Effects of Hyperuricemia on Beta-Cell Function, Renal Function, and Lipid Panels of Patients with Diabetic Kidney Disease: A Gender-Based Retrospective Study

Abstract

<b><i>Objective:</i></b> Serum uric acid (SUA) has been linked with development and progression of diabetic kidney disease (DKD). In this study, we intend to compare the effects of hyperuricemia (HUA) on beta-cell function, renal function, and lipid panels of patients with DKD. <b><i>Methods:</i></b> A total of 492 patients with DKD were included for data collection and analysis. Males and females have different standard SUA levels; thus, we analyzed these 2 groups separately. Normouricemia (NUA) for men (<i>n</i> = 253) was ≤428 μmol/L and for women (<i>n</i> = 83) was ≤357 μmol/L, whereas HUA for men (<i>n</i> = 94) was &#x3e;428 μmol/L and for women (<i>n</i> = 62) was &#x3e;357 μmol/L. Clinical characteristics of patients were analyzed based on gender-specific NUA and HUA. The Spearman rank correlation test was used to evaluate the correlation between SUA and other clinical variables. Finally, stepwise multinomial logistic regression test was performed to identify the factors that are independently associated with HUA. <b><i>Results:</i></b> A total of 492 patients were included in this study. The regression analysis showed that there was a significant association between HUA and decreased estimated glomerular filtration rate (eGFR) in both male and female patients (odds ratio (OR) [95% confidence interval (CI)] = 4.73 [2.19–10.24], <i>p</i> value ≤0.01 in male patients and OR [95% CI] = 3.07 [], <i>p</i> value = 0.04 in female patients). FBG, 2hPBG, and HbA1c were negatively correlated with SUA in male patients (<i>r =</i> −0.182, <i>p</i> value ≤0.01; <i>r =</i> −0.168, <i>p</i> value ≤0.01; and <i>r</i> = −0.187, <i>p</i> value ≤0.01, respectively), whereas fasting insulin was positively correlated in male patients (<i>r =</i> 0.131, <i>p</i> value = 0.023) and female patients (<i>r =</i> 0.192, <i>p</i> value = 0.041). The atherogenic index of plasma was significantly high in patients with HUA (OR [95% CI] = 5.75 [2.32–14.23], <i>p</i> value ≤0.01 in male patients and OR [95% CI] = 8.37 [1.96–35.78], <i>p</i> value ≤0.01 in female patients). Other indices of lipid profile such as lipoprotein combine index, atherosclerosis index, and triglyceride/high-density lipoprotein ratio were also independently associated with HUA in both male and female patients. <b><i>Conclusion:</i></b> SUA can affect various clinical parameters in patients with DKD. There is a significant association between HUA and decline in eGFR in both male and female patients. HUA is also associated with dyslipidemia in DKD, increasing the risk of cardiac complications and mortality.