Prognostic importance of baseline and changes in serum uric acid for macro/microvascular and mortality outcomes in individuals with type 2 diabetes: The Rio de Janeiro type 2 diabetes cohort
To investigate the associations between baseline/changes in serum uric acid (sUA) and the risks for cardiovascular/microvascular outcomes and mortality in a type 2 diabetes cohort. Baseline sUA was measured in 685 individuals, and 463 had a second sUA measurement during follow-up; sUA was analyzed a...
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| Veröffentlicht in: | Journal of diabetes and its complications 2025-01, Vol.39 (1), p.108921, Article 108921 |
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| creator | Cardoso, Claudia R.L. da Silva Pereira, Lucas Leite, Nathalie C. Salles, Gil F. |
| description | To investigate the associations between baseline/changes in serum uric acid (sUA) and the risks for cardiovascular/microvascular outcomes and mortality in a type 2 diabetes cohort.
Baseline sUA was measured in 685 individuals, and 463 had a second sUA measurement during follow-up; sUA was analyzed as a continuous variable and categorized into sex-specific tertile subgroups and low/high levels (>4.5 mg/dl women; >5.5 mg/dl men). The risks associated with baseline sUA and its changes were examined by Cox analyses for all outcomes.
Median follow up was 10.7 years, there were 173 major cardiovascular events (MACEs), 268 all-cause deaths, 127 microalbuminuria, 104 renal failure, 160 retinopathy and 178 peripheral neuropathy outcomes. Baseline sUA was predictor of all outcomes, except all-cause mortality and retinopathy. In tertile and high/low sUA analyses, the hazard ratios (HRs) varied from 1.6 (microalbuminuria development) to 2.4 (MACEs; cardiovascular mortality). There was interaction with sex for MACEs, an increased risk was observed in women (HR: 2.6), but not in men (HR: 1.2). Changes in sUA were associated with the renal failure (HR: 2.4).
In a prospective cohort, high baseline sUA was a predictor of cardiovascular, renal and peripheral neuropathy. However, sUA changes were only predictor of renal failure.
•Are baseline and changes in serum uric acid (sUA) levels associated with cardiovascular and microvascular outcomes in type 2 diabetes?•Baseline sUA was a predictor for cardiovascular, renal and peripheral neuropathy outcomes.•2-year changes in sUA were predictor of advanced renal failure outcome.•Whether sUA might be a modifiable risk factor shall be addressed in future studies. |
| doi_str_mv | 10.1016/j.jdiacomp.2024.108921 |
| format | Article |
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Baseline sUA was measured in 685 individuals, and 463 had a second sUA measurement during follow-up; sUA was analyzed as a continuous variable and categorized into sex-specific tertile subgroups and low/high levels (>4.5 mg/dl women; >5.5 mg/dl men). The risks associated with baseline sUA and its changes were examined by Cox analyses for all outcomes.
Median follow up was 10.7 years, there were 173 major cardiovascular events (MACEs), 268 all-cause deaths, 127 microalbuminuria, 104 renal failure, 160 retinopathy and 178 peripheral neuropathy outcomes. Baseline sUA was predictor of all outcomes, except all-cause mortality and retinopathy. In tertile and high/low sUA analyses, the hazard ratios (HRs) varied from 1.6 (microalbuminuria development) to 2.4 (MACEs; cardiovascular mortality). There was interaction with sex for MACEs, an increased risk was observed in women (HR: 2.6), but not in men (HR: 1.2). Changes in sUA were associated with the renal failure (HR: 2.4).
In a prospective cohort, high baseline sUA was a predictor of cardiovascular, renal and peripheral neuropathy. However, sUA changes were only predictor of renal failure.
•Are baseline and changes in serum uric acid (sUA) levels associated with cardiovascular and microvascular outcomes in type 2 diabetes?•Baseline sUA was a predictor for cardiovascular, renal and peripheral neuropathy outcomes.•2-year changes in sUA were predictor of advanced renal failure outcome.•Whether sUA might be a modifiable risk factor shall be addressed in future studies.</description><identifier>ISSN: 1056-8727</identifier><identifier>ISSN: 1873-460X</identifier><identifier>EISSN: 1873-460X</identifier><identifier>DOI: 10.1016/j.jdiacomp.2024.108921</identifier><identifier>PMID: 39616659</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Albuminuria - blood ; Ankle ; Body mass index ; Brazil - epidemiology ; Cardiovascular disease ; Cardiovascular Diseases - blood ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - mortality ; Cardiovascular events ; Cohort Studies ; Cohort study ; Creatinine ; Diabetes ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - mortality ; Diabetic Angiopathies - blood ; Diabetic Angiopathies - epidemiology ; Diabetic Angiopathies - mortality ; Diabetic Nephropathies - blood ; Diabetic Nephropathies - mortality ; Diabetic Neuropathies - blood ; Diabetic Neuropathies - epidemiology ; Diabetic Neuropathies - mortality ; Diabetic retinopathy ; Diabetic Retinopathy - blood ; Diabetic Retinopathy - epidemiology ; Diabetic Retinopathy - mortality ; Exercise ; Female ; Follow-Up Studies ; Health risks ; Heart failure ; Hospitals ; Humans ; Hypertension ; Kidney diseases ; Laboratories ; Male ; Medical prognosis ; Microvascular complications ; Middle Aged ; Mortality ; Peripheral neuropathy ; Physical fitness ; Prognosis ; Prospective Studies ; Questionnaires ; Rheumatism ; Risk Factors ; Serum uric acid ; Type 2 diabetes ; Uric acid ; Uric Acid - blood ; Vein & artery diseases</subject><ispartof>Journal of diabetes and its complications, 2025-01, Vol.39 (1), p.108921, Article 108921</ispartof><rights>2024 Elsevier Inc.</rights><rights>Copyright © 2024 Elsevier Inc. All rights reserved.</rights><rights>2024. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jdiacomp.2024.108921$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39616659$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cardoso, Claudia R.L.</creatorcontrib><creatorcontrib>da Silva Pereira, Lucas</creatorcontrib><creatorcontrib>Leite, Nathalie C.</creatorcontrib><creatorcontrib>Salles, Gil F.</creatorcontrib><title>Prognostic importance of baseline and changes in serum uric acid for macro/microvascular and mortality outcomes in individuals with type 2 diabetes: The Rio de Janeiro type 2 diabetes cohort</title><title>Journal of diabetes and its complications</title><addtitle>J Diabetes Complications</addtitle><description>To investigate the associations between baseline/changes in serum uric acid (sUA) and the risks for cardiovascular/microvascular outcomes and mortality in a type 2 diabetes cohort.
Baseline sUA was measured in 685 individuals, and 463 had a second sUA measurement during follow-up; sUA was analyzed as a continuous variable and categorized into sex-specific tertile subgroups and low/high levels (>4.5 mg/dl women; >5.5 mg/dl men). The risks associated with baseline sUA and its changes were examined by Cox analyses for all outcomes.
Median follow up was 10.7 years, there were 173 major cardiovascular events (MACEs), 268 all-cause deaths, 127 microalbuminuria, 104 renal failure, 160 retinopathy and 178 peripheral neuropathy outcomes. Baseline sUA was predictor of all outcomes, except all-cause mortality and retinopathy. In tertile and high/low sUA analyses, the hazard ratios (HRs) varied from 1.6 (microalbuminuria development) to 2.4 (MACEs; cardiovascular mortality). There was interaction with sex for MACEs, an increased risk was observed in women (HR: 2.6), but not in men (HR: 1.2). Changes in sUA were associated with the renal failure (HR: 2.4).
In a prospective cohort, high baseline sUA was a predictor of cardiovascular, renal and peripheral neuropathy. However, sUA changes were only predictor of renal failure.
•Are baseline and changes in serum uric acid (sUA) levels associated with cardiovascular and microvascular outcomes in type 2 diabetes?•Baseline sUA was a predictor for cardiovascular, renal and peripheral neuropathy outcomes.•2-year changes in sUA were predictor of advanced renal failure outcome.•Whether sUA might be a modifiable risk factor shall be addressed in future studies.</description><subject>Adult</subject><subject>Aged</subject><subject>Albuminuria - blood</subject><subject>Ankle</subject><subject>Body mass index</subject><subject>Brazil - epidemiology</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular Diseases - blood</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - mortality</subject><subject>Cardiovascular events</subject><subject>Cohort Studies</subject><subject>Cohort study</subject><subject>Creatinine</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 2 - blood</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - mortality</subject><subject>Diabetic Angiopathies - blood</subject><subject>Diabetic Angiopathies - epidemiology</subject><subject>Diabetic Angiopathies - mortality</subject><subject>Diabetic Nephropathies - blood</subject><subject>Diabetic Nephropathies - mortality</subject><subject>Diabetic Neuropathies - blood</subject><subject>Diabetic Neuropathies - epidemiology</subject><subject>Diabetic Neuropathies - mortality</subject><subject>Diabetic retinopathy</subject><subject>Diabetic Retinopathy - blood</subject><subject>Diabetic Retinopathy - epidemiology</subject><subject>Diabetic Retinopathy - mortality</subject><subject>Exercise</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Health risks</subject><subject>Heart failure</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Kidney diseases</subject><subject>Laboratories</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Microvascular complications</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Peripheral neuropathy</subject><subject>Physical fitness</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Questionnaires</subject><subject>Rheumatism</subject><subject>Risk Factors</subject><subject>Serum uric acid</subject><subject>Type 2 diabetes</subject><subject>Uric acid</subject><subject>Uric Acid - blood</subject><subject>Vein & artery diseases</subject><issn>1056-8727</issn><issn>1873-460X</issn><issn>1873-460X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkt1u1DAQhSMEoqXwCtVI3HCTrX8SJ-EKVPGrSiBUJO4sxx53J0rixU4W7cvxbHjZ9qY3tjX65uiM5xTFJWcbzri6GjaDI2PDtNsIJqpcbDvBnxTnvG1kWSn262l-s1qVbSOas-JFSgNjTNU1f16cyU5xperuvPj7PYa7OaSFLNC0C3Exs0UIHnqTcKQZwcwO7NbMd5iAZkgY1wnWmBuMJQc-RJiMjeFqonzuTbLraOL_tumoN9JygLAu2exJgWZHe3KrGRP8oWULy2GHICAP1OOC6S3cbhF-UACH8NXMSDE8ZsCGbRZ_WTzzWQZf3d8Xxc-PH26vP5c33z59uX5_UyJvGl4qzrywztXGihpdzWxvpeXeG9d5UVVoPAplfS24M8h72aha5c-S2NbSm1ZeFG9OursYfq-YFj1RsjiO2V1Yk5a8yguQXSMy-voROoQ1ztndkZJCyqrimbq8p9Z-Qqd3kSYTD_phMxl4dwIwj7UnjDpZwrwbRxHtol0gzZk-hkEP-iEM-hgGfQqD_AcSzqyj</recordid><startdate>20250101</startdate><enddate>20250101</enddate><creator>Cardoso, Claudia R.L.</creator><creator>da Silva Pereira, Lucas</creator><creator>Leite, Nathalie C.</creator><creator>Salles, Gil F.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20250101</creationdate><title>Prognostic importance of baseline and changes in serum uric acid for macro/microvascular and mortality outcomes in individuals with type 2 diabetes: The Rio de Janeiro type 2 diabetes cohort</title><author>Cardoso, Claudia R.L. ; da Silva Pereira, Lucas ; Leite, Nathalie C. ; Salles, Gil F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-e1771-610f2cdd5ac25ed50cbc3c1ffad9f244eafe26cf521dae1b376560653e853fa83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Albuminuria - blood</topic><topic>Ankle</topic><topic>Body mass index</topic><topic>Brazil - epidemiology</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular Diseases - blood</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Cardiovascular Diseases - mortality</topic><topic>Cardiovascular events</topic><topic>Cohort Studies</topic><topic>Cohort study</topic><topic>Creatinine</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 2 - blood</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - mortality</topic><topic>Diabetic Angiopathies - blood</topic><topic>Diabetic Angiopathies - epidemiology</topic><topic>Diabetic Angiopathies - mortality</topic><topic>Diabetic Nephropathies - blood</topic><topic>Diabetic Nephropathies - mortality</topic><topic>Diabetic Neuropathies - blood</topic><topic>Diabetic Neuropathies - epidemiology</topic><topic>Diabetic Neuropathies - mortality</topic><topic>Diabetic retinopathy</topic><topic>Diabetic Retinopathy - blood</topic><topic>Diabetic Retinopathy - epidemiology</topic><topic>Diabetic Retinopathy - mortality</topic><topic>Exercise</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Health risks</topic><topic>Heart failure</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Kidney diseases</topic><topic>Laboratories</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Microvascular complications</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Peripheral neuropathy</topic><topic>Physical fitness</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Questionnaires</topic><topic>Rheumatism</topic><topic>Risk Factors</topic><topic>Serum uric acid</topic><topic>Type 2 diabetes</topic><topic>Uric acid</topic><topic>Uric Acid - blood</topic><topic>Vein & artery diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cardoso, Claudia R.L.</creatorcontrib><creatorcontrib>da Silva Pereira, Lucas</creatorcontrib><creatorcontrib>Leite, Nathalie C.</creatorcontrib><creatorcontrib>Salles, Gil F.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of diabetes and its complications</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cardoso, Claudia R.L.</au><au>da Silva Pereira, Lucas</au><au>Leite, Nathalie C.</au><au>Salles, Gil F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic importance of baseline and changes in serum uric acid for macro/microvascular and mortality outcomes in individuals with type 2 diabetes: The Rio de Janeiro type 2 diabetes cohort</atitle><jtitle>Journal of diabetes and its complications</jtitle><addtitle>J Diabetes Complications</addtitle><date>2025-01-01</date><risdate>2025</risdate><volume>39</volume><issue>1</issue><spage>108921</spage><pages>108921-</pages><artnum>108921</artnum><issn>1056-8727</issn><issn>1873-460X</issn><eissn>1873-460X</eissn><abstract>To investigate the associations between baseline/changes in serum uric acid (sUA) and the risks for cardiovascular/microvascular outcomes and mortality in a type 2 diabetes cohort.
Baseline sUA was measured in 685 individuals, and 463 had a second sUA measurement during follow-up; sUA was analyzed as a continuous variable and categorized into sex-specific tertile subgroups and low/high levels (>4.5 mg/dl women; >5.5 mg/dl men). The risks associated with baseline sUA and its changes were examined by Cox analyses for all outcomes.
Median follow up was 10.7 years, there were 173 major cardiovascular events (MACEs), 268 all-cause deaths, 127 microalbuminuria, 104 renal failure, 160 retinopathy and 178 peripheral neuropathy outcomes. Baseline sUA was predictor of all outcomes, except all-cause mortality and retinopathy. In tertile and high/low sUA analyses, the hazard ratios (HRs) varied from 1.6 (microalbuminuria development) to 2.4 (MACEs; cardiovascular mortality). There was interaction with sex for MACEs, an increased risk was observed in women (HR: 2.6), but not in men (HR: 1.2). Changes in sUA were associated with the renal failure (HR: 2.4).
In a prospective cohort, high baseline sUA was a predictor of cardiovascular, renal and peripheral neuropathy. However, sUA changes were only predictor of renal failure.
•Are baseline and changes in serum uric acid (sUA) levels associated with cardiovascular and microvascular outcomes in type 2 diabetes?•Baseline sUA was a predictor for cardiovascular, renal and peripheral neuropathy outcomes.•2-year changes in sUA were predictor of advanced renal failure outcome.•Whether sUA might be a modifiable risk factor shall be addressed in future studies.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>39616659</pmid><doi>10.1016/j.jdiacomp.2024.108921</doi></addata></record> |
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| subjects | Adult Aged Albuminuria - blood Ankle Body mass index Brazil - epidemiology Cardiovascular disease Cardiovascular Diseases - blood Cardiovascular Diseases - epidemiology Cardiovascular Diseases - mortality Cardiovascular events Cohort Studies Cohort study Creatinine Diabetes Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - mortality Diabetic Angiopathies - blood Diabetic Angiopathies - epidemiology Diabetic Angiopathies - mortality Diabetic Nephropathies - blood Diabetic Nephropathies - mortality Diabetic Neuropathies - blood Diabetic Neuropathies - epidemiology Diabetic Neuropathies - mortality Diabetic retinopathy Diabetic Retinopathy - blood Diabetic Retinopathy - epidemiology Diabetic Retinopathy - mortality Exercise Female Follow-Up Studies Health risks Heart failure Hospitals Humans Hypertension Kidney diseases Laboratories Male Medical prognosis Microvascular complications Middle Aged Mortality Peripheral neuropathy Physical fitness Prognosis Prospective Studies Questionnaires Rheumatism Risk Factors Serum uric acid Type 2 diabetes Uric acid Uric Acid - blood Vein & artery diseases |
| title | Prognostic importance of baseline and changes in serum uric acid for macro/microvascular and mortality outcomes in individuals with type 2 diabetes: The Rio de Janeiro type 2 diabetes cohort |
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