Correlations of hyperuricemia and matrix metalloproteinase-9 level with left ventricular remodeling in patients with type 2 diabetes and the clinical effect of intervention for hyperuricemia

Abstract

Objective To investigate correlations of hyperuricemia and matrix metalloproteinase -9 level with left ventricular remodeling in patients with type 2 diabetes and the clinical effect of intervention for hyperuricemia. Methods 100 type 2 diabetic patients with hyperuricemia in our hospital from June 2011 to June 2012 were selected as hyperuricemia group, 50 type 2 diabetic cases with normal uric acid were considered as DM group. Levels of blood glucose, blood lipids, glycosylated hemoglobin and matrix metalloproteinase-9 were detected. All patients underwent echocardiography. Patients in hyperuricemia group were randomly divided into treatment group (receiving allopurinol and alkaline urine-alkalify therapy added to hypoglycemic treatment, n=50) and control group (receiving hypoglycemic treatment, n=50). After 6 months of treatment, levels of blood glucose, blood lipids, glycosylated hemoglobin, matrix metalloproteinase-9 and echocardiography were rechecked. Results The levels of triglyceride (TG), blood uric acid, MMP-9, left ventricular posterior wall thickness (LVPWT), interventricular septal thickness (IVST) and left ventricular mass index (LVMI) were increased in hyperuricemia group versus DM group〔(2.3±0.5) mmol/L vs. (1.6±0.30) mmol/L, (498.9±32.5) μmol/L vs. (322.8±35.6) μmol/L, (765±38) g/L vs. (420±26) pg/L, (11.0±1.1) mm vs. (9.2±0.8) mm, (11.5±1.6) mm vs. (10.1±1.1) mm, (138.7±35.6) g/m2vs. (115.0±10.4)g/m2,t=4.945, 5.124, 4.895, 3.985, 3.965, 3.989, respectively, all P<0.05〕. Levels of TG, blood uric acid, MMP, LVPWT, IVST were decreased in treatment group after treatment versus before treatment〔(1.6±0.5) mmol/L vs. (2.3±0.6) mmol/L, (323.0±30.5) μmol/L vs. (496.6±32.6) μmol/L, (766±34) pg/L vs. (410±25) pg/L, (9.1±0.8) mm vs. (11.0±1.1) mm, (9.2±1.1) mm vs. (11.6±1.5) mm, (116±10.5) g/m2vs.(138.8±35.2) g/m2,t=3.386, 4.525, 4.865, 3.256, 3.895, 3.985, all P<0.05〕. Correlation analysis showed that LVMI had positive correlations with levels of blood uric acid, TG, MMP-9 (r=0.435, 0.348, 0.356, respectively). Conclusions Hyperuricemia involves in left ventricular remodeling, and therapeutic intervention on the hyperuricemia can reverse this remodeling. Key words: Hyperuricemia; Diabetes, type 2; Matrix metalloproteinase9; Ventricular remodeling