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Diabetes Care. 2016 Apr;39(4):611-6. doi: 10.2337/dc15-2345. Epub 2016 Feb 19.

Association Between Plasma Uric Acid Levels and Cardiorenal Function in Adolescents With Type 1 Diabetes.

Author information

1
Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada Division of Nephrology, Department of Medicine, The University Health Network, University of Toronto, Toronto, Canada.
2
Division of Endocrinology, Department of Paediatrics and JDRF Canadian Clinical Trial Network SickKids Multicenter Clinical Trial Center, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
3
Department of Pediatrics, University of Cambridge, Cambridge, U.K.
4
University College Hospital, London, U.K.
5
WellChild Laboratory, Evelina London Children's Hospital, St Thomas' Hospital, London, U.K.
6
Division of Nephrology, Department of Medicine, The University Health Network, University of Toronto, Toronto, Canada.
7
Division of Cardiology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
8
Department of Family & Community Medicine, University of Toronto, Toronto, Canada.
9
Division of Nephrology, Department of Medicine, The University Health Network, University of Toronto, Toronto, Canada david.cherney@uhn.ca.

Abstract

OBJECTIVE:

The relationship between plasma uric acid (PUA) and renal and cardiovascular parameters in adolescents with type 1 diabetes (T1D) is not well understood. Our aims in this exploratory analysis were to study the association between PUA and estimated glomerular filtration rate (eGFR), urinary albumin-to-creatinine ratio (ACR), blood pressure, endothelial function, and arterial stiffness in T1D adolescents. These associations were also studied in healthy control (HC) subjects.

RESEARCH DESIGN AND METHODS:

We studied 188 T1D subjects recruited to the Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT) and 65 HC subjects. Baseline PUA, eGFRcystatin C, ACR, blood pressure, flow-mediated dilation (FMD), and carotid-femoral pulse wave velocity (PWV) were measured.

RESULTS:

PUA was lower in T1D vs. HC subjects (242 ± 55 vs. 306 ± 74 μmol/L, respectively; P < 0.0001). Higher PUA was inversely associated with eGFR in T1D subjects (r = -0.48, P < 0.0001) even after correction for baseline clinical demographic characteristics. PUA was not associated with ACR in T1D after adjustment for potential confounders such as eGFR. For cardiovascular parameters, PUA levels did not associate with systolic blood pressure, FMD, or PWV in T1D or HC subjects.

CONCLUSIONS:

Even within the physiological range, PUA levels were significantly lower in T1D adolescent patients compared with HC subjects. There was an inverse relationship between PUA and eGFR in T1D, likely reflecting an increase in clearance. There were no associations observed with ACR, blood pressure, arterial stiffness, or endothelial function. Thus, in contrast with adults, PUA may not yet be associated with cardiorenal abnormalities in adolescents with T1D.

PMID:
26895883
DOI:
10.2337/dc15-2345
[Indexed for MEDLINE]

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