Взаимоотношения при сахарном диабете 2 типа основных параметров мочекислого обмена с показателями инсулинорезистентности

Abstract

Hyperuricemia (HU) occurs in one third of patients with type 2 diabetes mellitus (DM 2). The formation of HU in DM 2 is due to metabolic factors and impaired renal function. At the stage of prediabetes, GU reveals a connection with insulin resistance (IR), it is not clear to what extent this phenomenon is associated with an increase in uricemia in DM 2. Direct assessment of IR in patients with DM 2 is difficult. There are methods for indirect estimation of IR based on the calculation of indices using the results of simple laboratory tests. These indices are based on the determination of fasting plasma levels of triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C) — TG/HDL-C, TG and glucose — TyG index, as well as TG, HDL-C and glucose — MI (metabolic index). The aim of the study was to study the relationship in patients DM 2 between the main indicators of uric acid metabolism and the TG/HDL-C index, TyG index, and MI. 368 patients with DM 2 an average age of 55.8 years, and an average disease duration of 7.2 years were examined. There were 147 men, 221 women. The connection of uricemia with TG/HDL-C was established (Rs=0.2, p=0.03). In the non-insulin-dependent course of DM 2, uricemia was positively correlated with TG/HDL-C (Rs=0.21, p=0.03), negative relations of renal clearance of urates with TG/HDL-C (Rs=0.34, p=0.007) and fractional clearance of urates with TyG (Rs =−0.27, p=0.007) were recorded. In the insulin-dependent course of DM 2, a positive association of TyG with uricuria (Rs=0.44, p=0.03) and a negative correlation with GGFRT, the main enzyme for purine reuse (Rs=−0.44, p=0.03), were revealed. The results obtained do not contradict the previously established patterns of uric acid metabolism in DM 2. The conclusion is made on the feasibility of using the TG/HDL-C index as an indicator of metabolic disorders of uric acid and IR in DM 2. In the insulin-dependent course of DM2, TyG index becomes important, an increase in which is associated with increased catabolism of purines and their insufficient reutilization.