Diabetes, Metabolic Syndrome and Obesity (Nov 2022)
The Serum Uric Acid to Serum Creatinine Ratio is an Independent Risk Factor for Diabetic Kidney Disease
Abstract
Li Chen,1,* Zhangxiang Zhu,1,* Shandong Ye,2,3 Mao Zheng2,3,* 1Department of Endocrinology, the Third Affiliated Hospital of Anhui Medical University (The First People’s Hospital of Hefei), Hefei, People’s Republic of China; 2Department of Endocrinology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People’s Republic of China; 3Laboratory of Diabetes, Department of Endocrinology, the First Affiliated Hospital of USTC, Hefei, People’s Republic of China*These authors contributed equally to this workCorrespondence: Li Chen, Department of Endocrinology, the Third Affiliated Hospital of Anhui Medical University (The First People’s Hospital of Hefei), Hefei, Anhui, 230001, People’s Republic of China, Tel +86 13855169122, Fax +86 055162283524, Email [email protected] Mao Zheng, Department of Endocrinology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, People’s Republic of China, Tel +86 13215603125, Fax +86 0551-62283524, Email [email protected]: A retrospective study was designed to evaluate whether the serum uric acid to serum creatinine ratio (SUA/SCr) can be used as an indicator of diabetic kidney disease (DKD) and macroangiopathy in patients with type 2 diabetes mellitus (T2DM).Patients and Methods: We screened 2227 patients diagnosed with T2DM, and 450 patients were finally included. They were assigned to three groups based on the tertile of SUA/SCr (Group Tertile 1, Tertile 2, Tertile 3). Demographic information and biochemical parameters were collected from Electronic Patient Record (EPR).Results: The estimated glomerular filtration rate (eGFR) values were lowest in Group Tertile 1 and highest in Group Tertile 3 (P 0.05). Partial correlation analyses revealed that SUA/SCr levels were significantly and positively correlated with eGFR, SUA, body mass index, gamma-glutamyl transpeptidase, alanine transaminase, triglycerides, C-peptide, high-density lipoprotein cholesterol and fatty liver, while they were negatively correlated with SCr, blood urea nitrogen, cystatin-c, age, male sex, DM duration and hypertension history (P < 0.05). Logistic regression analysis revealed that SUA/SCr was an independent risk factor for eGFR < 60 mL/min/1.73 m² (P < 0.05). The ROC curve showed that the cutoff value of SUA/SCr for the identification of eGFR < 60 mL/min/1.73 m² was 3.434. In patients with normal UACR, SUA/SCr levels of patients with eGFR < 60 mL/min/1.73 m² were lower than those with eGFR ≥ 60 mL/min/1.73 m² (P < 0.05). Regression analysis did not show SUA/SCr associate to macrovascular disease after adjusting for confounding factors.Conclusion: SUA/SCr is an independent risk factor for DKD in patients with T2DM and may be helpful for identifying normoalbuminuric DKD.Keywords: diabetes mellitus, glomerular filtration rate, serum uric acid, creatinine
