Department of Endocrinology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
Medicine (Baltimore). 2022 Dec 16;101(50):e32128. doi: 10.1097/MD.0000000000032128.
Previous studies suggested that increased serum uric acid (SUA) level is an independent risk factor for albuminuria in Type 2 diabetes (T2D) patients. However, the association between SUA and onset of Type 2 DKD (T2DKD) remained to be clarified. This was a cross-sectional clinical study in which 1210 Chinese T2D patients were enrolled. According to the urine albumin-to-creatinine ratio (UACR), the cohort was divided into normal-albuminuria (UACR < 30 mg/g), micro-albuminuria (UACR 30-300 mg/g) and macro-albuminuria (UACR > 300 mg/g). The micro- and macro-albuminuria groups were combined into albuminuria category. Results showed that T2D patients with macro-albuminuria have significantly higher SUA than the other 2 groups (P < .001). In the binary logistic regression model, the subjects with SUA higher than 420 μmol/L were associated with a 2-fold increase in the odds of albuminuria (odds ratio = 2.024, 95% confidence interval: 1.232-3.325, P = .005), as compared with those with SUA lower than 300 μmol/L. Moreover, the multinomial regression analysis revealed that the subjects with SUA higher than 420 μmol/L had about 3-fold increase in the odds of macro-albuminuria (odds ratio = 3.758, 95% confidence interval: 2.051-6.885, P < .001), as compared with those with SUA lower than 300 μmol/L. However, SUA was not significantly associated with the presence of micro-albuminuria. Although the SUAwas not independently risk factor for micro-albuminuria, it was closely correlated with the development of macro-albuminuria in Chinese T2DKD patients. Elevated SUA may be useful for predicting the occurrence of macro-albuminuria but not onset of micro-albuminuria at the early stage of T2DKD.
先前的研究表明,血清尿酸(SUA)水平升高是 2 型糖尿病(T2D)患者白蛋白尿的独立危险因素。然而,SUA 与 2 型糖尿病肾病(T2DKD)发病之间的关系仍需阐明。这是一项横断面临床研究,共纳入 1210 例中国 T2D 患者。根据尿白蛋白与肌酐比值(UACR),将队列分为正常白蛋白尿(UACR < 30mg/g)、微量白蛋白尿(UACR 30-300mg/g)和大量白蛋白尿(UACR > 300mg/g)。将微量白蛋白尿和大量白蛋白尿组合并为白蛋白尿组。结果显示,大量白蛋白尿组的 T2D 患者的 SUA 明显高于其他两组(P <.001)。在二项逻辑回归模型中,SUA 高于 420μmol/L 的受试者发生白蛋白尿的几率增加 2 倍(比值比=2.024,95%置信区间:1.232-3.325,P=.005),与 SUA 低于 300μmol/L 的受试者相比。此外,多项回归分析显示,SUA 高于 420μmol/L 的受试者发生大量白蛋白尿的几率增加约 3 倍(比值比=3.758,95%置信区间:2.051-6.885,P <.001),与 SUA 低于 300μmol/L 的受试者相比。然而,SUA 与微量白蛋白尿的发生无显著相关性。尽管 SUA 不是微量白蛋白尿的独立危险因素,但它与中国 T2DKD 患者大量白蛋白尿的发生密切相关。升高的 SUA 可能有助于预测 T2DKD 早期大量白蛋白尿的发生,但不能预测微量白蛋白尿的发生。