Study on the relationship between glucose metabolism,serum uric acid level and FGF21 in middle-aged and elderly patients with type 2 diabetes
Objective To analyze the relationship between fibroblast growth factor21(FGF21)and glucose metabolism and serum uric acid(SUA)in middle-aged and elderly patients with type 2 diabetes mellitus(T2DM).Methods 245 middle-aged and elderly T2DM patients(171 males and 74 females)hospitalized in Department of Endocrinology of The Frist Hospital of Lanzhou University were randomly selected,the gener-al data and biochemical indexes of all subjects were collected.The level of serum FGF21 was detected by ELISA.Firstly,the patients were divided into three groups according to glycosylated hemoglobin(HbA1c):blood glucose control standard group(HbA1c≤7%)、poor blood glucose control group(7%<HbA1c≤10%)、poorer blood glucose control group(HbA1c>10%),and the difference of serum FGF21 levels among three groups was compared.Secondly,according to the quartile levels of serum FGF21,T2DM patients were divid-ed into 4 groups:Q1[10.00,55.00]mmol/L,Q2[55.01,88.00]mmol/L,Q3[88.01,129.00]mmol/L,Q4[129.01,213.00]mmol/L,the difference of biochemical indexes among the groups was compared.Spearman correlation analysis was used to analyze the correlation between serum FGF21 and glucose metabolism and SUA levels.The independent influencing factors of serum FGF21 were analyzed by multiple linear regression.Result The serum FGF21 level in the poorer blood glucose control group(81.48±43.29)mmol/L was signifi-cantly lower than that in the standard blood glucose control group and the poor blood glucose control group[(104.56±52.67)mmol/L and(97.64±48.28)mmol/L,P<0.05].The levels of SUA in Q3 and Q4 groups[(355.92±70.15)and(365.49±81.45)mmol/L]were significantly higher than those in Q1 group[(322.92±77.35),all P<0.05].The HbA1c level of Q4 group[7.55(6.70,9.10)%]was significantly lower than that in Q1 group[8.50(7.00,10.40)%]、Q2 group[9.00(7.60,11.00)%]and Q3 group[8.80(7.30,9.90)%].Serum FGF21 level was positively correlated with SUA(r=0.183,P=0.004),negatively correlated with HbA1c and FPG(r=-0.157,P=0.013;r=-0.133,P=0.038).Multiple linear regression showed that SUA was indepen-dently positively correlated with serum FGF21 level(B=0.086,95%CI:[0.001,0.172],P=0.048).Conclusion Serum FGF21 levels were positively correlated with SUA and negatively correlated with HbA1c and FPG in middle-aged and elderly T2DM patients,and FGF21 was independently associated with increased SUA levels.It suggests that high levels of serum FGF21 are associated with achieving glycemic control in middle-aged and elderly T2DM patients,but increase the risk of hyperuricemia.
type 2 diabetes mellitusfibroblast growth factor21glucose metabolismserum uric acid
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