Mu Haoran, Zhang Qilun, Huang Wenyao, Pan Qiang, Zhang Yan, Lu Yanyan, Zhu Zhangxiang, Jiang Xu, Wang Guojuan, Zheng Mao, Chen Li
Department of Endocrinology, The Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), Hefei, Anhui, China.
Department of Central Laboratory, The Third People's Hospital of Bengbu Affiliated to Bengbu Medical University (Bengbu Central Hospital), Bengbu, Anhui, China.
Front Med (Lausanne). 2025 May 14;12:1584049. doi: 10.3389/fmed.2025.1584049. eCollection 2025.
To evaluate the potential of the serum uric acid to serum creatinine ratio (SUA/SCr) as a diagnostic biomarker for normoalbuminuric diabetic kidney disease (NADKD).
We retrospectively analyzed demographic and biochemical data from 3,101 type 2 diabetes patients. Patients were stratified into non-diabetic kidney disease (non-DKD), albuminuric diabetic kidney disease (ADKD), and NADKD groups according to their estimated glomerular filtration rate (eGFR), urinary albumin creatinine ratio (UACR), and urinary albumin excretion rate (UAER). We employed multivariate logistic regression analyses using a stepwise forward-LR method to develop a nomogram. Both area under the curve (AUC) from receiver operating characteristic (ROC), and calibration curves were employed to assess the predictive accuracy of the nomogram. A decision curve analysis (DCA) was conducted to assess the clinical utility of the nomogram.
SUA/SCr, along with glycosylated hemoglobin A1c (HbA1C) and fasting plasma glucose (FPG), showed significant associations with NADKD, both pre- and post-propensity score matching (PSM). Seven variables were incorporated into the risk nomogram. The calibration plots indicated strong agreement between predicted and observed outcomes in both training and validation cohorts. The NADKD risk model demonstrated robust performance, as evidenced by the AUC from ROC analysis and DCA.
SUA/SCr is a significant and independent predictor of NADKD risk. The developed nomograms offer valuable tools for clinical decision-making, potentially enhancing diagnostic accuracy for NADKD in type 2 diabetes patients.
评估血清尿酸与血清肌酐比值（SUA/SCr）作为正常白蛋白尿性糖尿病肾病（NADKD）诊断生物标志物的潜力。
我们回顾性分析了3101例2型糖尿病患者的人口统计学和生化数据。根据估计的肾小球滤过率（eGFR）、尿白蛋白肌酐比值（UACR）和尿白蛋白排泄率（UAER），将患者分为非糖尿病肾病（非DKD）、白蛋白尿性糖尿病肾病（ADKD）和NADKD组。我们采用逐步向前逻辑回归分析方法进行多变量逻辑回归分析以构建列线图。采用受试者工作特征曲线（ROC）下的面积（AUC）和校准曲线来评估列线图的预测准确性。进行决策曲线分析（DCA）以评估列线图的临床实用性。
在倾向评分匹配（PSM）前后，SUA/SCr与糖化血红蛋白A1c（HbA1C）和空腹血糖（FPG）均与NADKD显著相关。七个变量被纳入风险列线图。校准图表明在训练和验证队列中预测结果与观察结果之间具有高度一致性。ROC分析和DCA的AUC证明了NADKD风险模型具有强大的性能。
SUA/SCr是NADKD风险的重要独立预测因子。所构建的列线图为临床决策提供了有价值的工具，可能提高2型糖尿病患者NADKD的诊断准确性。
