在2型糖尿病和无症状高尿素血症患者中,尿酸降低疗法的开始和全因死亡率之间的关联
Ruixuan Chen1, Sheng Nie1, Shiyu Zhou1
1Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Diabetes & metabolic syndrome
|June 22, 2024
概括
开始尿酸降低疗法 (ULT) 显著降低了2型糖尿病和无症状高尿血症患者的全因死亡率. 保持血清尿酸水平在360-420μmol/L之间可以进一步增强这些益处.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内分泌学 在内分泌学.
- 心脏病学 心脏病学
背景情况:
- 无症状的高尿路血常见于2型糖尿病 (T2D).
- 尿酸降低疗法 (ULT) 对该人群死亡率的影响尚未得到充分证实.
- 了解这些关联可以为临床管理策略提供信息.
研究的目的:
- 调查启动ULT和全因死亡率之间的关联.
- 检查ULT对心血管和非心血管死亡率的影响.
- 探索治疗后血清尿酸 (SUA) 水平与死亡风险之间的关系.
主要方法:
- 在中国进行全国性的回顾性队列研究 (2000-2021).
- 包括2型糖尿病患者无症状高尿路血症.
- 倾向性得分匹配用于平衡ULT发起者和非发起者之间的共变量.
主要成果:
- 开始ULT治疗与全因死亡风险降低有关 (HR 0.77;95% CI,0.71-0.84).
- 还观察到心血管 (HR 0.86; 95% CI, 0.76-0.97) 和非心血管死亡率 (HR 0.72; 95% CI, 0.64-0.80) 的风险降低.
- 建议对治疗后的SUA水平进行U形关系,与360-420μmol/L相比,与420μmol/L相比,与较低的全因死亡风险相关.
结论:
- 启动ULT显著降低了T2D患者无症状高尿血症的全因死亡率.
- 在治疗后保持SUA水平在360-420μmol/L范围内,可以优化降低死亡率.
- 这些发现支持在治疗高尿血症T2D患者时考虑ULT.
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