Introduction & Objective: To clarify the correlation between SUA levels and the risk of DN in Chinese patients with T1DM, and determine the SUA threshold associated with an increased risk of DN.
Methods: Both cross-sectional study and longitudinal study were conducted. The cross-sectional study was conducted with 681 subjects with T1DM. Adjusted multivariable logistic regression analysis was used to investigate the association between SUA levels and the risk of developing DN in patients with T1DM. Restricted cubic spline (RCS) was applied to determine the optimal threshold for SUA. Longitudinal data were collected from 94 patients with at least 3 visits to evaluate the variability of SUA levels with estimated glomerular filtration rate (eGFR) and urinary albumin creatinine ratio (UACR).
Results: The 681 patients were divided into four groups based on the quartile SUA levels. The median SUA level was 4.18mg/dL. Among 681 participants in this analysis, median age was 42 (IQR 28-55) years and 52.4% were male, the incidence of DN was 12.6%. After adjusting for confounding factors, the SUA level was inversely significantly correlated with the risk of DN (OR 1.57 [95% confidence interval (CI) 1.26; 1.95], P<0.001). The RCS plot revealed a U-shaped relationship between SUA levels and DN, with the identified threshold of SUA being 3.85mg/dL in female and 4.64mg/dL in male (Figure 1). Correlation analysis showed the SUA variability was significantly correlate with eGFR variability (r=0.206, p=0.046) and UACR variability(r=0.405, p<0.01) (Figure 2).
Conclusion: Our study identified SUA as a significant risk factor for DN in Chinese T1DM patients and established the optimal threshold with 3.85mg/dL in female and 4.64mg/dL in male for predicting DN risk. Our findings provide important evidence for improving risk discrimination and reclassification of high-risk DN subjects in clinical practice.
M. Zhang: None. M. Huang: None. Q. Wei: None. X. Chen: None. S. Wang: None. Y. Qin: None. L. Dai: None. T. Yang: None.
