Le Hoa Tuyet, Le Tung Thanh, Tran Nguyet Minh Thi, Nguyen Thuy Thanh Thi, Minh Ni Chanh Su, Le Quyen Thi, Tram Tuyet Anh Thi, Tran Thang Duc, Doan Tung Xuan, Duong Mai Huynh Thi, Thai Truc Thanh
Faculty of Internal Medicine, School of Medicine, Vietnam National University, Ho Chi Minh City 700000, Vietnam.
Faculty of Internal Medicine, Pham Ngoc Thach School of Medicine, Ho Chi Minh City 700000, Vietnam.
Healthcare (Basel). 2021 Oct 9;9(10):1341. doi: 10.3390/healthcare9101341.
This study investigated the association between serum uric acid (SUA) levels with rapid decline of the estimated glomerular filtration rate (eGFR) in type 2 diabetes (T2 DM) patients. A prospective cohort study was conducted in a community-based hospital in Vietnam. We followed 405 T2DM patients with normal kidney function for five years. Rapid progression of kidney function was defined as an average annual decrease of eGFR of at least 4 mL/min/1.73 m and was found in 16.0% of patients. Patients in the SUA high tertile ( ≥6 mg/dL) had higher BMI ( = 0.004), lower HbA1c ( = 0.001), lower eGFR ( < 0.001) and higher rate of hypertension than low and middle tertile. After adjusting for age and sex, rapid progression of renal function was significantly associated with SUA level (OR = 1.22, 95% CI 1.02-1.45, = 0.026). This association was marginally significant when more covariates were included in the model (OR = 1.20, 95% CI 0.99-1.46, = 0.065). However, the association between tertiles of SUA and rapid decline of eGFR was not statistically significant. This study demonstrates neither a strong significant association between SUA and rapid decline of eGFR nor evidence to refuse the role of SUA levels in the increased risk of renal function decline in in T2DM patients.
本研究调查了2型糖尿病（T2 DM）患者血清尿酸（SUA）水平与估算肾小球滤过率（eGFR）快速下降之间的关联。在越南一家社区医院进行了一项前瞻性队列研究。我们对405例肾功能正常的T2DM患者进行了为期五年的随访。肾功能快速进展定义为eGFR平均每年至少下降4 mL/min/1.73 m²，在16.0%的患者中发现。SUA处于高三分位（≥6 mg/dL）的患者比低、中三分位患者有更高的体重指数（P = 0.004）、更低的糖化血红蛋白（P = 0.001）、更低的eGFR（P < 0.001）以及更高的高血压发生率。在调整年龄和性别后，肾功能快速进展与SUA水平显著相关（OR = 1.22，95% CI 1.02 - 1.45，P = 0.026）。当模型中纳入更多协变量时，这种关联接近显著（OR = 1.20，95% CI 0.99 - 1.46，P = 0.065）。然而，SUA三分位与eGFR快速下降之间的关联无统计学意义。本研究既未证明SUA与eGFR快速下降之间有强显著关联，也未提供拒绝SUA水平在T2DM患者肾功能下降风险增加中作用的证据。
