Correlations between blood uric acid and the incidence and progression of type 2 diabetes nephropathy.

OBJECTIVE: To investigate the relationships between blood uric acid (BUA) level and the incidence, progression and deterioration of diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM).

PATIENTS AND METHODS: A total of fifty patients with T2DM alone whose glycosylated hemoglobin (HbA1c) were under normal range (4-6.5%) at their admission to our hospital were randomly selected as diabetes mellitus (DM) group. Fifty patients with hyperuricemia alone were randomly selected as hyperuricemia (HUA) group. Fifty patients with T2DM complicated with hyperuricemia who were admitted to the hospital with HbAlc of 4-6.5% were randomly selected as diabetes mellitus hyperuricemia (DM-HUA) group. In addition, fifty healthy persons who passed the health examination were randomly selected as normal control (NC) group. The general data such as name and body mass index (BMI), metabolic-related indexes such as fasting blood glucose (FBG), total cholesterol (TC) and triglyceride (TG) as well as kidney-related indexes such as blood urea nitrogen (BUN), creatinine (Cr) and albumin-creatinine-ratio (ACR) in four groups were tested and recorded at the same time. The interrelationships between uric acid (UA) and the above indexes were statistically analyzed.

RESULTS: In DM-HUA group, serum TC, TG and low density lipoprotein (LDL) as well as urine ACE were greatly increased (p<0.05) compared with the other three groups, high-density lipoprotein (HDL) was significantly decreased compared with the remaining three groups (p<0.05), and BMI and Cr were increased compared with those in NC group and DM group (p<0.05). There were no significant differences in metabolic indexes and renal functions in DM group and HUA group. Compared with NC group, TC, LDL, serum β2 macroglobulin and BMI in above two groups were greatly increased (p<0.05); BUN and Cr in HUA group were slightly higher than those in NC group (p<0.05). Multiple linear regression analysis showed that UA level was the main factor affecting ACR (R2=0.636, p<0.001).

CONCLUSIONS: UA level is an independent risk factor for early renal disease in patients with T2DM, which can promote the progression and deterioration of renal disease in T2DM patients.