Serum Uric Acid Levels and Risk of Rapid Decline of Estimated Glomerular Filtration Rate in Patients with Type 2 Diabetes: Findings from a 5-Year Prospective Cohort Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Setting and Participants
2.2. Clinical and Biochemical Measurement
2.3. Diagnosis Criteria
2.4. Outcome Variable
2.5. Statistical Analysis
2.6. Ethics
3. Results
3.1. Participants’ Characteristics
3.2. Serum Acid Uric and Rapid Decline in eGFR
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Participant Characteristics at Baseline | All (n = 405) | Low-Tertile (n = 136) | Middle-Tertile (n = 136) | High-Tertile (n = 133) | p Value |
---|---|---|---|---|---|
Age, years [Mean (SD)] | 61.2 (7.8) | 60.1 (8.6) | 61.9 (7.3) | 61.7 (7.3) | 0.130 a |
Sex, n (%) | |||||
Male | 129 (31.9) | 36 (26.5) | 42 (30.9) | 51 (38.3) | 0.108 c |
Female | 276 (68.1) | 100 (73.5) | 94 (69.1) | 82 (61.7) | |
BMI, kg/m2 [Mean (SD)] | 24.3 (3.4) | 23.7 (3.1) | 23.9 (2.8) | 25.3 (4.0) | 0.004 a |
Overweight/obesity, n (%) | 253 (62.5) | 81 (59.6) | 84 (61.8) | 88 (66.2) | 0.523 c |
Smoking, n (%) | 72 (17.8) | 21 (15.4) | 19 (14.0) | 32 (24.1) | 0.066 c |
Duration of diabetes, years [Mean (SD)] | 8.8 (4.6) | 8.5 (4.3) | 8.6 (4.1) | 9.1 (5.4) | 0.763 a |
HbA1c (%) [Mean (SD)] | 7.9 (1.6) | 8.2 (1.4) | 8.0 (1.8) | 7.5 (1.4) | <0.001 a |
Type of treatment, n (%) | |||||
Insulin use | 89 (22.0) | 36 (26.5) | 28 (20.7) | 25 (18.8) | 0.286 c |
OAD | 315 (78.0) | 100 (73.5) | 107 (79.3) | 108 (81.2) | |
Serum uric acid, mg/dL [Mean (SD)] | 5.6 (1.5) | 4.1 (0.6) | 5.4 (0.3) | 7.2 (1.1) | <0.001 a |
Hyperuricemia, n (%) | 121 (29.9) | 0 (0) | 14 (10.3) | 107 (80.5) | <0.001 c |
Creatinine, mg/dL [Mean (SD)] | 0.8 (0.1) | 0.7 (0.1) | 0.8 (0.1) | 0.8 (0.1) | <0.001 a |
eGFR (mL/min/1,73 m2) [Mean (SD)] | 88.3 (12.5) | 91.5 (12.4) | 88.2 (12.7) | 85.2 (11.7) | <0.001 a |
≥ 90 (G1), n (%) | 195 (48.1) | 74 (54.4) | 74 (54.4) | 47 (35.3) | 0.001 c |
60–89 (G2) | 210 (51.9) | 62 (45.6) | 62 (45.6) | 86 (64.7) | |
ACR, mg/g [Median (IQR)] | 20.0 (11.7–54.5) | 21.2 (12.2–64.4) | 21.6 (12.6–60.6) | 18.5 (10.4–48.6) | 0.270 b |
Hypertension, n (%) | 342 (84.4) | 107 (78.7) | 116 (85.3) | 119 (89.5) | 0.048 c |
Systolic BP, mmHg [Mean (SD)] | 124.8 (11.5) | 123.2 (11.0) | 125.4 (12.0) | 125.7 (11.5) | 0.138 a |
Diastolic BP [Mean (SD)] | 75.2 (8.0) | 74.9 (7.9) | 75.1 (7.8) | 75.7 (8.4) | 0.683 a |
ACEI/ARB use, n (%) (n= 345) | 332 (97.1) | 104 (97.2) | 111 (95.7) | 117 (98.3) | 0.478 c |
Diuretic use, n (%) | 28 (6.9) | 6 (4.4) | 10 (7.4) | 12 (9.0) | 0.319 c |
Total cholesterol, mg/dL [Mean (SD)] | 177.3 (41.7) | 181.7 (40.4) | 175.4 (41.9) | 174.8 (42.7) | 0.319 a |
Triglyceride, mg/dL [Mean (SD)] | 206.2 (110.5) | 205.1 (104.4) | 202.0 (109.2) | 211.6 (118.3) | 0.768 a |
Previous CVD, n (%) | 146 (36.0) | 43 (31.6) | 56 (41.2) | 47 (35.3) | 0.254 c |
Characteristics | Rapid Decline eGFR (n = 65, 16.0%) | Non-Rapid Decline eGFR (n = 340, 84.0%) | p | OR (95% CI) |
---|---|---|---|---|
Age, years [Mean (SD)] | 60.9 (7.4) | 61.3 (7.9) | 0.675 a | 0.99 (0.96–1.03) |
Sex, n (%) | ||||
Male | 18 (27.7) | 111 (32.6) | 0.432 c | 0.79 (0.44–1.42) |
Female | 47 (72.3) | 229 (67.4) | ||
BMI, kg/m2 [Mean (SD)] | 24.5 (3.5) | 24.3 (3.4) | 0.658 a | 1.02 (0.94–1.10) |
Duration of diabetes, years [Mean (SD)] | 9.1 (4.4) | 8.7 (4.7) | 0.574 a | 1.02 (0.96–1.07) |
HbA1c (%)[Mean (SD)] | 8.1 (1.8) | 7.9 (1.5) | 0.248 a | 1.10 (0.94–1.29) |
Diuretic use | 9 (13.8) | 19 (5.6) | 0.028 c | 2.72 (1.17–6.30) |
Type of treatment, n (%) | ||||
Insulin use, n (%) | 17 (26.2) | 72 (21.2) | 0.381 c | 1.31 (0.71–2.42) |
OAD n (%) | 48 (73.8) | 267 (78.8) | ||
SUA, mg/dL [Mean (SD)] | 5.9 (1.6) | 5.5 (1.5) | 0.042 a | 1.19 (1.01–1.41) |
HUA, n (%) | 22 (33.8) | 99 (29.1) | 0.445 c | 1.25 (0.71–2.19) |
SUA tertiles, n (%) | ||||
Low-tertile | 16 (24.6) | 120 (35.3) | 0.228 c | 1 |
Middle-tertile | 26 (40.0) | 110 (32.4) | 1.77 (0.90–3.48) | |
High-tertile | 23 (35.4) | 110 (32.4) | 1.57 (0.79–3.12) | |
Creatinine, mg/dL [Mean (SD)] | 0.8 (0.1) | 0.8 (0.1) | 0.852 a | 0.84 (0.13–5.40) |
eGFR mL/min/1,73 m2 [Mean (SD)] | 88.3 (11.6) | 88.3 (12.7) | 0.998 a | 1.00 (0.98–1.02) |
ACR, mg/g [Median (IQR)] | 24.7 (13.6–78.3) | 19.9 (11.6–53.1) | 0.188 b | 1.00 (1.00–1.00) |
Hypertension, n (%) | 56 (86.2) | 286 (84.1) | 0.678 c | 1.17 (0.55–2.52) |
Systolic BP, mmHg [Mean (SD)] | 126.5 (13.8) | 124.4 (11.0) | 0.193 a | 1.02 (0.99–1.04) |
Diastolic BP | 76.1 (8.1) | 75.1 (8.0) | 0.354 a | 1.02 (0.98–1.05) |
ACEI/ARB use (n = 345), n (%) | 54 (96.4) | 278 (97.2) | 0.671 c | 0.78 (0.16–3.76) |
Total cholesterol mg/dL [Mean (SD)] | 184.8 (48.9) | 175.9 (40.1) | 0.115 a | 1.01 (1.00–1.01) |
Hypercholesterol- -emia, n (%) | 27 (41.5) | 86 (25.3) | 0.007 c | 2.10 (1.21–3.64) |
Triglyceride, mg/dL [Mean (SD)] | 246.1 (139.9) | 198.6 (102.5) | 0.011 a | 1.00 (1.00–1.01) |
Hypertriglyceride n (%) | 47 (72.3) | 214 (62.9) | 0.148 c | 1.54 (0.86–2.76) |
SUA | OR | 95% CI | p |
---|---|---|---|
Crude | 1.19 | 1.01–1.41 | 0.044 |
Model 1 | 1.22 | 1.02–1.45 | 0.026 |
Model 2 | 1.18 | 0.99–1.41 | 0.061 |
Model 3 | 1.20 | 0.99–1.46 | 0.065 |
Tertiles | OR | 95% CI | p |
---|---|---|---|
Crude | |||
Low-tertile | 1 | ||
Middle-tertile | 1.77 | 0.90–3.48 | 0.096 |
High-tertile | 1.57 | 0.79–3.12 | 0.200 |
Model 1 | |||
Low-tertile | 1 | ||
Middle-tertile | 1.77 | 0.90–3.48 | 0.096 |
High-tertile | 1.57 | 0.79–3.12 | 0.200 |
Model 2 | |||
Low-tertile | 1 | ||
Middle-tertile | 1.90 | 0.95–3.83 | 0.071 |
High-tertile | 1.61 | 0.79–3.29 | 0.193 |
Model 3 | |||
Low-tertile | 1 | ||
Middle-tertile | 1.88 | 0.93–3.81 | 0.079 |
High-tertile | 1.57 | 0.73–3.37 | 0.251 |
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Le, H.T.; Le, T.T.; Tran, N.M.T.; Nguyen, T.T.T.; Minh, N.C.S.; Le, Q.T.; Tram, T.A.T.; Tran, T.D.; Doan, T.X.; Duong, M.H.T.; et al. Serum Uric Acid Levels and Risk of Rapid Decline of Estimated Glomerular Filtration Rate in Patients with Type 2 Diabetes: Findings from a 5-Year Prospective Cohort Study. Healthcare 2021, 9, 1341. https://doi.org/10.3390/healthcare9101341
Le HT, Le TT, Tran NMT, Nguyen TTT, Minh NCS, Le QT, Tram TAT, Tran TD, Doan TX, Duong MHT, et al. Serum Uric Acid Levels and Risk of Rapid Decline of Estimated Glomerular Filtration Rate in Patients with Type 2 Diabetes: Findings from a 5-Year Prospective Cohort Study. Healthcare. 2021; 9(10):1341. https://doi.org/10.3390/healthcare9101341
Chicago/Turabian StyleLe, Hoa Tuyet, Tung Thanh Le, Nguyet Minh Thi Tran, Thuy Thanh Thi Nguyen, Ni Chanh Su Minh, Quyen Thi Le, Tuyet Anh Thi Tram, Thang Duc Tran, Tung Xuan Doan, Mai Huynh Thi Duong, and et al. 2021. "Serum Uric Acid Levels and Risk of Rapid Decline of Estimated Glomerular Filtration Rate in Patients with Type 2 Diabetes: Findings from a 5-Year Prospective Cohort Study" Healthcare 9, no. 10: 1341. https://doi.org/10.3390/healthcare9101341