Serum uric acid level as an indicator for CKD regression and progression in patients with type 2 diabetes mellitus-a 4.6-year cohort study
Serum uric acid level as an indicator for CKD regression and progression in patients with type 2 diabetes mellitus-a 4.6-year cohort study
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DOI：
10.1002/dmrr.2768
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发表时间：
2016-09-01
影响因子：
8
通讯作者：
Lee, Yau-Jiunn
中科院分区：
文献类型：
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作者：
Chang, Yu-Hung;Lei, Chen-Chou;Lee, Yau-Jiunn
目的探讨2型糖尿病（T2 DM）患者血尿酸水平与肾功能变化的关系。参与者根据其慢性肾脏病（CKD）分期的变化分为稳定、进展或消退组。在随访期间，计算所有代谢因素的数值，包括尿酸水平和药物拥有率，以研究它们与CKD发展的相关性。多因素考克斯回归分析，以确定与CKD的变化相关的独立因素。结果共有2367例T2 DM患者参加了这项研究，并随访了平均4.6年。稳定、进展和消退组的患者数量分别为1133例（47.9%）、487例（20.6%）和747例（31.5%）。进展组的血清尿酸水平最高（6.9 +/- 1.8 mg/dL），消退组的尿酸水平最低（5.4 +/- 1.5 mg/dL）。此外，我们发现，当血清尿酸水平超过6.3 mg/dL时，血清尿酸水平是与CKD进展相关的独立因素。结论血尿酸水平与慢性肾脏病（CKD）的消退和进展有关，提示应密切监测T2 DM患者的血尿酸水平。版权所有（C）2015约翰威利父子有限公司
Background To investigate the association of serum uric acid level with renal function change in patients with type 2 diabetes mellitus (T2DM).Methods T2DM patients who had been followed-up for at least 3 years were included. Participants were categorized into stable, progression, or regression groups according to their change in chronic kidney disease (CKD) stage. During the follow-up period, all numeric values of metabolic factors, including the uric acid level and the medication possession rate, were calculated in order to investigate their associations with CKD development. Multivariate Cox regression analyses were used to identify independent factors associated with change in CKD.Results A total of 2367 T2DM patients were enrolled in this study and followed-up for a mean of 4.6 years. The numbers of patients in the stable, progression and regression groups were 1133 (47.9%), 487 (20.6%), and 747 (31.5%), respectively. The progression group had the highest serum uric acid level (6.9 +/- 1.8 mg/dL), and the regression group had the lowest uric acid level (5.4 +/- 1.5 mg/dL). In addition, we found that the serum uric acid level was an independent factor associated with CKD progression when the value exceeded 6.3 mg/dL. A lower uric acid level could be beneficial for CKD improvement in T2DM patients with stage 3-5 CKD.Conclusions Our data indicated that the serum uric acid level is associated with CKD regression and progression and suggested that a high normal serum uric acid level should be closely monitored in patients with T2DM. Copyright (C) 2015 John Wiley & Sons, Ltd.