Elevated serum uric acid levels are independent risk factors for diabetic foot ulcer in female Chinese patients with type 2 diabetes (血尿酸水平升高是中国女性2型糖尿病患者糖尿病足溃疡的独立危险因素)

Background To investigate the relationship between elevated serum uric acid levels and the presence of diabetic foot ulcer (DFU) in Chinese patients with type 2 diabetes (T2D). Methods A retrospective study was performed on 829 outpatients with T2D (478 men, 351 women) who visited the Diabetes Clinic (Nanfang Hospital, Southern Medical University) from January 2007 to December 2009. Information regarding their clinical history, anthropometric measurements, and laboratory data were collected. Potential confounding variables with P < 0.10 were adjusted for in multivariate logistic regression analysis. Results In univariate analyses, there was a significant difference in serum uric acid levels between female patients with and without DFU (370 ± 128 vs. 313 ± 107 μmol/L, respectively; P < 0.05), but not between male patients with and without DFU (317 ± 100 vs. 348 ± 111 μmol/L, respectively; P = 0.643). The prevalence of DFU among quintiles of uric acid levels (from 1–20% to 80–100%) was 5.3%, 3.9%, 7.7%, 5.5%, and 16.7%, respectively. Using uric acid level as a continuous variable, the multivariate-adjusted odds ratio for diabetic foot ulcer in female patients was 1.004 (95% confidence interval 1.001–1.008; P < 0.05). Conclusions Elevated uric acid levels are a significant and independent risk factor for diabetic foot ulcer in female Chinese patients with T2D. Whether serum uric acid is involved in the pathogenesis of DFU in female patients remains to be investigated. 摘要 背景 研究旨在调查中国2型糖尿病患者血尿酸水平升高与发生糖尿病足溃疡的关系。 方法 本研究为回顾性研究，纳入2007年1月到2009年12月期间至糖尿病门诊（南方医院，南方医科大学）就诊的糖尿病患者，共829例（478例男性，351例女性）。收集的信息包括临床病史，人口学指标和实验室数据。P < 0.10的潜在混淆变量在多元logistic回归分析中进行校正。 结果 在单变量分析中，伴或不伴糖尿病足溃疡的女性患者的尿酸水平存在显著差异（370 ± 128 vs 313 ± 107 µmol/L，P < 0.05），但在男性患者中差异无统计学意义（317 ± 100 vs 348 ± 111 µmol/L，P=0.643）。根据患者的血尿酸水平将其分为五分位区间（从1%-20%到80%-100%），糖尿病足溃疡的发生率分别是5.3%，3.9%，7.7%，5.5%和16.7%。将血尿酸水平作为一个连续变量，经多元回归模型校正后女性患者的糖尿病足溃疡的优势比是1.004（95% 可信区间1.001-1.008；P < 0.05）。 结论 对于中国2型糖尿病女性患者，血尿酸水平升高是糖尿病足溃疡的独立危险因素。尿酸是否参与了女性患者糖尿病足溃疡的发病机制仍需要进一步的研究调查。