Relationship Between Monosodium Urate Deposition And Renal Injury In Male Patients With Asymptomatic Hyperuricemia

Objective:In order to provide a clinical basis for timing of uric acid-lowering therapy in asymptomatic hyperuricemia(HUA)patients,the relationship between monosodium urate(MSU)deposition and renal injury was investigated by analyzing the basic data,biochemical metabolic indexes and renal function indexes of asymptomatic HUA patients.Methods:Medical examiners who underwent physical examination at the Medical Examination Center of Shanxi Provincial People’s Hospital from June 1,2021 to August 31,2022 were included in this study.According to their serum uric acid levels,they were categorized into patients with asymptomatic HUA(serum uric acid concentration of>420μmol/L)and healthy controls with normouricemia(serum uric acid concentration of≤420μmol/L).In patients with asymptomatic HUA,MSU deposition was determined by DECT of both feet.And then these patients were divided into a group with asymptomatic HUA alone and a group with HUA with MSU deposition.The normouricemia group served as a control group.Basic data,biochemical metabolic indexes and renal function indexes were collected in all patients and healthy controls.The relationship between MSU deposition and kidney damage was explored by multifactorial logistic regression analysis.Results:1.Base data:A total of 151 male medical examiners were included in this study,including 92 in the normouricemia group,36 in the asymptomatic HUA alone group,and23 in the HUA with MSU deposition group.There were no statistical differences in diastolic blood pressure(DBP),heart rate(HR),and histories of diabetes,smoking,physical activity,antihypertensive medication,glucose-lowering medication,and lipid-lowering medication between the three groups.Age,body mass index(BMI),systolic blood pressure(SBP),and history of alcohol consumption were found to be statistically different.Compared to the normouricemia group,the asymptomatic HUA alone group had a lower age,higher SBP and presence of a history of alcohol consumption.In addition,BMI was higher in both the asymptomatic HUA alone and HUA with MSU deposition groups than in the normouricemia group.There were no significant differences in age,BMI,and SBP between the asymptomatic HUA alone group and the HUA with MSU deposition group.2.Biochemical metabolic indexes:The comparison of aspartate aminotransferase(AST),fasting blood glucose(FBG),total cholesterol(CHO),and low density lipoprotein(LDL-C)between the three groups was not statistically significant.There was a statistical difference in alanine aminotransferase(ALT),triglyceride(TG),and high-density lipoprotein(HDL-C).ALT was significantly higher in the HUA with MSU deposition group than in the normouricemia group,whereas HDL-C was significantly lower.TG was significantly higher in the asymptomatic HUA alone group and the HUA with MSU deposition group than in the normouricemia group.There was no significant difference in ALT,TG,and HDL-C between the asymptomatic HUA alone group and the HUA with MSU deposition group.3.Renal function indexes:There were no statistical differences in blood urea nitrogen(BUN),serum creatinine(Scr),urine microalbumin(Um Alb),urineβ2 microglobulin(Uβ2MG),and urinary microalbumin to creatinine ratio(ACR)between the three groups.Uric acid(UA)and estimated glomerular filtration rate(e GFR)were statistically different.UA was significantly higher in the asymptomatic HUA alone group and the HUA with MSU deposition group than in the normouricemia group.The HUA with MSU deposition group had a higher proportion of patients with mildly impaired renal function(defined as an e GFR of 60-89 ml/min·1.73 m~2)than the normouricemia group.There was no statistical difference in the UA and e GFR between the asymptomatic HUA alone group and the HUA with MSU deposition group.4.Spearman correlation analysis showed a correlation between UA,Scr,e GFR and MSU deposition.5.Significant basic information and biochemical metabolic indicators were included in a multifactorial logistic regression model after univariate analysis.The results showed that HUA with or without MSU deposition was an independent risk factor for mildly impaired renal function.The risk of mildly impaired renal function was 4.028 and 5.682times higher in the asymptomatic HUA alone and HUA with MSU deposition group than in the normouricemia group,respectively.In addition,age was an independent risk factor for mildly impaired renal function(OR=1.093,95%CI:1.033 to 1.156).6.Renal function grouping characteristics:The highest percentage of mildly impaired renal function was observed in the HUA with MSU deposition group.The incidence of HUA with MSU deposition was significantly higher in the group with mildly impaired renal function than in the group with normal renal function(defined as e GFR≥90ml/min·1.73 m~2).Conclusion:1.There was a correlation between serum UA,Scr,e GFR and MSU deposition in male patients with asymptomatic HUA.2.HUA with or without MSU deposition and age are independent risk factors for mildly impaired renal function(defined as an e GFR of 60-89 ml/min·1.73 m~2)in male patients with asymptomatic HUA.3.HUA with MSU deposition was more likely to develop renal injury than male patients with asymptomatic HUA alone.This may provide new ideas on whether and when to initiate treatment for asymptomatic HUA patients in clinical practice.