Serum uric acid, the metabolic syndrome, and the risk of chronic kidney disease in patients with type 2 diabetes.

BACKGROUND

Serum uric acid (SUA) has been suggested as a potentially modifiable mediator associated with the metabolic syndrome. Hyperuricemia and metabolic syndrome were both associated with adverse renal outcome. However, epidemiologic data are limited regarding this relationship in patients with type 2 diabetes mellitus (T2DM). This study aims to determine whether elevated SUA is associated with an increased prevalence of metabolic risk factors, albuminuria, and chronic kidney disease (CKD) in a large sample of patients with T2DM. It also examines the combined effect of SUA and metabolic syndrome components on the odds of CKD.

METHODS

A total of 1463 patients with T2DM were recruited. Blood samples were obtained to measure metabolic parameters. Patients with macroalbuminuria or an estimated glomerular filtration rate of <60 mL/min per 1.73 m(2) were considered as CKD cases.

RESULTS

The prevalence of metabolic syndrome, central obesity, hypertension, high triglycerides (TGs), CKD, and macroalbuminuria was significantly higher in patients with hyperuricemia than those in the lowest tertile of SUA (T1). One standard deviation (SD) increment of SUA was significantly associated with metabolic syndrome, central obesity, and high TGs after adjustment for age, sex, estimated glomerular filtration rate (eGFR), and albuminuria. The odds of CKD went up to 1.37-fold with every 1 SD increment of SUA, independent of age, sex, and components of metabolic syndrome. There was a significant, graded increase in odds of CKD by increasing SUA levels and the number of metabolic syndrome risk factors (P<0.001).

CONCLUSION

This study proposed a synergistic effect between SUA and metabolic syndrome components on the odds of CKD.