Metabolic syndrome, serum uric acid and renal risk in patients with T2D

Francesca Viazzi, Pamela Piscitelli, Carlo Giorda, Antonio Ceriello, Stefano Genovese, Giuseppina Russo, Pietro Guida, Paola Fioretto, Salvatore De Cosmo, Roberto Pontremoli

Research output: Contribution to journalArticle

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Abstract

Background and aims: Metabolic Syndrome (Mets) and increased serum uric acid (SUA), are well known renal risk predictors and often coexist in patients with type 2 diabetes (T2D). Whether they independently contribute to the onset of CKD is at present unclear. Methods and results: Within the AMD Annals database we identified patients with T2D and normal renal function and urine albumin excretion at baseline and regular follow-up visits during a 4-year period. Blood pressure, BMI, HDL, triglycerides, and SUA were available in 14,267 patients. The association between Mets and/or hyperuricemia (HU, top fifth gender specific quintile) and the occurrence of renal outcomes were evaluated. Results: At baseline 59% of patients (n = 8,408) showed Mets and 18% (n = 2,584) HU. Over the 4-year follow-up, 14% (n = 1,990) developed low eGFR (i.e. below 60 mL/min/1.73 m2), and 26% (n = 3,740) albuminuria. After adjustment for confounders, BP≥130/85, low HDL, triglycerides ≥150 and HU were independently related to the development of low eGFR (1.57, P<0.001; 1.13, P = 0.056; 1.18, P = 0.008; 1.26, P = 0.001) and of albuminuria (1.35, P<0.001; 1.18, P = 0.001; 1.15, P = 0.002; 1.24, P = 0.001), respectively. The incidence of low eGFR was higher in patients with HU independent of the presence or absence of Mets (21%, OR 1.30, p = 0.009 and 20%, 1.57, p<0.000 respectively), while albuminuria occurred more frequently in those with Mets and HU (32%, OR 1.25, p = 0.005) as compared to the reference group. Conclusions: HU and Mets are independent predictors of CKD and its individual components in patients with T2D.

Original languageEnglish
Article numbere0176058
JournalPLoS One
Volume12
Issue number4
DOIs
Publication statusPublished - Apr 1 2017

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metabolic syndrome
uric acid
Medical problems
Uric Acid
noninsulin-dependent diabetes mellitus
Type 2 Diabetes Mellitus
kidneys
Kidney
Albuminuria
Triglycerides
Serum
Blood pressure
Albumins
hyperuricemia
triacylglycerols
Hyperuricemia
renal function
blood pressure
albumins
urine

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Viazzi, F., Piscitelli, P., Giorda, C., Ceriello, A., Genovese, S., Russo, G., ... Pontremoli, R. (2017). Metabolic syndrome, serum uric acid and renal risk in patients with T2D. PLoS One, 12(4), [e0176058]. https://doi.org/10.1371/journal.pone.0176058

Metabolic syndrome, serum uric acid and renal risk in patients with T2D. / Viazzi, Francesca; Piscitelli, Pamela; Giorda, Carlo; Ceriello, Antonio; Genovese, Stefano; Russo, Giuseppina; Guida, Pietro; Fioretto, Paola; De Cosmo, Salvatore; Pontremoli, Roberto.

In: PLoS One, Vol. 12, No. 4, e0176058, 01.04.2017.

Research output: Contribution to journalArticle

Viazzi, F, Piscitelli, P, Giorda, C, Ceriello, A, Genovese, S, Russo, G, Guida, P, Fioretto, P, De Cosmo, S & Pontremoli, R 2017, 'Metabolic syndrome, serum uric acid and renal risk in patients with T2D', PLoS One, vol. 12, no. 4, e0176058. https://doi.org/10.1371/journal.pone.0176058
Viazzi, Francesca ; Piscitelli, Pamela ; Giorda, Carlo ; Ceriello, Antonio ; Genovese, Stefano ; Russo, Giuseppina ; Guida, Pietro ; Fioretto, Paola ; De Cosmo, Salvatore ; Pontremoli, Roberto. / Metabolic syndrome, serum uric acid and renal risk in patients with T2D. In: PLoS One. 2017 ; Vol. 12, No. 4.
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abstract = "Background and aims: Metabolic Syndrome (Mets) and increased serum uric acid (SUA), are well known renal risk predictors and often coexist in patients with type 2 diabetes (T2D). Whether they independently contribute to the onset of CKD is at present unclear. Methods and results: Within the AMD Annals database we identified patients with T2D and normal renal function and urine albumin excretion at baseline and regular follow-up visits during a 4-year period. Blood pressure, BMI, HDL, triglycerides, and SUA were available in 14,267 patients. The association between Mets and/or hyperuricemia (HU, top fifth gender specific quintile) and the occurrence of renal outcomes were evaluated. Results: At baseline 59{\%} of patients (n = 8,408) showed Mets and 18{\%} (n = 2,584) HU. Over the 4-year follow-up, 14{\%} (n = 1,990) developed low eGFR (i.e. below 60 mL/min/1.73 m2), and 26{\%} (n = 3,740) albuminuria. After adjustment for confounders, BP≥130/85, low HDL, triglycerides ≥150 and HU were independently related to the development of low eGFR (1.57, P<0.001; 1.13, P = 0.056; 1.18, P = 0.008; 1.26, P = 0.001) and of albuminuria (1.35, P<0.001; 1.18, P = 0.001; 1.15, P = 0.002; 1.24, P = 0.001), respectively. The incidence of low eGFR was higher in patients with HU independent of the presence or absence of Mets (21{\%}, OR 1.30, p = 0.009 and 20{\%}, 1.57, p<0.000 respectively), while albuminuria occurred more frequently in those with Mets and HU (32{\%}, OR 1.25, p = 0.005) as compared to the reference group. Conclusions: HU and Mets are independent predictors of CKD and its individual components in patients with T2D.",
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AU - Piscitelli, Pamela

AU - Giorda, Carlo

AU - Ceriello, Antonio

AU - Genovese, Stefano

AU - Russo, Giuseppina

AU - Guida, Pietro

AU - Fioretto, Paola

AU - De Cosmo, Salvatore

AU - Pontremoli, Roberto

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N2 - Background and aims: Metabolic Syndrome (Mets) and increased serum uric acid (SUA), are well known renal risk predictors and often coexist in patients with type 2 diabetes (T2D). Whether they independently contribute to the onset of CKD is at present unclear. Methods and results: Within the AMD Annals database we identified patients with T2D and normal renal function and urine albumin excretion at baseline and regular follow-up visits during a 4-year period. Blood pressure, BMI, HDL, triglycerides, and SUA were available in 14,267 patients. The association between Mets and/or hyperuricemia (HU, top fifth gender specific quintile) and the occurrence of renal outcomes were evaluated. Results: At baseline 59% of patients (n = 8,408) showed Mets and 18% (n = 2,584) HU. Over the 4-year follow-up, 14% (n = 1,990) developed low eGFR (i.e. below 60 mL/min/1.73 m2), and 26% (n = 3,740) albuminuria. After adjustment for confounders, BP≥130/85, low HDL, triglycerides ≥150 and HU were independently related to the development of low eGFR (1.57, P<0.001; 1.13, P = 0.056; 1.18, P = 0.008; 1.26, P = 0.001) and of albuminuria (1.35, P<0.001; 1.18, P = 0.001; 1.15, P = 0.002; 1.24, P = 0.001), respectively. The incidence of low eGFR was higher in patients with HU independent of the presence or absence of Mets (21%, OR 1.30, p = 0.009 and 20%, 1.57, p<0.000 respectively), while albuminuria occurred more frequently in those with Mets and HU (32%, OR 1.25, p = 0.005) as compared to the reference group. Conclusions: HU and Mets are independent predictors of CKD and its individual components in patients with T2D.

AB - Background and aims: Metabolic Syndrome (Mets) and increased serum uric acid (SUA), are well known renal risk predictors and often coexist in patients with type 2 diabetes (T2D). Whether they independently contribute to the onset of CKD is at present unclear. Methods and results: Within the AMD Annals database we identified patients with T2D and normal renal function and urine albumin excretion at baseline and regular follow-up visits during a 4-year period. Blood pressure, BMI, HDL, triglycerides, and SUA were available in 14,267 patients. The association between Mets and/or hyperuricemia (HU, top fifth gender specific quintile) and the occurrence of renal outcomes were evaluated. Results: At baseline 59% of patients (n = 8,408) showed Mets and 18% (n = 2,584) HU. Over the 4-year follow-up, 14% (n = 1,990) developed low eGFR (i.e. below 60 mL/min/1.73 m2), and 26% (n = 3,740) albuminuria. After adjustment for confounders, BP≥130/85, low HDL, triglycerides ≥150 and HU were independently related to the development of low eGFR (1.57, P<0.001; 1.13, P = 0.056; 1.18, P = 0.008; 1.26, P = 0.001) and of albuminuria (1.35, P<0.001; 1.18, P = 0.001; 1.15, P = 0.002; 1.24, P = 0.001), respectively. The incidence of low eGFR was higher in patients with HU independent of the presence or absence of Mets (21%, OR 1.30, p = 0.009 and 20%, 1.57, p<0.000 respectively), while albuminuria occurred more frequently in those with Mets and HU (32%, OR 1.25, p = 0.005) as compared to the reference group. Conclusions: HU and Mets are independent predictors of CKD and its individual components in patients with T2D.

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