significant (Z=-6.22, -7.01, all P<0.01). Based on serum UA level quartiles, Framingham 10-year coronary heart disease risk was 15(8, 20)%, 16(10, 20) %, 20(13, 25) %, and 20(13, 31)% from group 1 to group 4, respectively. Patients with higher serum UA levels had a significantly higher 10-year risk of coronary heart disease (P<0.05). Patients in the higher Framingham 10-year risk groups had significantly higher serum UA levels (P<0.05). According to a Logistic regression analysis, serum UA level was an independent factor in the Framingham 10-year risk of coronary heart disease (P=0.022, OR=1.003, 95%CI: 1.000-1.006).

Conclusion

Serum UA level is an independent factor in Framingham 10-year risk of coronary heart disease in patients with T2DM, at the same time, serum UA level is positively associated with the Framingham 10-year risk degree of coronary heart disease in T2DM.

Key words: Diabetes mellitus, type 2, Framingham risk score, Coronary heart disease, Uric acid

Kuanping Ye, Hua Li, Xiaowen Ma, Xiaoyan Liu, Fengling Chen. Relationship between serum uric acid level and Framingham 10-year risk of coronary heart disease in patients with type 2 diabetes mellitus[J]. Chinese Journal of Diagnostics(Electronic Edition), 2022, 10(03): 145-151.

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Figures/Tables 4

References 27

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组别	例数	血尿酸(μmol/L)	十年冠心病发生风险(%)
男性	559	340.00(287.00，393.00)	20(13，31)
女性	345	305.00(255.00，365.50)	15(10，20)
Z值		－6.22	－7.01
P值		<0.01	<0.01

组别	例数	血尿酸(μmol/L)	十年冠心病发生风险(%)
男性	559	340.00(287.00，393.00)	20(13，31)
女性	345	305.00(255.00，365.50)	15(10，20)
Z值		－6.22	－7.01
P值		<0.01	<0.01

项目	总计(n＝904)	组1(n＝227)	组2(n＝226)	组3(n＝226)	组4(n＝225)	统计量	P值
性别(男，%)	559(61.84)	105(46.26)	133(58.85)^a	157(69.47)^a	164(72.89)^ab	χ²＝41.43	0.000
吸烟史(例，%)	361(39.93)	68(29.96)	88(38.94)	94(41.59)	111(49.33)^a	χ²＝18.06	0.000
并发症史(例，%)	765(84.62)	186(81.94)	189(83.63)	200(88.50)	190(84.44)	χ²＝4.04	0.257
年龄[岁，M(P₂₅，P₇₅)]	57(48.00，63.00)	57(47.00，63.00)	58(49.25，64.00)	56(48.00，63.00)	55(46.00，63.00)	Z＝3.44	0.329
病程[年，M(P₂₅，P₇₅)]	7(2，11)	6(2，10)	7.5(2，13)	7.5(3，13)	7(2，13)	Z＝3.96	0.266
收缩压[mmHg，M(P₂₅，P₇₅)]	137(126.00，150.00)	135(121.50，145.50)	131(122.00，144.00)	138(129.00，150.25)^ab	140(129.00，154.00)^ab	Z＝19.04	0.000
舒张压[mmHg，M(P₂₅，P₇₅)]	82(77.00，90.00)	80(74.00，88.50)	80(75.25，88.00)	85(79.00，90.25)^ab	83(78.00，90.00)^ab	Z＝26.51	0.000
体重指数[kg/m²，M(P₂₅，P₇₅)]	25.06(23.03，27.78)	23.34(21.91，25.81)	25.26(23.12，27.36)^a	25.56(23.74，28.03)^a	26.85(24.22，29.70)^abc	Z＝75.13	0.000
空腹血糖[mmol/L，M(P₂₅，P₇₅)]	8.50(6.90，10.80)	8.5(6.75，11.70)	8.15(6.45，10.48)	8.5(6.90，10.90)	8.3(6.80，10.20)	Z＝5.32	0.150
糖化血红蛋白[%，M(P₂₅，P₇₅)]	8.80(7.40，10.10)	9.4(8.10，10.75)	8.85(7.40，10.18)	8.8(7.40，10.20)	8.4(7.30，9.60)^abc	Z＝17.24	0.001
甘油三酯[mmol/L，M(P₂₅，P₇₅)]	1.61(1.09，2.39)	1.38(0.88，2.06)	1.51(1.08，2.09)	1.6(1.16，2.59)^ab	2.01(1.43，3.03)^ab	Z＝66.11	0.000
总胆固醇[mmol/L，M(P₂₅，P₇₅)]	4.88(4.16，5.75)	4.78(4.12，5.78)	4.85(4.06，5.57)	5.06(4.30，5.85)	4.88(4.23，5.91)	Z＝6.89	0.075
高密度脂蛋白胆固醇[mmol/L，M(P₂₅，P₇₅)]	1.09(0.93，1.30)	1.16(1.00，1.39)	1.09(0.95，1.32)^a	1.07(0.91，1.28)^a	1.03(0.88，1.20)^ab	Z＝44.64	0.000
低密度脂蛋白胆固醇[mmol/L，M(P₂₅，P₇₅)]	2.87(2.29，3.50)	2.84(2.31，3.57)	2.94(2.24，3.47)	3.03(2.44，3.62)	2.85(2.30，3.51)	Z＝2.37	0.499
总胆红素[μmol/L，M(P₂₅，P₇₅)]	13.30(10.40，16.85)	13.5(9.80，17.75)	13.1(10.60，16.90)	13.75(10.98，16.85)	13(10.20，16.10)	Z＝1.93	0.587
直接胆红素[μmol/L，M(P₂₅，P₇₅)]	2.30(1.80，3.00)	2.30(1.80，3.10)	2.40(1.90，3.08)	2.30(1.90，3.03)	2.20(1.70，2.80)	Z＝2.47	0.481
间接胆红素[μmol/L，M(P₂₅，P₇₅)]	11.00(8.50，13.90)	11.30(7.85，14.65)	10.95(8.75，14.18)	11.30(9.00，14.05)	10.80(8.40，13.30)	Z＝1.96	0.580
血尿素氮[mmol/L，M(P₂₅，P₇₅)]	5.20(4.30，6.20)	4.80(4.00，6.20)	5.20(4.30，6.08)	5.20(4.48，6.13)	5.40(4.40，6.40)^abc	Z＝12.31	0.006
血肌酐[μmol/L，M(P₂₅，P₇₅)]	62(51.00，72.00)	52(46.00，62.50)	59.5(50.00，69.00)^a	63(53.75，72.00)^ab	70(57.00，83.00)^abc	Z＝99.25	0.000
尿白蛋白肌酐比[mg/mmol，M(P₂₅，P₇₅)]	1.32(0.71，5.03)	1.11(0.69，2.43)	1.19(0.69，2.45)	1.23(0.69，5.40)	2.35(0.89，14.14)^abc	Z＝30.24	0.000
十年冠心病发生风险[%，M(P₂₅，P₇₅)]	16(10，25)	15(8，20)	16(10，20)^a	20(13，25)^ab	20(13，31)^ab	Z＝45.67	0.000

项目	总计(n＝904)	组1(n＝227)	组2(n＝226)	组3(n＝226)	组4(n＝225)	统计量	P值
性别(男，%)	559(61.84)	105(46.26)	133(58.85)^a	157(69.47)^a	164(72.89)^ab	χ²＝41.43	0.000
吸烟史(例，%)	361(39.93)	68(29.96)	88(38.94)	94(41.59)	111(49.33)^a	χ²＝18.06	0.000
并发症史(例，%)	765(84.62)	186(81.94)	189(83.63)	200(88.50)	190(84.44)	χ²＝4.04	0.257
年龄[岁，M(P₂₅，P₇₅)]	57(48.00，63.00)	57(47.00，63.00)	58(49.25，64.00)	56(48.00，63.00)	55(46.00，63.00)	Z＝3.44	0.329
病程[年，M(P₂₅，P₇₅)]	7(2，11)	6(2，10)	7.5(2，13)	7.5(3，13)	7(2，13)	Z＝3.96	0.266
收缩压[mmHg，M(P₂₅，P₇₅)]	137(126.00，150.00)	135(121.50，145.50)	131(122.00，144.00)	138(129.00，150.25)^ab	140(129.00，154.00)^ab	Z＝19.04	0.000
舒张压[mmHg，M(P₂₅，P₇₅)]	82(77.00，90.00)	80(74.00，88.50)	80(75.25，88.00)	85(79.00，90.25)^ab	83(78.00，90.00)^ab	Z＝26.51	0.000
体重指数[kg/m²，M(P₂₅，P₇₅)]	25.06(23.03，27.78)	23.34(21.91，25.81)	25.26(23.12，27.36)^a	25.56(23.74，28.03)^a	26.85(24.22，29.70)^abc	Z＝75.13	0.000
空腹血糖[mmol/L，M(P₂₅，P₇₅)]	8.50(6.90，10.80)	8.5(6.75，11.70)	8.15(6.45，10.48)	8.5(6.90，10.90)	8.3(6.80，10.20)	Z＝5.32	0.150
糖化血红蛋白[%，M(P₂₅，P₇₅)]	8.80(7.40，10.10)	9.4(8.10，10.75)	8.85(7.40，10.18)	8.8(7.40，10.20)	8.4(7.30，9.60)^abc	Z＝17.24	0.001
甘油三酯[mmol/L，M(P₂₅，P₇₅)]	1.61(1.09，2.39)	1.38(0.88，2.06)	1.51(1.08，2.09)	1.6(1.16，2.59)^ab	2.01(1.43，3.03)^ab	Z＝66.11	0.000
总胆固醇[mmol/L，M(P₂₅，P₇₅)]	4.88(4.16，5.75)	4.78(4.12，5.78)	4.85(4.06，5.57)	5.06(4.30，5.85)	4.88(4.23，5.91)	Z＝6.89	0.075
高密度脂蛋白胆固醇[mmol/L，M(P₂₅，P₇₅)]	1.09(0.93，1.30)	1.16(1.00，1.39)	1.09(0.95，1.32)^a	1.07(0.91，1.28)^a	1.03(0.88，1.20)^ab	Z＝44.64	0.000
低密度脂蛋白胆固醇[mmol/L，M(P₂₅，P₇₅)]	2.87(2.29，3.50)	2.84(2.31，3.57)	2.94(2.24，3.47)	3.03(2.44，3.62)	2.85(2.30，3.51)	Z＝2.37	0.499
总胆红素[μmol/L，M(P₂₅，P₇₅)]	13.30(10.40，16.85)	13.5(9.80，17.75)	13.1(10.60，16.90)	13.75(10.98，16.85)	13(10.20，16.10)	Z＝1.93	0.587
直接胆红素[μmol/L，M(P₂₅，P₇₅)]	2.30(1.80，3.00)	2.30(1.80，3.10)	2.40(1.90，3.08)	2.30(1.90，3.03)	2.20(1.70，2.80)	Z＝2.47	0.481
间接胆红素[μmol/L，M(P₂₅，P₇₅)]	11.00(8.50，13.90)	11.30(7.85，14.65)	10.95(8.75，14.18)	11.30(9.00，14.05)	10.80(8.40，13.30)	Z＝1.96	0.580
血尿素氮[mmol/L，M(P₂₅，P₇₅)]	5.20(4.30，6.20)	4.80(4.00，6.20)	5.20(4.30，6.08)	5.20(4.48，6.13)	5.40(4.40，6.40)^abc	Z＝12.31	0.006
血肌酐[μmol/L，M(P₂₅，P₇₅)]	62(51.00，72.00)	52(46.00，62.50)	59.5(50.00，69.00)^a	63(53.75，72.00)^ab	70(57.00，83.00)^abc	Z＝99.25	0.000
尿白蛋白肌酐比[mg/mmol，M(P₂₅，P₇₅)]	1.32(0.71，5.03)	1.11(0.69，2.43)	1.19(0.69，2.45)	1.23(0.69，5.40)	2.35(0.89，14.14)^abc	Z＝30.24	0.000
十年冠心病发生风险[%，M(P₂₅，P₇₅)]	16(10，25)	15(8，20)	16(10，20)^a	20(13，25)^ab	20(13，31)^ab	Z＝45.67	0.000

项目	总计(n＝904)	低危组(n＝165)	中危组(n＝461)	高危组(n＝278)	统计量	P值
性别(男，%)	559(61.84)	91(55.15)	254(55.10)	214(76.98)^ab	χ²＝39.01	0.000
吸烟史(例，%)	361(39.93)	31(18.79)	157(34.06)^a	173(62.23)^ab	χ²＝95.01	0.000
并发症史(例，%)	765(84.62)	104(63.03)	398(86.33)^a	263(94.60)^ab	χ²＝81.45	0.000
年龄[岁，M(P₂₅，P₇₅)]	56.50(47.25，63.00)	43(36.00，48.00)	57(49.50，63.00)^a	61(56.00，65.50)^ab	Z＝228.22	0.000
病程[年，M(P₂₅，P₇₅)]	7(2，12)	3(1，8)	7(2，11)^a	10(5，15)^ab	Z＝54.85	0.000
收缩压[mmHg，M(P₂₅，P₇₅)]	137(126.00，149.75)	128(119.00，136.00)	135(125.00，145.00)^a	145(135.00，159.50)^ab	Z＝137.14	0.000
舒张压[mmHg，M(P₂₅，P₇₅)]	82(77，90)	80(75，86.25)	81(76，89)	86(80，91)^ab	Z＝40.40	0.000
体重指数(kg/m²，±s)	25.54±3.75	25.02±4.18	25.40±3.69	26.08±3.55^ab	Z＝5.79	0.003
空腹血糖(mmol/L，±s)	9.07±3.27	9.38±3.33	9.08±3.29	8.88±3.21	Z＝1.19	0.305
糖化血红蛋白(%，±s)	9.00±2.00	9.12±2.23	9.08±2.04	8.81±1.78	Z＝1.24	0.290
甘油三酯[mmol/L，M(P₂₅，P₇₅)]	1.62(1.10，2.36)	1.27(0.88，1.99)	1.56(1.08，2.31)^a	1.84(1.31，2.80)^ab	Z＝38.39	0.000
总胆固醇[mmol/L，M(P₂₅，P₇₅)]	4.89(4.16，5.75)	4.35(3.80，5.07)	4.79(4.07，5.72)^a	5.30(4.66，6.03)^ab	Z＝65.06	0.000
高密度脂蛋白胆固醇[mmol/L，M(P₂₅，P₇₅)]	1.08(0.93，1.29)	1.10(0.92，1.35)	1.11(0.95，1.31)	1.04(0.90，1.22)^ab	Z＝18.44	0.000
低密度脂蛋白胆固醇[mmol/L，M(P₂₅，P₇₅)]	2.89(2.32，3.53)	2.50(2.12，3.14)	2.81(2.21，3.50)	3.24(2.70，3.83)^ab	Z＝45.55	0.000
总胆红素[μmol/L，M(P₂₅，P₇₅)]	13.30(10.40，16.90)	13.75(10.38，18.43)	13.30(10.60，17.40)	13.00(10.15，16.15)	Z＝2.75	0.253
直接胆红素[μmol/L，M(P₂₅，P₇₅)]	2.30(1.80，3.00)	2.50(2.00，3.20)	2.30(1.80，3.05)	2.20(1.70，2.70)^ab	Z＝8.25	0.016
间接胆红素[μmol/L，M(P₂₅，P₇₅)]	11.00(8.60，14.08)	11.30(8.40，15.23)	11.00(8.90，14.30)	10.90(8.35，13.45)	Z＝2.41	0.299
血尿素氮[mmol/L，M(P₂₅，P₇₅)]	5.20(4.30，6.20)	4.70(3.90，5.63)	5.10(4.30，6.10)	5.50(4.50，6.70)^ab	Z＝23.99	0.000
血肌酐[μmol/L，M(P₂₅，P₇₅)]	62(50.00，72.00)	56(48.00，68.25)	60(49.00，70.00)	66(56.00，78.00)^ab	Z＝51.00	0.000
血尿酸(μmol/L，±s)	333.06±86.05	308.81± 90.89	325.94±79.49^a	359.26±87.36^ab	Z＝21.48	0.000
尿白蛋白肌酐比[mg/mmol，M(P₂₅，P₇₅)]	1.30(0.71，4.80)	0.97(0.61，2.34)	1.23(0.70，3.10)^a	1.94(0.80，13.98)^ab	Z＝26.76	0.000
Framingham危险评分[分，M(P₂₅，P₂₅)]	10(7，12)	4(2，5)	9(8，12)^a	12(10，14)^ab	Z＝436.40	0.000

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