Effects of irbesartan on serum uric acid levels in patients with hypertension and diabetes

Figures & data

Table 1 Clinical characteristics of the patients

	Number/mean ± SD
Age (years)	68±11
Men	65
Women	42
IRB	35
ARBs–IRB switch	72
Type I DM	3
Type II DM	104
Insulin treatment	16
Diabetic duration (years)	14±8
BMI baseline (kg/m^2)
IRB	24.1±3.4
ARBs–IRB switch	24.4±3.7
Total	24.3±3.6
SBP baseline (mmHg)
IRB	137±8.5
ARBs–IRB switch	134±6.0*
Total	135±7.0
DBP baseline (mmHg)
IRB	82±7.9
ARBs–IRB switch	79±5.2**
Total	80±6.4
Glucose baseline (mg/dL)
IRB	165±72
ARBs–IRB switch	145±38*
Total	152±52
HbA1c baseline (%)
IRB	6.8±1.2
ARBs–IRB switch	6.6±0.98
Total	6.7±1.1
HDL-C baseline (mg/dL)
IRB	62±19
ARBs–IRB switch	56±17
Total	58±18
LDL-C baseline (mg/dL)
IRB	116±22
ARBs–IRB switch	107±23*
Total	110±23
TG baseline (mg/dL)
IRB	142±67
ARBs–IRB switch	139±77
Total	140±74
SCr baseline (mg/dL)
Male	0.86±0.30
Female	0.65±0.14
IRB	0.75±0.31
ARBs–IRB switch	0.80±0.29
Total	0.79±0.27
eGFR baseline (mL/min/1.73 m^2)
Male	74±22
Female	72±19
IRB	76±21
ARBs–IRB switch	72±21
Total	73±21
SUA baseline (mg/dL)
Male	5.7±1.1
Female	4.7±1.0
IRB	5.0±1.0
ARBs–IRB switch	5.4±1.1*
Total	5.3±1.1
Diabetic nephropathy
Stage I	11
Stage II	50
Stage III	19
Stage IV	2
Myocardial disease	7
Cerebrovascular disease	7
Arteriosclerosis	2

Notes:

* P<0.05,

** P<0.01 versus IRB group by Student’s t-test.

Abbreviations: ARB, angiotensin II receptor blockers; BMI, body mass index; DBP, diastolic blood pressure; DM, diabetes mellitus; eGFR, estimated glomerular filtration rate; HbA_1c, glycated hemoglobin; HDL-C, high-density lipoprotein cholesterol; IRB, irbesartan; LDL-C, low-density lipoprotein cholesterol; SBP, systolic blood pressure; SCr, serum creatinine; SD, standard deviation; SUA, serum uric acid; TG, triglyceride.

Figure 1 Changes in blood pressure (A) and eGFR (B) of a total of 107 patients from the baseline compared with 12 months’ irbesartan treatment.

Notes: *P<0.05, **P<0.01, ***P<0.001 versus the baseline.
Abbreviations: DBP, diastolic blood pressure; eGFR, estimated glomerular filtration rate; SBP, systolic blood pressure.

Figure 2 Mixed-linear model plots for SUA changes of patients classified according to SUA baseline value (<5.9 mg/dL (A) or ≥5.9 mg/dL (B)). Estimated marginal means of SUA were plotted from SUA at 0–12 months in covariance with diabetic disease duration.

Note: *P<0.05 versus SUA baseline, calculated by the Bonferroni multi-comparison test method.
Abbreviation: SUA, serum uric acid.

Figure S1 ROC analysis of SUA baseline values.

Notes: Decrease of SUA over 12 months was set to a positive influence and specificity and sensitivity of SUA baseline value were plotted. The cutoff point of SUA when the sum of specificity and sensitivity is maximized was 5.9 mg/dL (specificity, 0.860; sensitivity, 0.414). Area under the curve: 0.6540 and 95% CI: 0.5510–0.7569.

Abbreviations: CI, confidence interval; ROC, receiver operating characteristic; SUA, serum uric acid.

Table S1 SUA changes of the ARBs–IRB switch group by the pre-treatment of ARBs

	Number
	> baseline	= baseline	< baseline
SUA at 6–12 months of the ARBs pre-treatment
Candesartan	15	0	12
Telmisartan	9	2	10
Valsartan	2	0	1
Olmesartan	1	0	1
Sum	27	2	24

Note: Baseline means the average of values between ARBs-naïve examinations and the onset of ARBs.

Abbreviations: ARB, angiotensin II receptor blockers; IRB, irbesartan; SUA, serum uric acid.

Table S2 The baseline values of the subjects classified with the stages of diabetic nephropathy

	Number	SBP (mmHg)	DBP (mmHg)	SCr (mg/dL)	eGFR (mL/min/1.73m^2)	SUA (mg/dL)
Diabetic nephropathy
Stage I	11	136±3.6	81±4.0	0.73±0.13	79±17	5.7±0.92
Stage II	50	136±4.7	79±5.3	0.79±0.19	71±18	5.2±1.1
Stage III	19	135±12	82±9.9	0.84±0.31	74±28	5.8±1.1

Note: The values are represented as mean±standard deviation.

Abbreviations: DBP, diastolic blood pressure; eGFR, estimated glomerular filtration rate; SBP, systolic blood pressure; SCr, serum creatinine; SUA, serum uric acid.

Table S3 SUA changes from baseline after 6–12 months of irbesartan treatment

	Number of patients
SUA at the end of the study period
≥baseline	50
<baseline	57

Abbreviation: SUA, serum uric acid.

Table S4 Logistic regression analysis of the factors associated with SUA decline

	Univariate logistic regression analysis
	OR	95% CI	P-value
Sex
Male	Reference
Female	0.620	0.283–1.356	0.231
Age	0.998	0.964–1.033	0.916
Dose
50 mg	Reference
100 mg	0.783	0.257–2.391	0.668
150 mg	0.667	0.073–6.111	0.720
ARBs pretreatment
IRB	Reference
ARBs–IRB switch	2.507	1.088–5.774	0.031*
Diabetic nephropathy
Stage II	1.009	0.429–2.373	0.984
Stage III	0.560	0.174–1.801	0.331
Myocardial disease	0.600	0.128–2.823	0.518
Cerebrovascular disease	0.600	0.128–2.823	0.518
Arteriosclerosis	ND	0.000–ND	0.999
Diabetic disease duration	0.948	0.898–1.000	0.052
History of alcohol intake	2.364	1.044–5.352	0.039*
SBP baseline	0.980	0.927–1.036	0.481
DBP baseline	0.965	0.905–1.029	0.274
HbA1c baseline	0.965	0.676–1.379	0.847
SCr baseline	1.908	0.482–7.553	0.357
SUA baseline	1.714	1.168–2.515	0.006**
	Multiple logistic regression analysis
	OR	95% CI	P-value
ARBs–IRB switch	2.710	1.028–7.144	0.044*
SUA baseline	1.609	1.050–2.467	0.029*
History of alcohol intake	1.576	0.612–4.057	0.346

Notes: SUA decline after 6–12 months was introduced as dependent variable and was coded 1.

* P<0.05;

** P<0.01.

Abbreviations: ARB, angiotensin II receptor blockers; CI, confidence interval; DBP, diastolic blood pressure; HbA_1c, glycated hemoglobin; IRB, irbesartan; OR, odds ratio; ND, not determined; SBP, systolic blood pressure; SCr, serum creatinine; SUA, serum uric acid.