Hu Yimeng, Li Qinge, Min Rui, Deng Yingfeng, Xu Yancheng, Gao Ling
Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, Wu Han, Hu Bei, China.
Department of Endocrinology, Zhongnan Hospital of Wuhan University, Wuhan, China.
PeerJ. 2021 Jan 13;9:e10691. doi: 10.7717/peerj.10691. eCollection 2021.
The relationship between serum uric acid (SUA) and several diabetic complications or co-morbidities remains a matter of debate. The study aims to explore the association between SUA levels and the prevalence of non-alcoholic fatty liver disease (NAFLD), diabetic retinopathy (DR), diabetic nephropathy (DN) and diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes mellitus (T2DM).
A total of 2,809 participants (1,784 males and 1,025 females) were included in this cross-sectional study. Clinical characteristics and the prevalence of each of the four diseases were analyzed based on gender-specific quartiles of SUA levels. The Pearson correlation analysis and linear-regression analysis were used to access the correlation between SUA levels and clinical characteristics. Furthermore, a binary logistic regression analysis was carried out to determine whether SUA was an independent risk factor for each of the four complications.
SUA levels were positively correlated to BMI, BUN, Scr and TG, but negatively associated with eGFR, HDL, FBG, 2h-PG and HbA1c% for the patients with T2DM. The prevalence of NAFLD and DN, but not DR or DPN, were increased with SUA levels from the first to the fourth quartile. Binary logistic regression further disclosed that SUA was an independent risk factor for NAFLD (ORs Male = 1.002, = 0.0013; ORs Female = 1.002, = 0.015) and DN (ORs Male = 1.006, < 0.001; ORs Female = 1.005, < 0.001), but not for DR and DPN. After adjustment for the confounders, SUA levels were significantly associated with NAFLD within the 3rd (ORs = 1.829, = 0.004) and 4th quartile (ORs = 2.064, = 0.001) for women, but not independently associated with SUA for man. On the other hand, our results revealed increased prevalence of DN for SUA quartile 2 (ORs = 3.643, = 0.039), quartile 3 (ORs = 3.967, = 0.024) and quartile 4 (ORs = 9.133, < 0.001) in men; however, SUA quartiles were significantly associated with DN only for quartile 4 (ORs = 4.083, = 0.042) in women.
For patients with T2DM, elevated SUA concentration is an independent risk factor for the prevalence of NAFLD and DN after adjustment for other indicators, but not DR or DPN.
血清尿酸（SUA）与多种糖尿病并发症或合并症之间的关系仍存在争议。本研究旨在探讨2型糖尿病（T2DM）患者中SUA水平与非酒精性脂肪性肝病（NAFLD）、糖尿病视网膜病变（DR）、糖尿病肾病（DN）和糖尿病周围神经病变（DPN）患病率之间的关联。
本横断面研究共纳入2809名参与者（1784名男性和1025名女性）。基于SUA水平的性别特异性四分位数分析了临床特征和四种疾病各自的患病率。采用Pearson相关分析和线性回归分析来评估SUA水平与临床特征之间的相关性。此外，进行二元逻辑回归分析以确定SUA是否为四种并发症各自的独立危险因素。
T2DM患者的SUA水平与BMI、BUN、Scr和TG呈正相关，但与eGFR、HDL、FBG、2h-PG和HbA1c%呈负相关。随着SUA水平从第一四分位数升高到第四四分位数，NAFLD和DN的患病率增加，但DR或DPN的患病率未增加。二元逻辑回归进一步表明，SUA是NAFLD（男性ORs = 1.002，P = 0.0013；女性ORs = 1.002，P = 0.015）和DN（男性ORs = 1.006，P < 0.001；女性ORs = 1.005，P < 0.001）的独立危险因素，但不是DR和DPN的独立危险因素。在对混杂因素进行调整后，女性SUA水平在第三四分位数（ORs = 1.829，P = 0.004）和第四四分位数（ORs = 2.064，P = 0.001）时与NAFLD显著相关，但男性SUA水平与NAFLD无独立关联。另一方面，我们的结果显示男性SUA四分位数2（ORs = 3.643，P = 0.039）、四分位数3（ORs = 3.967，P = 0.024）和四分位数4（ORs = 9.133，P < 0.001）时DN患病率增加；然而，女性SUA四分位数仅在四分位数4（ORs = 4.083，P = 0.042）时与DN显著相关。
对于T2DM患者，在调整其他指标后，SUA浓度升高是NAFLD和DN患病率的独立危险因素，但不是DR或DPN的独立危险因素。
