diabetes research and clinical practice 106 (2014) 366–372
Contents available at ScienceDirect
Diabetes Research and Clinical Practice jou rnal hom ep ag e: w ww.e l s e v i er . c om/ loca te / d i ab r es
Serum uric acid concentration is associated with worsening in severity of diabetic retinopathy among type 2 diabetic patients in Taiwan—A 3-year prospective study Jong-Jer Lee a, I-Hui Yang a, Hsi-Kung Kuo a, Ming-Shien Chung b, Yung-Jen Chen a, Chih-Hsin Chen a, Rue-Tsuan Liu b,* a
Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taiwan b Division of Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taiwan
article info
abstract
Article history:
Aims: To explore the role of serum uric acid (SUA) concentration in diabetic retinopathy (DR)
Received 19 February 2014
for patients with type 2 diabetes mellitus (T2DM).
Received in revised form
Methods: A 3-year prospective study in 749 patients with T2DM and without proliferative
16 May 2014
diabetic retinopathy (PDR) was conducted at a medical center. Baseline SUA concentration
Accepted 20 July 2014
and parameters of glycemic control, blood pressure, kidney disease, and lipid profiles were
Available online 27 July 2014
analyzed to determine their contribution to DR. Results: Fundus examination showed that 184 patients (24.6%) had non-proliferative
Keywords:
retinopathy and 565 (75.4%) without DR at baseline. After 3 years, increase in the severity
Type 2 diabetes mellitus
of DR was recognized in 103 patients (13.8%), including 81 patients with newly developed
Diabetic retinopathy
DR. Patients with increase in severity of DR positively associated with duration of DM
Uric acid
(11.9 vs. 9.4 years, p = 0.001), HbA1c (7.6 vs. 7.2%, p = 0.001), albuminuria (45.5 vs. 31.0%, p = 0.006), and SUA (6.47 vs. 5.87 mg/dl, p < 0.001) than did those without change in DR stage. Cox regression showed that patients with SUA in the 3rd (5.9–6.9 mg/dl) and 4th (7.0 mg/dl) quartiles had hazard ratios for DR worsening of 2.57 and 3.66 (95% C.I. 1.30–5.08 and 1.92–7.00) when compared with patients with SUA in the 1st quartile (140 mmHg and/or a diastolic blood pressure >90 mmHg, or if the patient was receiving antihypertensive treatment. The metabolic syndrome was defined as the fulfillment of at least two of the following criteria: (1) waist circumference >90 cm for men and >80 cm for women (based on a ethnicity-specific value for the Chinese population); (2) serum triglycerides 1.695 mmol/l or drug treatment for elevated triglycerides; (3) serum HDL cholesterol
Contents available at ScienceDirect
Diabetes Research and Clinical Practice jou rnal hom ep ag e: w ww.e l s e v i er . c om/ loca te / d i ab r es
Serum uric acid concentration is associated with worsening in severity of diabetic retinopathy among type 2 diabetic patients in Taiwan—A 3-year prospective study Jong-Jer Lee a, I-Hui Yang a, Hsi-Kung Kuo a, Ming-Shien Chung b, Yung-Jen Chen a, Chih-Hsin Chen a, Rue-Tsuan Liu b,* a
Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taiwan b Division of Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taiwan
article info
abstract
Article history:
Aims: To explore the role of serum uric acid (SUA) concentration in diabetic retinopathy (DR)
Received 19 February 2014
for patients with type 2 diabetes mellitus (T2DM).
Received in revised form
Methods: A 3-year prospective study in 749 patients with T2DM and without proliferative
16 May 2014
diabetic retinopathy (PDR) was conducted at a medical center. Baseline SUA concentration
Accepted 20 July 2014
and parameters of glycemic control, blood pressure, kidney disease, and lipid profiles were
Available online 27 July 2014
analyzed to determine their contribution to DR. Results: Fundus examination showed that 184 patients (24.6%) had non-proliferative
Keywords:
retinopathy and 565 (75.4%) without DR at baseline. After 3 years, increase in the severity
Type 2 diabetes mellitus
of DR was recognized in 103 patients (13.8%), including 81 patients with newly developed
Diabetic retinopathy
DR. Patients with increase in severity of DR positively associated with duration of DM
Uric acid
(11.9 vs. 9.4 years, p = 0.001), HbA1c (7.6 vs. 7.2%, p = 0.001), albuminuria (45.5 vs. 31.0%, p = 0.006), and SUA (6.47 vs. 5.87 mg/dl, p < 0.001) than did those without change in DR stage. Cox regression showed that patients with SUA in the 3rd (5.9–6.9 mg/dl) and 4th (7.0 mg/dl) quartiles had hazard ratios for DR worsening of 2.57 and 3.66 (95% C.I. 1.30–5.08 and 1.92–7.00) when compared with patients with SUA in the 1st quartile (140 mmHg and/or a diastolic blood pressure >90 mmHg, or if the patient was receiving antihypertensive treatment. The metabolic syndrome was defined as the fulfillment of at least two of the following criteria: (1) waist circumference >90 cm for men and >80 cm for women (based on a ethnicity-specific value for the Chinese population); (2) serum triglycerides 1.695 mmol/l or drug treatment for elevated triglycerides; (3) serum HDL cholesterol
