高血清尿酸水平与长期糖尿病患者的微血管并发症相关。

High levels of serum uric acid are associated with microvascular complications in patients with long-term diabetes.

作者信息

Wang Hanying, Gu Liping, Ma Yuhang, Xing Xindan, Qu Yuan, Shi Xin, Liu Xinyi, Wan Hancong, Zhu Qian, Shen Yingchen, Chen Chong, Su Li, Wang Yufan, Liu Kun

机构信息

Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University, National Clinical Research Center for Eye Diseases, No. 100 Haining Road, Shanghai, 20080, P. R. China.

Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China.

出版信息

Diabetol Metab Syndr. 2025 Mar 28;17(1):106. doi: 10.1186/s13098-025-01656-1.

DOI:10.1186/s13098-025-01656-1

PMID:40148898

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11951721/

Abstract

AIMS

To assess the association between serum uric acid (SUA) level and the prevalence of diabetic retinopathy (DR) and chronic kidney disease (CKD) in patients with long-term diabetes.

METHODS

A cross-sectional analysis was conducted involving diabetic patients from Shanghai General hospital during October 2018 and October 2021. Participants underwent measurements of SUA, renal function test and DR assessments via fundus photography. Multivariable ordinal logistic regression models assessed odd ratios (ORs) and 95% confidence intervals (95% CIs) for the progression of DR and CKD. Receiver operating characteristics (ROC) curves identified SUA thresholds, categorizing participants into low and high SUA groups.

RESULTS

Among the 1015 patients with diabetes, SUA levels were higher in individuals with advanced CKD stages (p < 0.001, compared with stage 1 CKD) and vision-threatening diabetic retinopathy (VTDR) (p = 0.019, compared with no diabetic retinopathy (NDR)). In multivariable models adjusted for potential confounders, higher SUA levels were associated with an increased risk of DR (OR: 1.002, 95% CI: 1.001-1.004) and CKD (OR: 1.008, 95% CI: 1.006-1.011). Notably, SUA levels exceeding 354.0 µmol/L (95% CI: 318.9-393.2) and 361.0 µmol/L (339.2-386.3) were associated with 1.571-fold (95% CI: 1.139-2.099, P = 0.006 for DR) and 1.395-fold (95% CI: 1.033-1.885, P = 0.030 for CKD) increased risks, respectively. Gender-specific analyses also demonstrated a positive correlation between higher SUA levels and the incidence of DR and CKD in both males and females.

CONCLUSIONS

Elevated SUA levels are independently coincided with increased risks of DR and CKD, suggesting that SUA may serve as a potential risk marker for diabetic complications.

摘要

目的

评估长期糖尿病患者血清尿酸（SUA）水平与糖尿病视网膜病变（DR）患病率及慢性肾脏病（CKD）之间的关联。

方法

对2018年10月至2021年10月期间上海交通大学医学院附属瑞金医院的糖尿病患者进行横断面分析。参与者接受了SUA测量、肾功能测试以及通过眼底摄影进行的DR评估。多变量有序逻辑回归模型评估了DR和CKD进展的比值比（OR）和95%置信区间（95%CI）。受试者工作特征（ROC）曲线确定了SUA阈值，将参与者分为低SUA组和高SUA组。

结果

在1015例糖尿病患者中，晚期CKD阶段（与CKD 1期相比，p < 0.001）和威胁视力的糖尿病视网膜病变（VTDR）（与无糖尿病视网膜病变（NDR）相比，p = 0.019）患者的SUA水平更高。在针对潜在混杂因素进行调整的多变量模型中，较高的SUA水平与DR风险增加（OR：1.002，95%CI：1.001 - 1.004）和CKD风险增加（OR：1.008，95%CI：1.006 - 1.011）相关。值得注意的是，SUA水平超过354.0 µmol/L（95%CI：318.9 - 393.2）和361.0 µmol/L（339.2 - 386.3）分别与DR风险增加1.571倍（95%CI：1.139 - 2.099，P = 0.006）和CKD风险增加1.395倍（95%CI：- 1.033 - 1.885，P = 0.030）相关。性别特异性分析还表明，较高的SUA水平与男性和女性的DR及CKD发病率均呈正相关。