Association Between Serum Uric Acid to Creatinine Ratio and Time in Range in Patients With Type 2 Diabetes

IF 2.4 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Yu Gong, Ying Li, Qianqian Zhang, Zhangxiang Zhu, Guojuan Wang
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Abstract

Background

Elevated serum uric acid (SUA) levels are an important marker of metabolic disorders. However, SUA levels largely depend on renal clearance function. This study aims to investigate the correlation between serum uric acid to creatinine (SUA/SCr) ratio and time in range (TIR) in patients with type 2 diabetes mellitus (T2DM).

Methods

TIR was assessed using continuous glucose monitoring (CGM) systems in 514 hospitalized patients with T2DM. Biochemical parameters, including blood glucose, liver and renal function markers, and blood lipids, were measured. SUA/SCr was calculated, and its association with TIR was analyzed.

Results

One-way ANOVA revealed significantly higher TIR levels in the SUA/SCrQ3 group compared to the Q1 group (72.90% [60.08%, 83.38%] vs. 80.20% [70.25%, 89.65%], p = 0.0084). Smooth curve fitting and threshold effect analyses demonstrated an inverted U-shaped association between SUA/SCr and TIR after multivariable adjustment. Before the inflection point (SUA/SCr = 6.471), a positive correlation was observed (β = 1.402, p = 0.0379), indicating a 1.402% increase in TIR per 1-unit increase in SUA/SCr. Beyond the inflection point, a negative correlation emerged (β = −4.406, p = 0.0043), corresponding to a 4.406% decrease in TIR per 1-unit increase in SUA/SCr. Trend tests confirmed the statistical significance of these bidirectional associations. Interaction analyses indicated that gender, BMI, GLP1RA-therapy, SGLT2i-therapy did not significantly modify the SUA/SCr-TIR association (p > 0.05 for all). However, age significantly modified this relationship (P for interaction = 0.0240). Subgroup analysis by age revealed a curvilinear association in participants aged < 65 years, with no significant association below the inflection point (SUA/SCr = 6.559; β = 0.796, p = 0.2803) but a significant negative association above it (β = −4.392, p = 0.0059). No significant association was found in participants aged ≥ 65 years.

Conclusions

An inverted U-shaped association exists between SUA/SCr and TIR in patients with T2DM, suggesting that maintaining SUA/SCr within a certain range may be a protective factor for TIR.

Abstract Image

2型糖尿病患者血清尿酸/肌酐比值与时间范围的关系
背景:血清尿酸(SUA)水平升高是代谢性疾病的重要标志。然而,SUA水平在很大程度上取决于肾脏清除功能。本研究旨在探讨2型糖尿病(T2DM)患者血清尿酸/肌酐(SUA/SCr)比值与时间范围(TIR)的相关性。方法:采用连续血糖监测(CGM)系统对514例住院T2DM患者的TIR进行评估。测定血糖、肝肾功能指标、血脂等生化指标。计算SUA/SCr,并分析其与TIR的相关性。结果:单因素方差分析显示,SUA/SCrQ3组的TIR水平显著高于Q1组(72.90%[60.08%,83.38%]对80.20% [70.25%,89.65%],p = 0.0084)。光滑曲线拟合和阈值效应分析表明,经多变量调整后,SUA/SCr与TIR呈倒u型相关。在拐点前(SUA/SCr = 6.471),二者呈正相关(β = 1.402, p = 0.0379),表明SUA/SCr每增加1单位,TIR增加1.402%。在拐点之外,出现负相关(β = -4.406, p = 0.0043),对应于SUA/SCr每增加1单位,TIR降低4.406%。趋势检验证实了这些双向关联的统计学意义。相互作用分析表明,性别、BMI、glp1ra治疗、sgltti治疗并没有显著改变SUA/SCr-TIR相关性(p < 0.05)。然而,年龄显著改变了这一关系(交互作用P = 0.0240)。结论:T2DM患者SUA/SCr与TIR呈倒u型相关,提示将SUA/SCr维持在一定范围内可能是TIR的保护因素。
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来源期刊
Clinical Endocrinology
Clinical Endocrinology 医学-内分泌学与代谢
CiteScore
6.40
自引率
3.10%
发文量
192
审稿时长
1 months
期刊介绍: Clinical Endocrinology publishes papers and reviews which focus on the clinical aspects of endocrinology, including the clinical application of molecular endocrinology. It does not publish papers relating directly to diabetes care and clinical management. It features reviews, original papers, commentaries, correspondence and Clinical Questions. Clinical Endocrinology is essential reading not only for those engaged in endocrinological research but also for those involved primarily in clinical practice.
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