血清尿酸与 1 型糖尿病患者糖尿病肾病的进展。

Serum uric acid and progression of diabetic nephropathy in type 1 diabetes.

机构信息

Department of Endocrinology, MEA, NBG, Institute for Clinical Medicine, Aarhus University Hospital, Denmark; Steno Diabetes Center Copenhagen, Gentofte, Denmark.

Steno Diabetes Center Copenhagen, Gentofte, Denmark.

出版信息

J Diabetes Complications. 2018 May;32(5):470-473. doi: 10.1016/j.jdiacomp.2018.02.002. Epub 2018 Feb 15.

DOI:10.1016/j.jdiacomp.2018.02.002

PMID:29534864

Abstract

AIMS

Uric acid (UA) is a risk factor for CKD. We evaluated UA in relation to change in GFR in patients with type 1 diabetes.

METHODS

Post hoc analysis of a trial of losartan in diabetic nephropathy, mean follow-up 3 years (IQR 1.5-3.5). UA was measured at baseline. Primary end-point was change in measured GFR. UA was tested in a linear regression model adjusted for known progression factors (gender, HbA, systolic blood pressure, cholesterol, baseline GFR and baseline urinary albumin excretion rate (UAER)).

RESULTS

Baseline UA was 0.339 mmol/l (SD ±0.107), GFR 87 ml/min/1.73 m (±23), geometric mean UAER 1023 mg/24 h (IQR, 631 - 1995). Mean rate of decline in GFR was 4.6 (3.7) ml/min/year. In the upper quartile of baseline UA the mean decline in GFR from baseline to the end of the study was 6.2 (4.9) ml/min/1.73 m and 4.1 (3.1) ml/min/1.73 m in the three lower quartiles of UA, (p = 0.088). In a linear model including baseline covariates (UAER, GFR, total cholesterol, HDL cholesterol) UA was associated with decline in GFR (r = 0.45, p < 0.001).

CONCLUSION

Uric acid was weakly associated with decline in GFR in type 1 diabetic patients with overt nephropathy.

摘要

目的

尿酸（UA）是慢性肾脏病（CKD）的危险因素。我们评估了 1 型糖尿病患者中尿酸与肾小球滤过率（GFR）变化的关系。

方法

对氯沙坦治疗糖尿病肾病试验的事后分析，平均随访 3 年（IQR 1.5-3.5）。在基线时测量 UA。主要终点是测量的 GFR 变化。UA 在调整了已知进展因素（性别、HbA、收缩压、胆固醇、基线 GFR 和基线尿白蛋白排泄率（UAER））的线性回归模型中进行检验。

结果

基线 UA 为 0.339mmol/l（SD±0.107），GFR 为 87ml/min/1.73m（±23），几何均数 UAER 为 1023mg/24h（IQR，631-1995）。GFR 的平均下降率为 4.6（3.7）ml/min/年。在基线 UA 的上四分位数中，从基线到研究结束时 GFR 的平均下降为 6.2（4.9）ml/min/1.73m，而在 UA 的三个下四分位数中为 4.1（3.1）ml/min/1.73m，（p=0.088）。在包括基线协变量（UAER、GFR、总胆固醇、高密度脂蛋白胆固醇）的线性模型中，UA 与 GFR 下降相关（r=0.45，p<0.001）。