Abstract
Early detection diabetic nephropathy (DN) is important. Whether serum uric acid (SUA) has a role in the development of DN is not known. To study the relationship between SUA and hypertension, early nephropathy and progression of chronic kidney disease (CKD) in type 2 diabetes mellitus (T2DM). The total number of the study was 986 participants, according to presence and duration of diabetes were classified into three groups. Group I; including 250 healthy participants. Group II; including 352 with onset of diabetes < 5 years. Group III; including 384, with the onset of diabetes > 5 years. All participants were submitted to complete clinical examination, anthropometric measurements, laboratory investigations, including glycosylated hemoglobin (HbA1C), as well triglycerides to high-density lipoprotein ratios (TG/HDL-C), SUA, urinary albumin/creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR). SUA, BP, HbA1c, TG/HDL-C ratio, and ACR levels were significantly higher in group III than group I, II and in II than I. eGFR significantly lower in group III than group I, II and in II than I (p < 0.001). Age, BMI, BP, HbA1c, TG/HDL-C, ACR, were positively correlated with SUA, while GFR negatively correlated. SUA at level of > 6.1 mg/dl, > 6.2 mg/dl and > 6.5 mg/dl had a greater sensitivity and specificity for identifying hypertension, early nephropathy and decline eGFR respectively. Even high normal SUA level, was associated with the risk of hypertension, early nephropathy and decline of eGFR. Moreover SUA level may identify the onset of hypertension, early nephropathy and progression of CKD in T2DM.
Highlights
serum uric acid (SUA), BP, HbA1c, TG/HDL-C ratio, and albumin/creatinine ratio (ACR) levels were significantly higher in group III than group I, II and in II than I. estimated glomerular filtration rate (eGFR) significantly lower in group III than group I, II and in II than I (p < 0.001)
SUA significantly higher in diabetic patients than the healthy control group, SUA levels were significantly higher in diabetic patients over 5 years duration than lesser duration of diabetes
Diastolic, mean arterial BP, duration of diabetes, HbA1C, TG, total cholesterol (TC), low-density lipoprotein (LDL), TG/HDL-C ratio, SCr and ACR levels were significantly higher in group III than group I, II, likewise higher in group II than group I
Summary
Detection diabetic nephropathy (DN) is important. Whether serum uric acid (SUA) has a role in the development of DN is not known. The prevalence of type 2 diabetes mellitus (T2DM) has significantly increased worldwide, which has resulted in an increased burden on individuals and health care systems.[1] Diabetic nephropathy (DN) is a common complication of diabetes and its earliest clinical sign is a slight elevation of urinary albumin excretion microalbuminuria (MA). Such leakage was believed to progress inexorably to gross proteinuria, which destroyed nephrons and led to end stage renal disease (ESRD).[2]. Including endothelial dysfunction,[10] increased activity of the renin-angiotensin aldosterone system (RAAS),[11] and induction of inflammatory cascades,[12] in addition to profibrotic cytokine activation,[13] all of which have been demonstrated to contribute to the progression of microvascular disease and thereby renal injury in DN
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