高尿酸血症预示中国2型糖尿病肾病患者的病情进展。
Hyperuricemia Predicts the Progression of Type 2 Diabetic Kidney Disease in Chinese Patients.
作者信息
Zhu Lin, Wang Xuening, Sun Jiaxing, Qian Qi, Yu Jiangyi, An Xiaofei
机构信息
Physical Examination Center, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, Jiangsu, China.
Department of Endocrinology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, Jiangsu, China.
出版信息
Diabetes Ther. 2023 Mar;14(3):581-591. doi: 10.1007/s13300-023-01374-9. Epub 2023 Feb 9.
INTRODUCTION
Diabetic kidney disease (DKD) has a high global disease burden and substantially increases the risk of end-stage renal disease and cardiovascular events. High levels of serum uric acid (SUA), or hyperuricemia, may indicate patients with type 2 diabetes (T2D) at risk for kidney disease.
METHODS
This study explored the association between SUA levels and progression of kidney disease among patients with T2D. A cross-sectional study of 993 Chinese patients aged 20-75 years with T2D and DKD was conducted. Patients were stratified by progression risk of kidney disease based on estimated glomerular filtration rate and ratio of urinary albumin to creatinine, according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Ordinal logistic regression was used to assess associations between SUA and different KDIGO risk categories.
RESULTS
Among 768 patients in the final analysis, those with hyperuricemia and higher SUA were more likely to be assigned to higher KDIGO risk categories. Patients with SUA > 420 μmol/L were ninefold more likely to be in a higher KDIGO risk category than those with SUA < 300 μmol/L (odds risk 9.74, 95% confidence interval 5.47-17.33, P < 0.001).
CONCLUSIONS
Hyperuricemia may be associated with higher risk of DKD progression in individuals with T2D.
引言
糖尿病肾病（DKD）在全球疾病负担中占比很高，并且大幅增加了终末期肾病和心血管事件的风险。高血清尿酸（SUA）水平，即高尿酸血症，可能表明2型糖尿病（T2D）患者有患肾病的风险。
方法
本研究探讨了T2D患者中SUA水平与肾病进展之间的关联。对993名年龄在20至75岁之间患有T2D和DKD的中国患者进行了一项横断面研究。根据改善全球肾脏病预后组织（KDIGO）标准，基于估计肾小球滤过率和尿白蛋白与肌酐比值，将患者按肾病进展风险进行分层。采用有序逻辑回归分析来评估SUA与不同KDIGO风险类别之间的关联。
结果
在最终分析的768名患者中，高尿酸血症患者及SUA水平较高者更有可能被归入较高的KDIGO风险类别。SUA＞420μmol/L的患者处于较高KDIGO风险类别的可能性是SUA＜300μmol/L患者的9倍（比值比9.74，95%置信区间5.47 - 17.33，P＜0.001）。
结论
高尿酸血症可能与T2D个体发生DKD进展的较高风险相关。
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