Xuan Yan, Zhang Wen, Wang Yuying, Wang Bin, Xia Fangzhen, Zhang Kun, Li Qing, Wang Ningjian, Lu Yingli
Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Department of Endocrinology, Luwan Branch, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200020, People's Republic of China.
Diabetes Metab Syndr Obes. 2023 Jan 19;16:167-177. doi: 10.2147/DMSO.S387726. eCollection 2023.
Previous studies have implicated the uric acid to high-density lipoprotein cholesterol (HDL-C) ratio (UHR) was associated with type 2 diabetes. However, the association between UHR and diabetes-related vascular damages is still unclear.
The total of 4551 patients with type 2 diabetes from the cross-sectional Environmental Pollutant Exposure and Metabolic Diseases in Shanghai study (METAL study) were enrolled. UHR was calculated as uric acid to HDL-C ratio. Cardiovascular disease (CVD) was defined as previously diagnosed with stroke, coronary heart disease, or peripheral arterial disease. Chronic kidney disease (CKD) was defined as estimated glomerular filtration rate ≤60 mL/min/1.73 m and/or urinary albumin to creatinine ratio ≥30 mg/g. Fundus image was examined by trained individuals and degree of diabetic retinopathy (DR) was evaluated.
UHR was positively correlated with CVD (OR = 1.28, 95% CI: 1.02-1.61) and CKD (OR = 1.78, 95% CI: 1.39-2.27) after adjusting for all confounders. No association was found between UHR and DR. In stratified analyses, UHR was predominantly correlated with CVD in diabetic patients with age older than 65 (OR = 1.41, 95% CI: 1.08-1.85), female (OR = 1.43, 95% CI: 1.06-1.94) and BMI≥24kg/m (OR = 1.57, 95% CI: 1.17-2.11). A 1-SD increment of UHR was also positively associated with CVD (OR 1.26, 95% CI 1.03, 1.15) and CKD (OR 1.28, 95% CI 1.20,1.39). UHR was positively associated with CKD in all subgroups analysis. No significant interaction effect was observed between UHR and all subgroup variables in CVD and CKD risk.
Our study reported a positive association between the UHR and diabetic-related vascular complications in men and postmenopausal women. The relationship between the UHR and DR seems to be uncertain and requires further investigation. And no significant interaction effect was observed between the UHR and all subgroup variables in CVD and CKD risk.
既往研究表明尿酸与高密度脂蛋白胆固醇（HDL-C）比值（UHR）与2型糖尿病有关。然而，UHR与糖尿病相关血管损伤之间的关联仍不清楚。
纳入上海横断面环境污染物暴露与代谢疾病研究（METAL研究）中的4551例2型糖尿病患者。UHR计算为尿酸与HDL-C的比值。心血管疾病（CVD）定义为既往诊断为中风、冠心病或外周动脉疾病。慢性肾脏病（CKD）定义为估计肾小球滤过率≤60 mL/min/1.73 m²和/或尿白蛋白与肌酐比值≥30 mg/g。由经过培训的人员检查眼底图像并评估糖尿病视网膜病变（DR）的程度。
在调整所有混杂因素后，UHR与CVD（OR = 1.28，95%CI：1.02 - 1.61）和CKD（OR = 1.78，95%CI：1.39 - 2.27）呈正相关。未发现UHR与DR之间存在关联。在分层分析中，UHR主要与年龄大于65岁的糖尿病患者（OR = 1.41，95%CI：1.08 - 1.85）、女性（OR = 1.43，95%CI：1.06 - 1.94）和BMI≥24kg/m²（OR = 1.57，95%CI：1.17 - 2.11）的CVD相关。UHR增加1个标准差也与CVD（OR 1.26，95%CI 1.03，1.15）和CKD（OR 1.28，95%CI 1.20，1.39）呈正相关。在所有亚组分析中，UHR与CKD呈正相关。在CVD和CKD风险方面，未观察到UHR与所有亚组变量之间存在显著的交互作用。
我们的研究报告了UHR与男性和绝经后女性糖尿病相关血管并发症之间存在正相关。UHR与DR之间的关系似乎不确定，需要进一步研究。并且在CVD和CKD风险方面，未观察到UHR与所有亚组变量之间存在显著的交互作用。
