Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston Salem, NC 27101, USA.
Section of Nephrology, Department of Pediatrics, Brenner Children's, Wake Forest University School of Medicine, Winston Salem, NC 27157, USA.
J Clin Endocrinol Metab. 2024 Jan 18;109(2):e726-e734. doi: 10.1210/clinem/dgad534.
Uric acid's role in cardiovascular health in youth with type 1 diabetes is unknown.
Investigate whether higher uric acid is associated with increased blood pressure (BP) and arterial stiffness over time in adolescents and young adults with type 1 diabetes and if overweight/obesity modifies this relationship.
Longitudinal analysis of data from adolescents and young adults with type 1 diabetes from 2 visits (mean follow up 4.6 years) in the SEARCH for Diabetes in Youth multicenter prospective cohort study from 2007 to 2018. Our exposure was uric acid at the first visit and our outcome measures were the change in BP, pulse wave velocity (PWV), and augmentation index between visits. We used multivariable linear mixed-effects models and assessed for effect modification by overweight/obesity.
Of 1744 participants, mean age was 17.6 years, 49.4% were female, 75.9% non-Hispanic White, and 45.4% had a follow-up visit. Mean uric acid was 3.7 mg/dL (SD 1.0). Uric acid was not associated with increased BP, PWV-trunk, or augmentation index over time. Uric acid was marginally associated with PWV-upper extremity (β = .02 m/s/year, 95% CI 0.002 to 0.04). The magnitude of this association did not differ by overweight/obesity status.
Among adolescents and young adults with type 1 diabetes, uric acid was not consistently associated with increased BP or arterial stiffness over time. These results support findings from clinical trials in older adults with diabetes showing that lowering uric acid levels does not improve cardiovascular outcomes.
尿酸在 1 型糖尿病青少年心血管健康中的作用尚不清楚。
研究尿酸是否与青少年和年轻成人 1 型糖尿病患者的血压（BP）和动脉僵硬度随时间的增加有关，以及超重/肥胖是否会改变这种关系。
对 2007 年至 2018 年在 SEARCH for Diabetes in Youth 多中心前瞻性队列研究中，来自 2 次就诊的青少年和年轻成人 1 型糖尿病患者的数据进行纵向分析（平均随访时间为 4.6 年）。我们的暴露因素是第一次就诊时的尿酸，我们的结局测量指标是两次就诊之间的 BP、脉搏波速度（PWV）和增强指数的变化。我们使用多变量线性混合效应模型，并评估超重/肥胖对其的影响。
在 1744 名参与者中，平均年龄为 17.6 岁，49.4%为女性，75.9%为非西班牙裔白人，45.4%有随访。尿酸平均为 3.7 mg/dL（SD 1.0）。尿酸与随时间增加的 BP、PWV-躯干或增强指数无关。尿酸与上肢 PWV 有一定的相关性（β=0.02 m/s/年，95%CI 0.002 至 0.04）。这种相关性的大小与超重/肥胖状况无关。
在青少年和年轻成人 1 型糖尿病患者中，尿酸与随时间增加的 BP 或动脉僵硬度无关。这些结果支持了在老年糖尿病患者中进行的临床试验结果，即降低尿酸水平并不能改善心血管结局。
