Metabolic syndrome, serum uric acid and renal risk in patients with T2D.

Abstract

BACKGROUND AND AIMS:

Metabolic Syndrome (Mets) and increased serum uric acid (SUA), are well known renal risk predictors and often coexist in patients with type 2 diabetes (T2D). Whether they independently contribute to the onset of CKD is at present unclear.

METHODS AND RESULTS:

Within the AMD Annals database we identified patients with T2D and normal renal function and urine albumin excretion at baseline and regular follow-up visits during a 4-year period. Blood pressure, BMI, HDL, triglycerides, and SUA were available in 14,267 patients. The association between Mets and/or hyperuricemia (HU, top fifth gender specific quintile) and the occurrence of renal outcomes were evaluated.

RESULTS:

At baseline 59% of patients (n = 8,408) showed Mets and 18% (n = 2,584) HU. Over the 4-year follow-up, 14% (n = 1,990) developed low eGFR (i.e. below 60 mL/min/1.73 m2), and 26% (n = 3,740) albuminuria. After adjustment for confounders, BP≥130/85, low HDL, triglycerides ≥150 and HU were independently related to the development of low eGFR (1.57, P<0.001; 1.13, P = 0.056; 1.18, P = 0.008; 1.26, P = 0.001) and of albuminuria (1.35, P<0.001; 1.18, P = 0.001; 1.15, P = 0.002; 1.24, P = 0.001), respectively. The incidence of low eGFR was higher in patients with HU independent of the presence or absence of Mets (21%, OR 1.30, p = 0.009 and 20%, 1.57, p<0.000 respectively), while albuminuria occurred more frequently in those with Mets and HU (32%, OR 1.25, p = 0.005) as compared to the reference group.

CONCLUSIONS:

HU and Mets are independent predictors of CKD and its individual components in patients with T2D.

• Authors: Francesca Viazzi, Pamela Piscitelli, Carlo Giorda, Antonio Ceriello, Stefano Genovese, Giuseppina Russo, Pietro Guida, Paola Fioretto, Salvatore De Cosmo, Roberto Pontremoli, AMD-Annals Study Group
• Journal: PloS one (PLoS One) Vol. 12 Issue 4 Pg. e0176058 ( 2017) ISSN: 1932-6203 [Electronic] United States
• PMID: 28423036 (Publication Type: Journal Article)

Chemical References

• Cholesterol, HDL
• Triglycerides
• Uric Acid

Topics

• Acute Kidney Injury (blood, diagnosis, etiology, physiopathology)
• Aged
• Albuminuria (blood, complications, diagnosis, physiopathology)
• Blood Pressure
• Body Mass Index
• Cholesterol, HDL (blood)
• Databases, Factual
• Diabetes Mellitus, Type 2 (blood, complications, diagnosis, physiopathology)
• Female
• Glomerular Filtration Rate
• Humans
• Hyperuricemia (blood, complications, diagnosis, physiopathology)
• Male
• Metabolic Syndrome (blood, complications, diagnosis, physiopathology)
• Middle Aged
• Prognosis
• Prospective Studies
• Triglycerides (blood)
• Uric Acid (blood)