Background: The association between serum uric acid (SUA) and the risk of diabetic kidney diseases (DKD) remains controversial. We aim to investigate the association between time-averaged SUA and long-term incident DKD among general population-based patients with diabetes.
Methods: Altogether 1327 patients with diabetes and without kidney disease (estimated glomerular filtration rate [eGFR] ≥ 60 mL/min/1.73m2 , and without proteinuria) were included. Incident DKD were defined by the occurrence of renal function decline (eGFR<60 mL/min/1.73m2 ) and/or macroalbuminuria (urinary albumin-creatinine-ratio ≥ 30 mg/mM creatinine). The associations between baseline and time-averaged SUA and DKD were analyzed.
Results: The mean age was 53.7 ± 8.0. During 10.2 ± 0.4 years' follow-up, 85 (6.4%) patients developed renal function decline and 101 (7.6%) patients developed macroalbuminuria. Compared to those with time-averaged SUA in the second quartile (207-240 μM/L for women, 233-272 μM/L for men), odds ratio (OR) for renal function decline was 1.92 (95% confidence interval [CI], 1.02 to 3.62; P = .04) among those with SUA in the top quartile (women≥285 μM/L; men≥324 μM/L); and OR for macroalbuminuria was 1.86 (95% CI 1.01 to 3.43; P = .05) among those with SUA in the bottom quartile (women ≤207 μM/L; men ≤233 μM/L)). No significant associations were observed between baseline SUA with incident DKD.
Conclusions: Long-term exposure to both high and low SUA level are associated with increased risk of incident DKD among patients with diabetes.
背景: 血清尿酸水平与糖尿病肾病发生风险的关系仍存在争议。我们的目的是在以一般人群为基础的糖尿病患者中, 研究时均血清尿酸水平与长期糖尿病肾病事件发生之间的关系。 方法: 共纳入1327例糖尿病不合并肾病的患者(肾小球滤过率≥60 mL/min/1.73m2 , 无蛋白尿)。新发糖尿病肾病事件的定义为肾功能下降(肾小球滤过率<60 mL/min/1.73m2 )和/或大量蛋白尿(尿白蛋白-肌酐比值≥30 mg/mM肌酐)。我们分别分析了基线和时均血清尿酸水平与新发糖尿病肾病的相关性。 结果: 患者平均年龄53.7±8.0岁。在10.2±0.4年的随访期间, 85例(6.4%)患者出现肾功能下降, 101例(7.6%)患者出现大量蛋白尿。与时均尿酸水平为第二4分位的患者相比(女性:207-240 μM/L, 男性:233-272 μM/L), 时均尿酸水平为最高4分位的患者(女性:≥285 μM/L; 男性:≥324 μM/L)发生肾功能降低的比值比为1.92(95% CI [1.02, 3.62]；P=0.04)；而时均尿酸水平为最低4分位的患者(女性:≤207 μM/L; 男性:≤233 μM/L)发生大量白蛋白尿的比值比为1.86 (95% CI [1.01, 3.43]; P=0.05)。未发现基线尿酸水平与新发糖尿病肾病的关系。 结论: 长期暴露于高水平和低水平的血清尿酸浓度与糖尿病患者发生肾病的风险增加有关。.
Keywords: macroalbuminuria; renal function decline; serum uric acid; time-averaged; 大量蛋白尿; 时均; 肾功能下降; 血清尿酸.
© 2019 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.