Han Rongfeng, Duan Lijun, Zhang Yang, Jiang Xia
Department of Endocrinology, Tianjin First Center Hospital, Tianjin, 300192, People's Republic of China.
Diabetes Metab Syndr Obes. 2023 Sep 5;16:2695-2703. doi: 10.2147/DMSO.S425511. eCollection 2023.
Type 2 diabetes mellitus (T2DM) patients are likely to develop kidney disease. Early diagnosis, finding predictors and controlling risk factors are of great significance for T2DM patients. This study investigated the ability of uric acid (UA), the uric acid to creatinine (CR) ratio (UA/CR) and the uric acid to high-density lipoprotein cholesterol ratio (UHR) to assess the kidney function of T2DM patients and determined the relationship between the three indicators and the estimated glomerular filtration rate (eGFR).
A total of 1326 adult T2DM patients were enrolled in the current study. Patients were stratified into three groups according to their eGFRs. Spearman correlation was used to analyze the correlation between three indicators and the clinical variables. Logistic regression analysis was used to assess the association between the three indicators and diabetic kidney disease (DKD) and kidney impairment (eGFR <60 mL/min/1.73 m). Receiver operating characteristic (ROC) analyses and the area under the ROC curve (AUC) were then used to assess the ability of UA, UA/CR, and UHR to discriminate kidney impairment in T2DM.
UA and UHR demonstrated a positive association with DKD risk (P < 0.05). The odds ratios (ORs) were 1.005 (95% CI, 1.004-1.007) and 1.057 (95% CI, 1.039-1.076), respectively. UA/CR was negatively correlated with DKD risk (OR, 0.922 (95% CI, 0.876, 0.970), P < 0.05). Furthermore, UA and UHR demonstrated a strong positive association with kidney impairment risk, while UA/CR was negatively correlated with kidney impairment risk in T2DM patients (P < 0.05 for all) after adjusting for confounding factors. UA had the highest AUC (0.762) among the three indicators. UHR had a greater AUC (0.713) than UA/CR, which had an AUC value of 0.148 (p < 0.001).
UA is the best indicator of renal impairment (eGFR <60 mL/min/1.73 m) among the three indicators, and UHR is a better indicator than UA/CR.
2型糖尿病（T2DM）患者易患肾脏疾病。早期诊断、寻找预测指标并控制危险因素对T2DM患者具有重要意义。本研究探讨了尿酸（UA）、尿酸与肌酐（CR）比值（UA/CR）以及尿酸与高密度脂蛋白胆固醇比值（UHR）评估T2DM患者肾功能的能力，并确定了这三个指标与估计肾小球滤过率（eGFR）之间的关系。
本研究共纳入1326例成年T2DM患者。根据eGFR将患者分为三组。采用Spearman相关性分析三个指标与临床变量之间的相关性。采用Logistic回归分析评估三个指标与糖尿病肾病（DKD）和肾脏损害（eGFR<60 mL/min/1.73 m²）之间的关联。然后采用受试者工作特征（ROC）分析和ROC曲线下面积（AUC）评估UA、UA/CR和UHR区分T2DM患者肾脏损害的能力。
UA和UHR与DKD风险呈正相关（P<0.05）。比值比（OR）分别为1.005（95%CI，1.004-1.007）和1.057（95%CI，1.039-1.076）。UA/CR与DKD风险呈负相关（OR，0.922（95%CI，0.876，0.970），P<0.05）。此外，在调整混杂因素后，UA和UHR与T2DM患者的肾脏损害风险呈强正相关，而UA/CR与肾脏损害风险呈负相关（均P<0.05）。三个指标中UA的AUC最高（0.762）。UHR的AUC（0.713）大于UA/CR，UA/CR的AUC值为0.148（P<0.001）。
在这三个指标中，UA是肾功能损害（eGFR<60 mL/min/1.73 m²）的最佳指标，UHR是比UA/CR更好的指标。
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