Uric acid is not associated with diabetic nephropathy and other complications in type 1 diabetes.

Autor:	Pilemann-Lyberg S; Medical Research Laboratory, Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark.; Steno Diabetes Center Copenhagen, Gentofte, Denmark., Hansen TW; Steno Diabetes Center Copenhagen, Gentofte, Denmark., Persson F; Steno Diabetes Center Copenhagen, Gentofte, Denmark., Theilade S; Steno Diabetes Center Copenhagen, Gentofte, Denmark., Singh Ahluwalia T; Steno Diabetes Center Copenhagen, Gentofte, Denmark., Frystyk J; Medical Research Laboratory, Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark.; Department of Endocrinology, Odense University Hospital & Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark., Rossing P; Steno Diabetes Center Copenhagen, Gentofte, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Jazyk:	angličtina
Zdroj:	Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association [Nephrol Dial Transplant] 2019 Apr 01; Vol. 34 (4), pp. 659-666.
DOI:	10.1093/ndt/gfy076
Abstrakt:	Background: To examine the association between plasma uric acid (UA) and the presence of diabetic complications including diabetic nephropathy and cardiovascular risk factors in patients with type 1 diabetes. Methods: This study, which is cross-sectional in design, included 676 Caucasian type 1 diabetes patients from the Steno Diabetes Center Copenhagen. Participants with UA within the three lowest sex-specific quartiles were compared with participants with levels in the highest quartile. Unadjusted and adjusted linear regression analyses were applied. Adjustment included sex, age, diabetes duration, body mass index, high-density lipoprotein cholesterol, smoking, haemoglobin A1c, 24-h pulse pressure, urinary albumin excretion rate (UAER), estimated glomerular filtration rate (eGFR) and treatment with renin-angiotensin-aldosterone system blockers. Results: Of the 676 patients, 372 (55%) were male, mean ± SD age was 55 ± 13 years and eGFR was 82 ± 26 mL/min/1.73 m2. The median UA was 0.30 (interquartile range 0.23-0.37) mmol/L. UA in the upper sex-specific quartile was associated with lower eGFR, higher UAER and carotid-femoral pulse wave velocity and lower 24 h and daytime diastolic blood pressure (BP) in unadjusted analyses (P < 0.001). Moreover, UA in the upper sex-specific quartile was associated with higher nighttime systolic BP and the presence of cardiovascular disease in unadjusted analyses (P ≤ 0.01), but significance was lost after adjustment (P ≥ 0.17). UA was higher across the retinopathy groups [nil (n = 142), simplex (n = 277), proliferative (n = 229) and blind (n = 19)] in unadjusted analyses (P < 0.0001), but not after adjustment (P = 0.12). Patients with an accelerated decline in eGFR (≥3 mL/min/year) had significantly higher UA at baseline (P = 0.006) compared with slow decliners (<3 mL/min/year), but significance was lost after adjustment (P = 0.10). Conclusions: In type 1 diabetes patients, higher UA was associated with lower kidney function and other diabetic complications. The association between higher UA and lower eGFR and lower diastolic BP was independent of traditional risk factors. (© The Author(s) 2018. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.)
Databáze:	MEDLINE
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