Association Between Uric Acid to HDL Cholesterol Ratio and Diabetic Complications in Men and Postmenopausal Women

Figures & data

Figure 1 Flowchart of the inclusion and exclusion of participants.

Table 1 Characteristics of the Participants by Gender

	Total	Male	Female	P for Trend
No. of participants (%)	4551(22.8)	2109 (25.2)	2442 (25.4)	0.919
Age at baseline (year)	67.40±8.71	67.61±8.79	67.22±8.63	<0.001
BMI (kg/m^2)	24.94±3.60	24.99±3.31	24.89±3.83	<0.001
WC (cm)	90.30±9.80	92.37±9.19	88.52±9.95	<0.001
SBP (mmHg)	145.00±19.76	144.22±19.45	145.68±19.99	0.130
DBP (mmHg)	78.83±10.85	80.14±11.15	77.50±10.42	0.003
FBG (mmol/L)	7.81±2.48	7.87±2.39	7.75±2.54	0.106
HbA1c (%)	7.51±1.40	7.61±1.43	7.42±1.37	0.051
TG (mmol/L)	1.91±1.62	1.87±1.76	1.94±1.49	0.078
TC (mmol/L)	5.10±1.20	4.81±1.11	5.34±1.22	<0.001
HDL-C (mg/dl)	21.67±5.25	19.96±4.61	23.15±5.32	<0.001
LDL-C (mmol/L)	3.15±0.85	3.21±0.85	3.16±0.85	<0.001
eGFR (mL/m/1.73 m^2)	91.62±17.10	90.35±17.31	92.73±16.84	<0.001
uACR (mg/g)	63.06±242.55	71.89±268.15	55.45±217.88	<0.001
UA (mg/dl)	3.68±0.92	3.87±0.92	3.52±0.88	<0.001
UHR	18.20±1.35	14.77±1.13	19.08±1.42	<0.001
CVD, (%)	1090 (23.9)	472 (43.3)	618 (56.7)	<0.001
CKD, (%)	1239 (27.2)	575 (46.4)	664 (53.6)	<0.001
DR, (%)	543 (17.2)	266 (48.9)	277 (51.1)	0.050
Hypertension, (%)	3003 (65.9)	1392 (46.3)	1611 (53.7)	0.360
Overweight/obesity, (%)	2582 (57.7)	1242 (48.1)	1340 (51.9)	0.024
Current smoker (%)	816 (18)	756 (92.6)	60 (7.4)	<0.001
Current drinker (%)	724 (16)	626 (86.5)	98 (13.5)	<0.001
Diabetes Duration, (year)	10.13±7.96	10.21±7.84	10.05±8.06	0.179
Hyperlipidemia, (%)	2089 (46.2)	886 (42.4)	1203(57.6)	<0.001
Treatment of diabetes, (%)	3429 (75.3)	1642 (77.8)	1742 (71.3)	<0.001
Oral-drug, (%)	4089 (89.8)	1899 (90)	1543 (88.6)	<0.001
Insulin, (%)	465 (10.2)	211 (10)	279 (11.4)	<0.001
Statin, (%)	681 (14.9)	269 (12.7)	412 (16.9)	<0.001
Treatment of hypertension, (%)	2910 (63.9)	1392 (65.9)	1511 (61.8)	<0.001

Abbreviations: BMI, body mass index; WC, waist circumference; SBP, systolic blood pressure; DBP, diastolic blood pressure; FPG, fasting blood glucose; TC, total cholesterol; TG, HDL-C, high density lipoprotein cholesterol; LDL-C, low density lipoprotein cholesterol, eGFR, estimated glomerular filtration rate; uACR, urinary albumin creatinine ratio; UA, uric acid; CVD, cardiovascular disease; CKD, diabetic kidney disease; DR, diabetic retinopathy; UHR, uric acid to HDL cholesterol ratio.

Table 2 The Correlation Between UHR and Cardiometabolic Risk Factors After Adjusted by Age, Sex and BMI

	r	P value
WC (cm)	0.360	<0.001
SBP (mmHg)	0.108	<0.001
DBP (mmHg)	0.191	<0.001
Fasting glucose (mmol/l)	0.053	0.030
HbA1c (%)	0.011	0.662
TC (mmol/l)	0.186	<0.001
LDL (mmol/l)	0.165	<0.001

Figure 2 Odds ratios for diabetes macrovascular and microvascular complications at UHR quartiles. Data are expressed as regression coefficients or odds ratios (95% CI). Model 1 was adjusted for age, sex, BMI, smoke status and drink status. Model 2 was adjusted for model 1 plus TC, LDL, HbA1c, eGFR (only in CVD and DR group), systolic blood pressure, diastolic blood pressure, anti-diabetes agents, hypertension, antihypertension drug.

Table 3 Odds Ratios for Macrovascular and Microvascular Complications According to UHR Quartiles by Various Subgroups

	Cases/Participants	Quartile 1	Quartile 2	Quartile 3	Quartile 4	P-Trend	P-Interaction
CVD
Age, years^a
<65	1655 /4525	1.00 (ref)	1.24 (0.83,1.83)	1.26 (0.84,1.89)	0.94 (0.61,1.43)	0.488	0.432
≥65	2870/4525	1.00 (ref)	1.14 (0.88,1.46)	1.16 (0.89,1.50)	1.41 (1.08,1.85)	0.015
BMI, kg/m^2b
< 24	2412/4525	1.00 (ref)	1.16 (0.88,1.52)	1.22(0.92,1.63)	1.03 (0.72,1.46)	0.082	0.638
≥ 24	2113/4525	1.00 (ref)	1.12 (0.79,1.59)	1.08 (0.76,1.53)	1.43 (1.06,1.94)	0.022
Sex ^c
Male	2096/4525	1.00 (ref)	1.04 (0.70,1.53)	0.89 (0.61,1.32)	0.89 (0.61,1.30)	0.543	0.714
Female	2429/4525	1.00 (ref)	1.21 (0.93,1.57)	1.37 (1.05,1.79)	1.57 (1.17,2.11)	0.003
HbA1c^d
<7.0%	1837/4525	1.00 (ref)	1.26 (0.89,1.79)	1.29 (0.90,1.85)	1.40 (0.96,2.05)	0.162	0.458
≥7.0%	2688/4525	1.00 (ref)	1.14 (0.87,1.49)	1.18 (0.89,1.56)	1.24 (0.92,1.61)	0.175
CKD
Age, years^a
<65	1581/4360	1.00 (ref)	1.45 (0.94,2.24)	1.69 (1.09,2.61)	2.54 (1.62,3.96)	0.019	0.262
≥65	2779/4360	1.00 (ref)	1.23 (0.92,1.64)	1.83 (1.37,2.46)	2.21 (1.64,2.99)	<0.001
BMI, kg/m^2b
< 24	2421/4360	1.00 (ref)	1.49 (1.09,2.06)	2.15 (1.55,2.98)	3.27 (2.33,4.58)	<0.001	0.347
≥ 24	1939/4360	1.00 (ref)	1.06 (0.72,1.54)	1.42 (0.98,2.05)	1.62 (1.12,2.34)	0.011
Sex ^c
Male	2020/4360	1.00 (ref)	0.79 (0.51,1.21)	1.29 (0.86,1.97)	1.50 (1.00,2.26)	0.049	0.432
Female	2340/4360	1.00 (ref)	1.57 (1.17,2.11)	2.01 (1.49,2.72)	3.09 (2.24,4.26)	<0.001
HbA1c^d
<7.0%	1775/4360	1.00 (ref)	1.83 (1.20,2.79)	2.03 (1.32,3.13)	2.50 (1.59,3.92)	<0.001	0.926
≥7.0%	2585/4360	1.00 (ref)	1.06 (0.79,1.42)	1.69 (1.26,2.27)	2.26 (1.68,3.04)	<0.001

Notes: Data are expressed as regression coefficients or odds ratios (95% CI). ^aFor age subgroup: adjusted for sex, BMI, LDL-C, TC, FBG, HbA1c, eGFR (only in CVD group), smoke status and drink status, systolic blood pressure, diastolic blood pressure, anti-diabetes agents, hypertension, anti-hypertension drug; ^bFor BMI subgroup: adjusted for age, sex, LDL-C, TC, FBG, HbA1c, eGFR (only in CVD group), smoke status and drink status, systolic blood pressure, diastolic blood pressure, anti-diabetes agents, hypertension, anti-hypertension drug; ^cFor sex subgroup: adjusted for age, BMI, LDL-C, TC, FBG, HbA1c, eGFR (only in CVD group), smoke status and drink status, systolic blood pressure, Diastolic blood pressure, anti-diabetes agents, hypertension, anti-hypertension drug; ^dFor HbA1c subgroup: adjusted for age, sex, BMI, LDL-C, TC, FBG, eGFR (only in CVD group), smoke status and drink status, systolic blood pressure, diastolic blood pressure, anti-diabetes agents, hypertension, anti-hypertension drug.