Abstract
AimsTo investigate the relationship between hyperuricemia (HUA) and the clinical backgrounds in Japanese patients with type 2 diabetes mellitus.MethodsAfter a cross-sectional study evaluating the association of HUA with the clinical characteristics in 1,213 patients with type 2 diabetes mellitus, the estimated glomerular filtration rate (eGFR) and the incidence of diabetic macroangiopathies was investigated in a prospective observational study in 1,073 patients during a 3.5 year period. HUA was defined by serum uric acid levels >327 μmol/L or as patients using allopurinol.ResultsThe frequency of HUA was significantly higher in the diabetic patients (32% in men and 15% in women) than in the normal controls (14% in men and 1% in women). In total, HUA was found in 299 (25%) of the patients during the cross-sectional study. Even after adjusting for sex, drinking status, treatment for diabetes mellitus, body mass index, hypertension, use of diuretics, hyperlipidemia, HbA1c and/or the eGFR, the HUA was independently associated with some diabetic complications. The eGFR was significantly reduced in HUA patients compared to those with normouricemia in the 12 months after observation was started. HUA was also an independent risk factor for coronary heart disease even after adjustment in the Cox proportional hazard model.ConclusionsHUA is a associated with diabetic micro- and macroangiopathies. HUA is a predictor of coronary heart disease and renal dysfunction in patients with type 2 diabetes mellitus. However, the influence of HUA is considered to be limited.
Highlights
It has been reported that hyperuricemia (HUA) is an independent risk factor for the progression of renal dysfunction [1,2] and cardiovascular events [1,2,3,4,5,6,7,8,9,10], as well as gout
OHA: oral hypoglycemic agents, ACEi: angiotensin-converting enzyme inhibitor, ARB: angiotensin II receptor blocker, CCB: calcium channel blocker, GFR: glomerular filtration rate, CKD: chronic kidney disease, ankle-brachial pressure index (ABI): ankle-brachial index, baPWV: brachial-ankle pulse wave velocity, and IMT: intima-media thickness #Drinkers were defined as those who consumed more than 20 g/day of ethanol. ##Obesity was considered to be present in individuals with a body mass index
Carotid IMT glomerular filtration rate, CKD: chronic kidney disease, ABI: ankle-brachial index, baPWV: brachial-ankle pulse wave velocity, and IMT: intima-media thickness #Drinkers were defined as those who consumed more than 20 g/day of ethanol. ##Obesity was considered to be present in individuals with a body mass index
Summary
It has been reported that hyperuricemia (HUA) is an independent risk factor for the progression of renal dysfunction [1,2] and cardiovascular events [1,2,3,4,5,6,7,8,9,10], as well as gout. Type 2 diabetes mellitus is well-known as a major risk factor for chronic kidney disease (CKD) and atherosclerotic disease. HUA has been reported to be associated with the onset of diabetes mellitus or metabolic syndrome [15,16,17,18,19,20]. Several studies have reported the relationship between HUA and diabetic macroangiopathies, such as coronary heart disease, stroke and peripheral arterial disease, the conclusions have been controversial [21,22,23,24,25,26,27]. The changes in kidney function associated with the HUA have not yet been sufficiently studied in the patients with type 2 diabetes mellitus
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