Diabetic retinopathy is a vascular complication of diabetes, and homocysteine is an intermediate product of methionine metabolism. Hyperhomocysteinemia can directly or indirectly damage vascular endothelial cells, causing vascular endothelial cells dysfunction and participating in the occurrence and development of diabetic retinopathy. Uric acid is the final product of purine metabolism. Hyperuricemia can cause vascular endothelial dysfunction, oxidative metabolism, platelet adhesion and aggregation dysfunction, thus participating in the occurrence and development of diabetic retinopathy. In recent years, there have been many studies on the correlation between diabetic retinopathy and levels of homocysteine and uric acid. This article reviews the relevant literature at home and abroad in order to provide new information for the prevention and treatment of diabetic retinopathy.
【摘要】 目的 探討無癥狀人群高尿酸血癥與高甘油三酯血癥的相關性，為臨床疾病的預防和治療提供實驗基礎研究。 方法 回顧分析2008年5月-2009年5月門診體檢中200名無臨床癥狀高血尿酸者（A組）的血脂檢查情況，并與同期200例血尿酸正常者（B組）的血脂檢查情況進行比較分析。A組：男121例，女79例；年齡20～60歲，平均43歲。男性患者血尿酸gt;420 mmol/L，女性患者gt;360 mmol/L。 B組：男115例，女85例；年齡20～60歲，平均41歲。男性患者血尿酸為99～420 mmol /L，女性患者為99～360 mmol/L。兩組性別和年齡差異無統計學意義（Pgt;0.05）。 結果 A組甘油三酯、總膽固醇、低密度脂蛋白、高密度脂蛋白分別為（3.09±0.98）、（4.05±1.07）、（3.38±0.98）、（1.30±0.51）mmol /L；B組為（1.65±0.86）、（3.99±0.99）、（2.97±0.89）、（1.41±0.66）mmol /L。 A組甘油三酯較B組比較，差異有統計學意義（Plt;0.01）；總膽固醇、低密度脂蛋白、高密度脂蛋白比較，差異無統計學意義（Pgt;0.05）。經相關性分析，A組血尿酸與甘油三酯呈正相關（r=0.69， Plt;0.01）。 結論 血尿酸代謝與甘油三酯代謝之間有一定的聯系。【Abstract】 Objective To explore the correlation between hyperuricemia and hypertriglyceridemia in asymptomatic people to provide the basic information for clinical prevention and treatment. Methods The blood lipid (TG, TC, LDL, and HDL) levels in 200 asymptomatic individuals with high uric acid (A group) and 200 sex-and age-matched ones with normal serum uric acid (B group) were examined and the results of the two groups were compared. Results The concentration of triacylglycerol, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were (3.09±0.98), (4.05±1.07), (3.38±0.98), and (1.30±0.51) mmol/L, respectively in group A; and were (1.65±0.86), (3.99±0.99), (2.97±0.89), and (1.41±0.66) mmol /L, respectively in group B. The concentration of TG in group A was obvious higher than that in group B (Plt;0.01). However, the differences of their total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were not significant (Pgt;0.05). The increase of TG was obvious compared with TC(Plt;0.01), LDL (Plt;0.01), and HDL (Plt;0.01) in group A; while the comparisons in group B were not significant (Pgt;0.05). Conclusion Uric acid metabolism correlates with triacylglycerol metabolism.
Objective To provide a clinical basis for the prevention of diabetic foot ulcers by analyzing the clinical data and prognosis of high-risk diabetic foot patients. Methods A retrospective analysis was performed on high-risk diabetic foot patients who were hospitalized in West China Hospital of Sichuan University between January 1, 2012 and December 31, 2018. Patients were divided into high-risk group and low-risk group according to whether they hada history of foot ulcer or amputation. The clinical characteristics of the two groups of patients were compared. The patients were followed up from hospital discharge to January 31, 2021, and their survival and ulcer recurrence or new-onset status were evaluated. Results Finally, 123 patients were included, including 29 patients in the high-risk group and 94 patients in the low-risk group. There was no statistical difference in the duration of diabetes, smoking history, drinking history, education level, proportion of receiving regular treatment, proportion of regular blood glucose monitoring, body mass index, proportion of diabetic peripheral neuropathy, callus, foot deformity, diabetic nephropathy, diabetic retinopathy, diabetic cardiac autonomic neuropathy, diabetic gastrointestinal autonomic neuropathy, hypertension, coronary heart disease and laboratory test results between the two groups (P>0.05). The proportion of women (51.7% vs. 29.8%), age [(69.8±10.3) vs. (64.4±11.3) years], proportion of lower extremity arterial disease (62.1% vs. 34.4%), proportion of hyperuricemia (27.6% vs. 10.6%) in the high-risk group were higher than the low-risk group (P<0.05). After follow-up (67±20) months, 25.8% of the patients had ulcer recurrence or new onset, and 24.2% of the patients died. The most common cause of death was diabetes complications (43.8%). The overall 1-, 3-, and 5-year cumulative mortality rates of the patients were 4.5%, 12.7%, and 20.6%, respectively. The 3- and 5-year recurrence or new ulcer rates were 8.3% and 18.2%, respectively. The 5-year recurrence or new ulcer rates in the low-risk group and high-risk group were 10.3% and 40.3%, respectively, and there was a difference in ulcer recurrence between the two groups (P=0.004). Conclusions Compared with high-risk diabetic foot patients without ulcer or amputation, patients with a history of ulcer or amputation have higher rates of lower extremity arterial disease and hyperuricemia. Patients with a history of ulceration or amputation have a higher risk of recurrent or new ulceration than patients without a history of ulceration or amputation.
Objective To investigate the correlation between the uric acid to high-density lipoprotein cholesterol ratio (UHR) and the presence of atherosclerotic stenosis in both intracranial and extracranial arteries among patients who have experienced cerebral infarction. Methods Patients with cerebral infarction admitted to the Department of Neurology of Sichuan Provincial People’s Hospital between January 2021 and June 2024 were retrospective selected. According to the digital subtraction angiography (DSA) performance, patients were divided into cerebral atherosclerotic stenosis group and no cerebral atherosclerotic stenosis group. According to the location of atherosclerotic stenosis, patients were divided into extracranial atherosclerotic stenosis group, intracranial atherosclerotic stenosis group, intracranial and extracranial atherosclerotic stenosis group. According to the severity of atherosclerotic stenosis, patients were divided into mild group, moderate group and severe group. Clinical data and laboratory indicators were collected. Multifactorial regression was used to analyze the risk factors, Spearman correlation analysis was used to evaluate the relationship between UHR and the degree of stenosis, and the predictive value of UHR for intracranial and extracranial atherosclerotic stenosis was analyzed by the receiver operating characteristic curve. Results A total of 388 patients were included. Among them, 291 cases in cerebral atherosclerotic stenosis group and 97 cases in no cerebral atherosclerotic stenosis group; 85 cases in the intracranial atherosclerotic stenosis group, 123 cases in the extracranial atherosclerotic stenosis group, and 83 cases in the intracranial and extracranial atherosclerotic stenosis group; There were 104 cases in the mild group, 81 cases in the moderate group, and 106 cases in the severe group. The results of multiple logistic regression analysis showed that age, hypertension, UHR and uric acid were independent influencing factors associated with atherosclerotic stenosis of intracranial and extracranial arteries. Furthermore, the uric acid and UHR were also risk factors for the degree of stenosis (P<0.05). Spearman correlation analysis results showed that UHR was positively correlated with the degree of stenosis (r=0.516, P < 0.001). Receiver operating characteristic curve showed that the predictive value of UHR (area under the curve was 0.724) was superior to that of uric acid (area under the curve was 0.638) or HDL-C (area under the curve was 0.709). It also showed good predictive value for stenosis in different locations of intracranial and extracranial arteries. Conclusion UHR is an independent risk factor for intracranial and extracranial atherosclerotic stenosis with notabla predictive value
【摘要】 目的 分析成都地區中老年居民脈壓（pulse pressure， PP）及脈壓指數（pulse presure index，PPI）與高尿酸血癥（hyperuricemia，HUA）的關系。 方法 利用2007年5月代謝綜合征研究調查資料（共1 061人），依據PP[≤60 mm Hg（1 mm Hg=0.133 kPa）、gt;60 mm Hg]和PPI（≤0.450、gt;0.450）將人群分為正常組及增高組，分析兩組人群尿酸水平及HUA患病率，采用單因素回歸及logistic回歸分析PP及PPI與HUA關系。 結果 ①PP/PPI增高組血漿尿酸水平明顯高于PP/PPI正常組，差異有統計學意義（P=0.000）。②PP/PPI增高組HUA患病率明顯高于PP/PPI正常組，差異有統計學意義（P=0.026、0.027）。③單因素回歸和logistic回歸分析皆提示PP及PPI與HUA呈正相關。 結論 成都地區PP及PPI與血漿尿酸水平關系密切，PP/PPI增高可能是HUA的危險因素。【Abstract】 Objective To evaluate the relationship between pulse pressure (PP), pulse pressure index (PPI) and hyperuricemia (HUA) among middle-aged and aged residents in Chengdu. Methods Based on the level of PP [≤60 mm Hg (1 mm Hg=0.133 kPa),gt;60 mm Hg] and PPI (≤0.450,gt;0.450), We divided the 1 061 middle-aged or aged people into normal PP/PPI group and augmented PP/PPI group. All patients came from the survey for metabolic syndrome study in May 2007. We analyzed the distribution of serum uric acid (UA) and HUA, and analyzed the relationship between PP, PPI and HUA by using single-factor and logistic regression analysis. Results The index of UA in the augmented PP/PPI groups was higher than that in the normal groups with a significant difference (P=0.000). The prevalence of HUA in the augmented PP/PPI groups was statistically higher than that in the normal groups (P=0.026, 0.027). Single-factor and logistic regression analysis showed that PP and PPI were both positively correlated to HUA. Conclusion The abnormalities of PP and PPI are closely related to metabolism disorder in Chengdu, and high level of PP or PPI is probably risk factors for HUA.
【摘要】 目的 探討血尿酸水平、頸動脈斑塊與冠心病之間的關系。 方法 收集2006年1月-2009年12月擬診為冠心病的住院患者280例,冠狀動脈造影檢查冠狀動脈狹窄程度gt;50%的194例為冠心病組,冠狀動脈無狹窄或狹窄程度lt;50%的86例為對照組;冠心病組又分為單支、雙支、多支病變亞組。分別測定冠心病組與對照組頸總動脈與頸動脈分叉處內膜中層厚度(IMT)、等級評分、Crouse積分、血尿酸濃度。結果 與對照組相比,冠心病組頸總動脈與頸動脈分叉處IMT、等級評分、Crouse積分、血尿酸濃度均高于對照組,差異有統計學意義。在冠心病組,隨病變分支的增多,頸動脈超聲檢查指標與血尿酸隨之升高(Plt;0.05或0.01)。 結論 頸動脈IMT、等級評分、Crouse積分、血尿酸濃度與冠心病相關,是冠心病的獨立危險因素。【Abstract】 Objective To investigate the relationships between serum uric acid levels, carotid artery plaque and coronary heart disease (CHD). Methods 194 patients with CHD and 86 nonCHD patients were selected through coronary angiography in patients with essential hypertension. CHD group was divided into three subgroups including a single branch, doublebranch and multivessel disease. Intimamedia thickness (IMT) of carotid artery and carotid bifurcation, grade score, Crouse score, serum uric acid concentrations were detected in patients with coronary heart disease and control group. Results IMT of carotid artery and carotid bifurcation, grade score,crouse score, serum uric acid concentrations were higher in CHD group than that in control group, and the difference was statistically significant. In the CHD group, ultrasound parameters of carotid artery and serum uric acid increased with the increase in branch lesions (Plt;005 or 001). Conclusions Carotid IMT, grade score, Crouse score, serum uric acid concentration relate to coronary heart disease, which is an independent risk factor for coronary heart disease, respectively.
Objective To analyze the effects of hyperuricemia (HUA) on the prevalence of dyslipidemia in the elderly. MethodsA total of 5 990 elderly people with complete and important variables from the China Health and Retirement Longitudinal Study (CHARLS) public database in 2015 were extracted. Their blood lipids, related physiological and biochemical indices, and basic demographic information were collected. The effects of HUA on the prevalence of dyslipidemia in the elderly were analyzed using the probit model, and empirical analysis was performed using the propensity score matching method (PSM). Results Among the 5 990 subjects, 13.6% of the elderly had HUA and the prevalence of dyslipidemia was 37.5%. After correcting the endogeneity among variables, the probability of dyslipidemia in elderly patients with HUA increased by 9.5%-11.7% (P<0.01), in which the probability of high triglyceridemia (TG), high total cholesterol (TC), high low-density lipoprotein cholesterol (LDL-C), and low high-density lipoprotein cholesterol (HDL-C) increased by 10.4%-11.5% (P<0.01), 2.7%-3.8% (P<0.01), 1.7%-2.3% (P<0.05), and 4.3%-4.9% (P<0.05), respectively. Conclusion HUA is associated with various types of dyslipidemia, among which its relationship with high TG and low HDL-C is strong. Targeted interventions should be taken for elderly HUA patients, aiming to reduce the rate of dyslipidemia and promote the goal of "healthy ageing" in China.
摘要:目的: 系統評價非布索坦治療痛風的療效及安全性。 方法 :計算機檢索PubMed、EMBASE、SCI、CBM、CNKI、VIP、萬方數據庫及Cochrane圖書館,手工補充檢索;納入非布索坦治療痛風的隨機對照試驗(RCT);進行方法學質量評價和Meta分析。 結果 :共納入3個RCT(受試者1985例),A級文獻1篇,B級文獻2篇。Meta分析結果顯示:最后3月血清尿酸(SU)持續低于60 mg/dl患者數、隨訪結束時SU低于60 mg/dl患者數非布索坦組與對照組差異均有統計學意義;治療相關不良事件發生數與安慰劑組差異無統計學意義,與別嘌呤組差異有統計學意義。 結論 :基于當前證據,非布索坦治療痛風,能有效降低SU含量,減少治療相關不良事件發生率。Abstract: Objective: Assessing the effectiveness and safety of febuxostat for the treatment of gout. Methods :Randomized controlled trails(RCT) of febuxostat for the treatment of gout were gathered from the Cochrane Library、PubMed、EMBASE、SCI、CBM、CNKI、VIP、Wangfang Database, other relative researches were handsearched, each RCT was methodological quality evaluated, then analyzed by software RevMan50 Results :A total of 3 RCTs were collected (involving 1985 subjects); 1 was graded A, 2 were B; according to the Metaanalysis: the differences of subjects with last 3 monthly serum urate(SU)＜60mg/dl and subjects with SU＜60mg/dl at final visits were significant; treatmentrelated adverse events between febuxostat and allopurinol was significant different, but not significant difference between febuxostat and placebo. Conclusion : According to the evidence currently, febuxostat could reduce SU and the episodes of treatmentrelated adverse events.
ObjectiveTo evaluate the association between extent and severity of acute coronary syndrome and uric acid, leukocytes.
MethodsA retrospective analysis of leukocytes, platelets, lipids and uric acid levels were performed on 23 patients with acute myocardial infarction (AMI group), 17 patients with unstable angina (UA group), and 17 healthy subjects (controls) between January and December 2010.
ResultsIn the three groups (AMI, UA, and Control), the leukocyte count was respectively (10.4±3.2)×109/L, (6.9±2.4)×109/L and (5.4±1.1)×109/L (P<0.05); neutrophil was (7.4±3.2)×109/L, (4.8±2.3)×109/L, and (3.4±0.8)×109/L (P<0.001); and uric acid was (401.4±94.3), (384.1±74.1) and (285.5±76.8) μmol/L, respectively (P<0.001). Multinomial Logistic regression showed leukocyte was a predictor for AMI (OR=1.712, P=0.003), while uric acid was not (OR=1.006, P=0.255), regarding the UA group as the reference. When the control group was using as reference, leukocyte was an independently significant factor for AMI (OR=2.942, P=0.004) and was not a significant factor for UA (OR=1.718, P=0.125); uric acid was a significant factor for AMI and UA (OR=1.027, P=0.016; OR=1.021, P=0.041).
ConclusionUric acid may be associated with the chronic development of coronary heart disease, while leukocytes may play a potential role in plaque destabilization and the onset of AMI.
Gout is the most common inflammatory arthritis, which is characterized by elevated urate and monosodium urate (MSU) crystal deposition in tissues, leading to arthritis, soft-tissue masses (tophi), nephrolithiasis, and urate nephropathy. It has a major impact on health-related quality of life. The American College of Rheumatology (ACR) published ACR guidelines for the management of gout in June 2020, in which 42 recommendations (including 16 strong recommendations) were generated. The guideline described indications for urate-lowering therapy (ULT), approaches to initiating, ongoing management, gout flares, and lifestyle and other medication strategies in patients with gout and in individuals with asymptomatic hyperuricemia. This paper interprets it to provide references for clinical practice.
