Is serum uric acid-to-HDL cholesterol ratio elevation associated with diabetic kidney injury?

ABSTRACT

Objectives

Diabetic kidney injury (DKI) is a serious microvascular complicationof type 2 diabetes mellitus (T2DM). Novel markers are being developedto make a timely diagnosis of this complication. Uric Acid to HDLratio (UHR) was reported to be associated with inflammatory andmetabolic diseases such as metabolic syndrome, type 2 diabetesmellitus, thyroiditis, and nonalcoholic hepatosteatosis, recently. Inthe present study, we aimed to show the diagnostic role of UHR indiabetic kidney injury (DKI), a condition characterized with chronicand low-grade inflammation.

Methods

We retrospectively analyzed data of 287 patients who already had T2D Min outpatient clinics of our institution. The study population was divided into two groups according to the presence of DKI. General characteristics and laboratory data, including UHR levels, of the diabetic subjects with DKI were compared to those of patients without DKI.

Results

The median UHR of the diabetic patients with DKI group (0,13 (0,06-0,33)) was significantly elevated compared to the UHR of diabetic patients without DKI (0,11 (0,04-0,34)) (p < 0.001). Median UHR was significantly and positively correlated with UACR (r=0.14, p=0.02), serum creatinine (r=0.18, p=0.002), and HbA1c (r=0.28, p<0.001) levels. There was also a significant inverse correlation between UHR and GFR (r=-0.19, p=0.001) values. Logistic regression analysis confirmed that a 0.1 point increase in UHR increases DKI odds by 2.3 times. UHR was also correlated with serum creatinine, GFR, and UACR, which are important signs for DKI.

Conclusion

In conclusion, we think that UHR could be a diagnostic tool indiabetic kidney injury according to the preliminary results of the present study. UHR has an independent predictive role in DKI, and ithas significant correlation with other markers of kidney functions, therefore, we suggest routine evaluation of UHR in patients with DKIalong with other markers such as serum creatinine, GFR, and UACR.

KEYWORDS:

• Type 2 diabetes mellitus
• diabetic kidney injury
• uric acid-to-HDL cholesterol ratio
• inflammation
• complication

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. No writing assistance was utilized in the production of this manuscript. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Conception and design: Gulali Aktas, Tuba Taslamacioglu Duman, and Burcin Meryem Atak Tel; data collection: Seyma Yilmaz, Didar Beyza Kantarci, and Satilmis Bilgin; analysis and interpretation of the data: Gulali Aktas, Seyma Yilmaz, Didar Beyza Kantarci, and Sumeyye Buse Balci; drafting of the paper: Seyma Yilmaz, Didar Beyza Kantarci, Gulali Aktas, and Sumeyye Buse Balci; critical review of the manuscript for intellectual content: Gulali Aktas, Tuba Taslamacioglu Duman, and Burcin Meryem Atak Tel; final approval of the version to be published: Gulali Aktas, Seyma Yilmaz, Didar Beyza Kantarci, Tuba Taslamacioglu Duman, Satilmis Bilgin, Sumeyye Buse Balci, and Burcin Meryem Atak Tel. All authors agreed to be accountable for all aspects of the work.

Data availability statement

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request. The study was a retrospective review of the medical records.

Ethics statement

This study was carried out in line with research regulations, including approval by the Abant Izzet Baysal University ethical committee (approval number: 2022/250). This study is in accordance to the principles of the ‘World Medical Association Helsinki Declaration.’

Additional information

Funding

This paper was not funded.