4.7 Article

The serum uric acid concentration is not causally linked to diabetic nephropathy in type 1 diabetes

期刊

KIDNEY INTERNATIONAL
卷 91, 期 5, 页码 1178-1185

出版社

ELSEVIER SCIENCE INC
DOI: 10.1016/j.kint.2016.11.025

关键词

diabetic nephropathy; Mendelian randomization; serum uric acid; type 1 diabetes

资金

  1. Signe and Ane Gyllenberg Foundation
  2. Folkhalsan Research Foundation
  3. Wilhelm and Else Stockmann Foundation
  4. Liv och Halsa Foundation
  5. Helsinki University Central Hospital Research Funds (EVO)
  6. Novo Nordisk Foundation
  7. Academy of Finland
  8. Finnish Medical Society (Finska Lakaresallskapet)

向作者/读者索取更多资源

Previous studies have shown a relationship between uric acid concentration and progression of renal disease. Here we studied causality between the serum uric acid concentration and progression of diabetic nephropathy in 3895 individuals with type 1 diabetes in the FinnDiane Study. The renal status was assessed with the urinary albumin excretion rate and estimated glomerular filtration rate (eGFR) at baseline and at the end of the follow-up. Based on previous genomewide association studies on serum uric acid concentration, 23 single nucleotide polymorphisms (SNPs) with good imputation quality were selected for the SNP score. This score was used to assess the causality between serum uric acid and renal complications using a Mendelian randomization approach. At baseline, the serum uric acid concentration was higher with worsening renal status. In multivariable Cox regression analyses, baseline serum uric acid concentration was not independently associated with progression of diabetic nephropathy over a mean follow-up of 7 years. However, over the same period, baseline serum uric acid was independently associated with the decline in eGFR. In the cross-sectional logistic regression analyses, the SNP score was associated with the serum uric acid concentration. Nevertheless, the Mendelian randomization showed no causality between uric acid and diabetic nephropathy, eGFR categories, or eGFR as a continuous variable. Thus, our results suggest that the serum uric acid concentration is not causally related to diabetic nephropathy but is a downstream marker of kidney damage.

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