Serum uric acid as a predictor for development of diabetic nephropathy in type 1 diabetes: an inception cohort study.
Serum uric acid as a predictor for development of diabetic nephropathy in type 1 diabetes: an inception cohort study.
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DOI：
10.2337/db09-0014
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发表时间：
2009-07
期刊：
影响因子：
7.7
通讯作者：
Parving HH
中科院分区：
文献类型：
--
作者：
Hovind P;Rossing P;Tarnow L;Johnson RJ;Parving HH
实验和临床研究表明，尿酸可能有助于高血压和肾脏疾病的发展。糖尿病肾病的发生发展与尿酸水平有关。本研究的目的是评估尿酸作为持续性微量和大量白蛋白尿的预测因子。这项前瞻性观察性随访研究包括277例1型糖尿病患者的初始队列。其中，270例患者在基线时采集了血液样本。在7例病例中，无法测定尿酸;因此，263例患者（156例男性）可用于分析。在糖尿病发病后3年，任何患者出现微量白蛋白尿之前测量尿酸。在中位随访18.1年（范围1.0-21.8）期间，263例患者中有23例发生持续性大量白蛋白尿（连续三个样本中至少有两个样本的尿白蛋白排泄率>300 mg/24 h）。在尿酸水平处于最高四分位数（>249 μmol/l）的患者中，持续性大量白蛋白尿的累积发生率为22.3%（95% CI 10.3-34.3），而尿酸水平处于三个较低四分位数的患者中，持续性大量白蛋白尿的累积发生率为9.5%（3.8-15.2）（对数秩检验，P = 0.006）。在以性别和年龄作为固定协变量的考克斯比例风险模型中，尿酸与随后发生持续性大量白蛋白尿相关（尿酸水平每增加100 μmol/l，风险比为2.37 [95% CI 1.04-5.37]; P = 0.04）。调整混杂因素后，估计值没有显著变化。1型糖尿病发病后不久的尿酸水平与以后发生糖尿病肾病的风险独立相关。
Experimental and clinical studies have suggested that uric acid may contribute to the development of hypertension and kidney disease. Whether uric acid has a causal role in the development of diabetic nephropathy is not known. The objective of the present study is to evaluate uric acid as a predictor of persistent micro- and macroalbuminuria. This prospective observational follow-up study consisted of an inception cohort of 277 patients followed from onset of type 1 diabetes. Of these, 270 patients had blood samples taken at baseline. In seven cases, uric acid could not be determined; therefore, 263 patients (156 men) were available for analysis. Uric acid was measured 3 years after onset of diabetes and before any patient developed microalbuminuria. During a median follow-up of 18.1 years (range 1.0–21.8), 23 of 263 patients developed persistent macroalbuminuria (urinary albumin excretion rate >300 mg/24 h in at least two of three consecutive samples). In patients with uric acid levels in the highest quartile (>249 μmol/l), the cumulative incidence of persistent macroalbumnuria was 22.3% (95% CI 10.3–34.3) compared with 9.5% (3.8–15.2) in patients with uric acid in the three lower quartiles (log-rank test, P = 0.006). In a Cox proportional hazards model with sex and age as fixed covariates, uric acid was associated with subsequent development of persistent macroalbuminuria (hazard ratio 2.37 [95% CI 1.04–5.37] per 100 μmol/l increase in uric acid level; P = 0.04). Adjustment for confounders did not change the estimate significantly. Uric acid level soon after onset of type 1 diabetes is independently associated with risk for later development of diabetic nephropathy.
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影响因子：
19.6
作者：
Khosla, UM;Zharikov, S;Johnson, RJ
通讯作者：
Johnson, RJ
影响因子：
158.5
作者：
Lurbe, E;Redon, J;Batlle, D
通讯作者：
Batlle, D
DOI：
10.3109/00365518509155256
发表时间：
1985-01-01
影响因子：
2.1
作者：
FELDTRASMUSSEN, B;DINESEN, B;DECKERT, M
通讯作者：
DECKERT, M
影响因子：
5.8
作者：
Voruganti, V. Saroja;Nath, Subrata D.;Arar, Nedal H.
通讯作者：
Arar, Nedal H.
影响因子：
105.7
作者：
Hovind, P;Tarnow, L;Parving, HH
通讯作者：
Parving, HH