Association of serum uric acid trajectories with renal function progression and diabetic kidney disease in elderly patients with type 2 diabetes mellitus
10.3760/cma.j.cn311282-20250507-00243
- VernacularTitle:血清尿酸轨迹与老年2型糖尿病患者肾功能进展及糖尿病肾脏疾病的关联研究
- Author:
Yijia CHEN
1
;
Qiannan SUN
1
;
Weiwei WANG
1
;
Hairong ZHOU
1
;
Huafeng YANG
1
;
Xin HONG
1
Author Information
1. 南京疾病预防控制中心慢性非传染病防制科，南京 210009
- Publication Type:Journal Article
- Keywords:
Diabetes mellitus, type 2;
Serum uric acid trajectory;
Renal function progression;
Diabetic kidney disease;
The elderly
- From:
Chinese Journal of Endocrinology and Metabolism
2025;41(9):740-746
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the association between serum uric acid trajectories and the risk of renal function decline and diabetic kidney disease(DKD) incidence in elderly patients with type 2 diabetes mellitus.Methods:This retrospective cohort study included 5 037 elderly patients with type 2 diabetes mellitus aged 60 years and above who underwent at least three health examinations between 2019 and 2023, with 2019 as the baseline. Latent growth mixture modeling(LGMM) was employed to identify distinct serum uric acid trajectories. Renal function changes and DKD incidence were followed from 2020 to 2023. Binary logistic regression models were used to assess the association between serum uric acid trajectories and the risks of renal function decline and DKD.Results:Two distinct serum uric acid trajectory groups were identified based on model selection criteria: A stable group( n=4 485, 89.04%) and an inverted U-shaped group( n=552, 10.96%). After adjusting for potential confounders, compared with the stable trajectory group, the inverted U-shaped group showed a significantly increased risk of estimated glomerular filtration rate(eGFR) <60 mL·min -1·(1.73 m 2) -1, ≥25% decline in eGFR, doubling of serum creatinine, and DKD events, with OR(95% CI) of 1.99(1.28-3.09), 2.27(1.65-3.13), 1.52(1.09-3.02), and 1.52(1.27-1.82), respectively(all P<0.05). In addition, multivariate analysis indicated that elevated baseline serum uric acid levels were also associated with an increased risk of adverse renal outcomes and DKD incidence; However, the magnitude of the associations was lower than that observed for serum uric acid trajectory groups. Conclusions:An inverted U-shaped serum uric acid trajectory is significantly associated with an increased risk of renal function progression and DKD in elderly patients with type 2 diabetes mellitus. These findings highlight the importance of long-term dynamic monitoring of serum uric acid levels to facilitate early identification and intervention for high-risk individuals.
