High levels of serum uric acid are associated with microvascular complications in patients with long-term diabetes

Abstract Aims To assess the association between serum uric acid (SUA) level and the prevalence of diabetic retinopathy (DR) and chronic kidney disease (CKD) in patients with long-term diabetes. Methods A cross-sectional analysis was conducted involving diabetic patients from Shanghai General hospita...

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Main Authors: Hanying Wang, Liping Gu, Yuhang Ma, Xindan Xing, Yuan Qu, Xin Shi, Xinyi Liu, Hancong Wan, Qian Zhu, Yingchen Shen, Chong Chen, Li Su, Yufan Wang, Kun Liu
Format: Article
Language:English
Published: BMC 2025-03-01
Series:Diabetology & Metabolic Syndrome
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Online Access:https://doi.org/10.1186/s13098-025-01656-1
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author Hanying Wang
Liping Gu
Yuhang Ma
Xindan Xing
Yuan Qu
Xin Shi
Xinyi Liu
Hancong Wan
Qian Zhu
Yingchen Shen
Chong Chen
Li Su
Yufan Wang
Kun Liu
author_facet Hanying Wang
Liping Gu
Yuhang Ma
Xindan Xing
Yuan Qu
Xin Shi
Xinyi Liu
Hancong Wan
Qian Zhu
Yingchen Shen
Chong Chen
Li Su
Yufan Wang
Kun Liu
author_sort Hanying Wang
collection DOAJ
description Abstract Aims To assess the association between serum uric acid (SUA) level and the prevalence of diabetic retinopathy (DR) and chronic kidney disease (CKD) in patients with long-term diabetes. Methods A cross-sectional analysis was conducted involving diabetic patients from Shanghai General hospital during October 2018 and October 2021. Participants underwent measurements of SUA, renal function test and DR assessments via fundus photography. Multivariable ordinal logistic regression models assessed odd ratios (ORs) and 95% confidence intervals (95% CIs) for the progression of DR and CKD. Receiver operating characteristics (ROC) curves identified SUA thresholds, categorizing participants into low and high SUA groups. Results Among the 1015 patients with diabetes, SUA levels were higher in individuals with advanced CKD stages (p < 0.001, compared with stage 1 CKD) and vision-threatening diabetic retinopathy (VTDR) (p = 0.019, compared with no diabetic retinopathy (NDR)). In multivariable models adjusted for potential confounders, higher SUA levels were associated with an increased risk of DR (OR: 1.002, 95% CI: 1.001–1.004) and CKD (OR: 1.008, 95% CI: 1.006–1.011). Notably, SUA levels exceeding 354.0 µmol/L (95% CI: 318.9–393.2) and 361.0 µmol/L (339.2–386.3) were associated with 1.571-fold (95% CI: 1.139–2.099, P = 0.006 for DR) and 1.395-fold (95% CI: 1.033–1.885, P = 0.030 for CKD) increased risks, respectively. Gender-specific analyses also demonstrated a positive correlation between higher SUA levels and the incidence of DR and CKD in both males and females. Conclusions Elevated SUA levels are independently coincided with increased risks of DR and CKD, suggesting that SUA may serve as a potential risk marker for diabetic complications.
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spelling doaj-art-5ba5809e6e7f4a85a23bd06d86e79fbb2025-08-20T03:40:48ZengBMCDiabetology & Metabolic Syndrome1758-59962025-03-0117111010.1186/s13098-025-01656-1High levels of serum uric acid are associated with microvascular complications in patients with long-term diabetesHanying Wang0Liping Gu1Yuhang Ma2Xindan Xing3Yuan Qu4Xin Shi5Xinyi Liu6Hancong Wan7Qian Zhu8Yingchen Shen9Chong Chen10Li Su11Yufan Wang12Kun Liu13Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University, National Clinical Research Center for Eye DiseasesDepartment of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University, National Clinical Research Center for Eye DiseasesDepartment of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University, National Clinical Research Center for Eye DiseasesDepartment of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University, National Clinical Research Center for Eye DiseasesDepartment of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University, National Clinical Research Center for Eye DiseasesDepartment of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University, National Clinical Research Center for Eye DiseasesDepartment of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University, National Clinical Research Center for Eye DiseasesDepartment of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University, National Clinical Research Center for Eye DiseasesDepartment of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University, National Clinical Research Center for Eye DiseasesDepartment of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University, National Clinical Research Center for Eye DiseasesDepartment of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University, National Clinical Research Center for Eye DiseasesAbstract Aims To assess the association between serum uric acid (SUA) level and the prevalence of diabetic retinopathy (DR) and chronic kidney disease (CKD) in patients with long-term diabetes. Methods A cross-sectional analysis was conducted involving diabetic patients from Shanghai General hospital during October 2018 and October 2021. Participants underwent measurements of SUA, renal function test and DR assessments via fundus photography. Multivariable ordinal logistic regression models assessed odd ratios (ORs) and 95% confidence intervals (95% CIs) for the progression of DR and CKD. Receiver operating characteristics (ROC) curves identified SUA thresholds, categorizing participants into low and high SUA groups. Results Among the 1015 patients with diabetes, SUA levels were higher in individuals with advanced CKD stages (p < 0.001, compared with stage 1 CKD) and vision-threatening diabetic retinopathy (VTDR) (p = 0.019, compared with no diabetic retinopathy (NDR)). In multivariable models adjusted for potential confounders, higher SUA levels were associated with an increased risk of DR (OR: 1.002, 95% CI: 1.001–1.004) and CKD (OR: 1.008, 95% CI: 1.006–1.011). Notably, SUA levels exceeding 354.0 µmol/L (95% CI: 318.9–393.2) and 361.0 µmol/L (339.2–386.3) were associated with 1.571-fold (95% CI: 1.139–2.099, P = 0.006 for DR) and 1.395-fold (95% CI: 1.033–1.885, P = 0.030 for CKD) increased risks, respectively. Gender-specific analyses also demonstrated a positive correlation between higher SUA levels and the incidence of DR and CKD in both males and females. Conclusions Elevated SUA levels are independently coincided with increased risks of DR and CKD, suggesting that SUA may serve as a potential risk marker for diabetic complications.https://doi.org/10.1186/s13098-025-01656-1Serum uric acidDiabetic retinopathyChronic kidney diseaseDiabetes mellitus
spellingShingle Hanying Wang
Liping Gu
Yuhang Ma
Xindan Xing
Yuan Qu
Xin Shi
Xinyi Liu
Hancong Wan
Qian Zhu
Yingchen Shen
Chong Chen
Li Su
Yufan Wang
Kun Liu
High levels of serum uric acid are associated with microvascular complications in patients with long-term diabetes
Diabetology & Metabolic Syndrome
Serum uric acid
Diabetic retinopathy
Chronic kidney disease
Diabetes mellitus
title High levels of serum uric acid are associated with microvascular complications in patients with long-term diabetes
title_full High levels of serum uric acid are associated with microvascular complications in patients with long-term diabetes
title_fullStr High levels of serum uric acid are associated with microvascular complications in patients with long-term diabetes
title_full_unstemmed High levels of serum uric acid are associated with microvascular complications in patients with long-term diabetes
title_short High levels of serum uric acid are associated with microvascular complications in patients with long-term diabetes
title_sort high levels of serum uric acid are associated with microvascular complications in patients with long term diabetes
topic Serum uric acid
Diabetic retinopathy
Chronic kidney disease
Diabetes mellitus
url https://doi.org/10.1186/s13098-025-01656-1
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