Increased Serum Uric Acid Level Is a Risk Factor for Left Ventricular Hypertrophy but Not Independent of eGFR in Patients with Type 2 Diabetic Kidney Disease.

Chuchu Zeng,Hongda Bao,Xiaohua Sheng,Niansong Wang,Junhui Li,Dongsheng Cheng,Guihua Jian,Yuqiang Chen,Ying Fan

doi:10.1155/2017/5016093

Chuchu Zeng, Hongda Bao + Show 7 more

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https://doi.org/10.1155/2017/5016093

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Journal: Journal of diabetes research	Publication Date: Jan 1, 2017
Citations: 6	License type: CC BY 4.0

Affiliation: Shanghai Jiao Tong University

Abstract

Background Although the relation between serum uric acid (SUA) and left ventricular hypertrophy (LVH) has been studied for decades, however, their association remains debatable. Methods This is a retrospective study in which a total of 435 hospitalized Chinese patients with type 2 DKD were enrolled. The subjects were stratified into quartiles according to SUA level. LVH was assessed by two-dimensional guided M-mode echocardiography. Results There was a significant increase in the prevalence of LVH in patients with type 2 DKD across SUA quartiles (28.9, 26.5, 36.1, and 49.5%; p < 0.001). The Spearman analysis indicated that SUA was positively correlated to LVMI and negatively correlated to eGFR. The logistic regression analysis revealed that the odd ratio for LVH in the highest SUA quartile was 2.439 (95% CI 1.265–4.699; p = 0.008; model 1) or 2.576 (95% CI 1.150–5.768; p = 0.021; model 2) compared with that in the lowest SUA quartile. However, there was no significant increased risk of LVH in the subjects with the highest SUA quartile after adjusting the eGFR (OR = 1.750; 95% CI 0.685–4.470; p = 0.242; model 3). Conclusions In selected population, such as type 2 DKD, the elevated SUA level is positively linked with the increased risk of LVH, but this relationship is not independent of eGFR.

Highlights

Left ventricular hypertrophy (LVH) is an imminent prognostic sign and an independent risk factor for cardiovascular morbidity and mortality [1, 2]
Accumulated studies indicate that increased serum uric acid (SUA) level which is associated with endothelial dysfunction, activation of RAAS, increase of oxidative stress, and inflammation may play an important role in the pathogenesis of cardiovascular disease and kidney dysfunction [3,4,5,6,7]
Age, smoking, alcohol, duration of diabetes, and the use of antihypertensive agents, compared with that with the subjects in quartile 1 (SUA < 324 μmol/L), there was significant increased risk of left ventricular hypertrophy (LVH) with the subjects in quartile 4 (SUA > 470 μmol/L) (OR = 2.439; 95% cerebral infarction (CI) 1.265–4.699; p = 0 008)

Summary

Introduction

Left ventricular hypertrophy (LVH) is an imminent prognostic sign and an independent risk factor for cardiovascular morbidity and mortality [1, 2]. In several epidemiological studies, this positive association became vague or did not remain significant after multivariate adjustment for classic risk factors [13, 14]. The relation between serum uric acid (SUA) and left ventricular hypertrophy (LVH) has been studied for decades, their association remains debatable. There was a significant increase in the prevalence of LVH in patients with type 2 DKD across SUA quartiles (28.9, 26.5, 36.1, and 49.5%; p < 0 001). There was no significant increased risk of LVH in the subjects with the highest SUA quartile after adjusting the eGFR (OR = 1.750; 95% CI 0.685–4.470; p = 0 242; model 3). In selected population, such as type 2 DKD, the elevated SUA level is positively linked with the increased risk of LVH, but this relationship is not independent of eGFR

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