Prognostic importance of baseline and changes in serum uric acid for macro/microvascular and mortality outcomes in individuals with type 2 diabetes: The Rio de Janeiro type 2 diabetes cohort

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications Pub Date : 2024-11-27 DOI:10.1016/j.jdiacomp.2024.108921

Claudia R.L. Cardoso, Lucas da Silva Pereira, Nathalie C. Leite, Gil F. Salles

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引用次数: 0

Abstract

Aims

To investigate the associations between baseline/changes in serum uric acid (sUA) and the risks for cardiovascular/microvascular outcomes and mortality in a type 2 diabetes cohort.

Methods

Baseline sUA was measured in 685 individuals, and 463 had a second sUA measurement during follow-up; sUA was analyzed as a continuous variable and categorized into sex-specific tertile subgroups and low/high levels (>4.5 mg/dl women; >5.5 mg/dl men). The risks associated with baseline sUA and its changes were examined by Cox analyses for all outcomes.

Results

Median follow up was 10.7 years, there were 173 major cardiovascular events (MACEs), 268 all-cause deaths, 127 microalbuminuria, 104 renal failure, 160 retinopathy and 178 peripheral neuropathy outcomes. Baseline sUA was predictor of all outcomes, except all-cause mortality and retinopathy. In tertile and high/low sUA analyses, the hazard ratios (HRs) varied from 1.6 (microalbuminuria development) to 2.4 (MACEs; cardiovascular mortality). There was interaction with sex for MACEs, an increased risk was observed in women (HR: 2.6), but not in men (HR: 1.2). Changes in sUA were associated with the renal failure (HR: 2.4).

Conclusions

In a prospective cohort, high baseline sUA was a predictor of cardiovascular, renal and peripheral neuropathy. However, sUA changes were only predictor of renal failure.

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基线和血清尿酸变化对2型糖尿病患者大血管/微血管和死亡结局的预后重要性：里约热内卢de Janeiro 2型糖尿病队列

目的研究2型糖尿病患者血清尿酸（sUA）基线/变化与心血管/微血管结局和死亡率风险之间的关系。方法对685例患者进行基线sUA测量，其中463例在随访期间进行了第二次sUA测量；将sUA作为连续变量进行分析，并将其分为性别特异性亚组和低/高水平(>；4.5 mg/dl女性；男性5.5毫克/分升)。所有结果的Cox分析检查了与基线sUA及其变化相关的风险。结果中位随访时间为10.7年，主要心血管事件（mace） 173例，全因死亡268例，微量白蛋白尿127例，肾功能衰竭104例，视网膜病变160例，周围神经病变178例。基线sUA是所有结果的预测因子，除了全因死亡率和视网膜病变。在分位数和高/低sUA分析中，风险比（hr）从1.6（微量白蛋白尿发展）到2.4 （mace）不等；心血管死亡率)。mace与性别有相互作用，在女性中观察到风险增加（HR: 2.6），但在男性中没有（HR: 1.2）。sUA的变化与肾功能衰竭有关（HR: 2.4）。结论在一项前瞻性队列研究中，高基线sUA是心血管、肾脏和周围神经病变的预测因子。然而，sUA变化仅是肾功能衰竭的预测因子。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of diabetes and its complications 医学-内分泌学与代谢

CiteScore

5.90

自引率

3.30%

发文量

153

审稿时长

16 days

期刊介绍： Journal of Diabetes and Its Complications (JDC) is a journal for health care practitioners and researchers, that publishes original research about the pathogenesis, diagnosis and management of diabetes mellitus and its complications. JDC also publishes articles on physiological and molecular aspects of glucose homeostasis. The primary purpose of JDC is to act as a source of information usable by diabetes practitioners and researchers to increase their knowledge about mechanisms of diabetes and complications development, and promote better management of people with diabetes who are at risk for those complications. Manuscripts submitted to JDC can report any aspect of basic, translational or clinical research as well as epidemiology. Topics can range broadly from early prediabetes to late-stage complicated diabetes. Topics relevant to basic/translational reports include pancreatic islet dysfunction and insulin resistance, altered adipose tissue function in diabetes, altered neuronal control of glucose homeostasis and mechanisms of drug action. Topics relevant to diabetic complications include diabetic retinopathy, neuropathy and nephropathy; peripheral vascular disease and coronary heart disease; gastrointestinal disorders, renal failure and impotence; and hypertension and hyperlipidemia.