Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, CO, USA.
Nephrol Dial Transplant. 2010 Jun;25(6):1865-9. doi: 10.1093/ndt/gfp740. Epub 2010 Jan 11.
Recent studies suggest that uric acid is a mediator of diabetic nephropathy. We hypothesized that elevated serum uric acid levels are a strong predictor of albuminuria in patients with type 1 diabetes.
We analyzed data from the Coronary Artery Calcification in Type 1 Diabetes study, a prospective observational study. A stepwise logistic regression model was applied to predict the development of micro- or macroalbuminuria after 6 years of follow-up in 324 participants who had no evidence of micro- or macroalbuminuria at baseline. A P-value <0.1 was used as the criteria for entry into and removal from the model.
The following factors were selected in the stepwise multivariate model as predictors of micro- or macroalbuminuria at the 6-year follow-up visit: baseline serum uric acid levels, HbA(1c) and pre-albuminuria. For every 1-mg/dl increase in serum uric acid levels at baseline, there was an 80% increased risk of developing micro- or macroalbuminuria at 6 years (odds ratio 1.8; 95% confidence interval 1.2, 2.8; P = 0.005). Additional covariates considered in the stepwise model were sex, age, duration of diabetes, angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker treatment, waist circumference, waist/hip ratio, body mass index, systolic and diastolic blood pressure, smoking, serum creatinine, cystatin C, high-density lipoprotein cholesterol and triglycerides.
Elevated serum uric acid levels are a strong predictor of the development of albuminuria in patients with type 1 diabetes.
最近的研究表明，尿酸是糖尿病肾病的中介物。我们假设血清尿酸水平升高是 1 型糖尿病患者蛋白尿的一个强有力预测指标。
我们分析了来自 1 型糖尿病冠状动脉钙化研究的数据，这是一项前瞻性观察性研究。应用逐步逻辑回归模型，对 324 名基线时无微蛋白尿或大量蛋白尿的参与者进行了 6 年随访后微蛋白尿或大量蛋白尿发展的预测。P 值<0.1 作为进入和退出模型的标准。
逐步多变量模型中选择了以下因素作为 6 年随访时微蛋白尿或大量蛋白尿的预测因素：基线血清尿酸水平、HbA(1c)和白蛋白尿前。与基线时血清尿酸水平每增加 1mg/dl 相比，6 年后发生微蛋白尿或大量蛋白尿的风险增加 80%（优势比 1.8；95%置信区间 1.2，2.8；P=0.005）。逐步模型中考虑的其他协变量包括性别、年龄、糖尿病病程、血管紧张素转换酶抑制剂或血管紧张素 II 受体阻滞剂治疗、腰围、腰臀比、体重指数、收缩压和舒张压、吸烟、血清肌酐、胱抑素 C、高密度脂蛋白胆固醇和甘油三酯。
血清尿酸水平升高是 1 型糖尿病患者蛋白尿发展的一个强有力预测指标。
