Study On The Correlation Between Serum Uric Acid Level And Type 2 Diabetic Nephropathy And Diabetic Retinopathy

Objective:To investigate the correlation between serum uric acid level and diabetic renal disease and diabetic retinopathy in type 2 diabetic patients..Methods:A total of 478 patients with Type 2 diabetes mellitus（T₂DM）admitted to the Endocrine Diabetes Hospital of Shanxi Provincial People’s Hospital from January 2020to December 2020 were selected.The enrolled patients ranged in age from 45 to 88 years old.All the enrolled patients had complete case data.The general clinical data,laboratory indexes and the prevalence of diabetic renal disease and diabetic retinopathy were collected by the electronic medical record system of our hospital.The included subjects were divided into DKD group and NDKD group according to whether they had Diabetic kidney disease（DKD）,and DR group and NDR group according to whether they had Diabetic retinopathy（DR）.SPSS25.0 was used for data analysis.Measurement data were expressed as mean±standard deviation（x±s）.Two independent samples t-test was used to compare the difference between measurement data.Was expressed as the rate of enumeration data（%）.X² test was used to compare the difference between enumeration data.Binary Logistic regression was used to analyze the risk factors of DR and DKD.ROC curve was used to analyze the blood uric acid level threshold of diabetic renal disease and diabetic retinopathy.Pearson correlation was used to analyze the correlation between Serum uric acid（SUA）and diabetes control factors,and P<0.05 was considered statistically significant.Results:（1）A total of 478 patients with T₂DM were collected in this study,with an age of61.53±9.72 years and a course of disease of 11.43±7.33 years.There were 159 patients in DR group,including 103 males and 56 females.There were 319 patients in NDR group,including 181 males and 138 females.There were 230 patients in DKD group,including158 males and 72 females.There were 248 patients in NDKD group,including 126 males and 122 females.Among 478 T₂DM patients,there were 342 patients with normal SUA level,136 patients with hyperuricemia,and the prevalence of T₂DM complicated with HUA was 28.45%（2）Multivariate Logistic regression analysis of DR showed that disease course,Hb A1c,urinary microalbumin/creatinine ratio and serum uric acid were independent risk factors for DR（P<0.05）.OR values were 1.097（95%CI 1.063-1.132）,1.169（95%CI 1.048-1.305）,1.001（95%CI 1-1.002）and 1.003（95%CI 1.001-1.005）,respectively.The ROC curve analysis results of DR risk factors showed that the area under the curve（AUC）for SUA to predict the occurrence of DR was 0.636,（95%CI 0.583-0.688）,and the P value was 0.000.When SUA level>304.75umol/L,the risk of DR was increased.（3）Multivariate Logistic regression analysis of DKD showed that smoking,disease course,body mass index,systolic blood pressure,Hb A1c and serum uric acid were independent risk factors for DKD（P<0.05）.OR values were 1.685（95%CI 1.015-2.8）,1.056（95%CI 1.018-1.096）,1.116（95%CI 1.027-1.214）,1.026（95%CI 1.008-1.044）,1.608（95%CI 1.377-1.878）,1.018（95%CI 1.014-1.021）.The ROC curve analysis of DKD risk factors showed that the area under the curve（AUC）of SUA for predicting DKD was 0.851,（95%C I 0.817-0.886）,w i t h a P v a l u e o f 0.000.When SUA level>379.05umol/L,the risk of DKD increased.（4）SUA with diabetes control factors,according to the results of the Pearson correlation analysis between SUA and body mass index（bmi）,systolic pressure,diastolic blood pressure,triglycerides,high-density lipoprotein cholesterol,low density lipoprotein cholesterol correlation,including SUA and body mass index（bmi）,systolic pressure,diastolic blood pressure,triglyceride,low density lipoprotein cholesterol were positively correlated,Was inversely associated with HDL cholesterol.Conclusions:（1）In T₂DM patients,SUA is an independent risk factor for DR and DKD.In order to delay the occurrence of complications,further attention should be paid to the metabolism of blood uric acid in patients on the basis of controlling blood glucose,blood pressure,blood lipids,weight and other factors as well as improving life style.（2）When SUA level>304.75umol/L,the risk of DR was increased.When SUA level>379.05umol/L,the risk of DKD increased.（3）SUA is associated with obesity,hypertension,and hyperlipidemia,and the combined effect of these factors may promote the occurrence of diabetic renal disease and diabetic retinopathy.