Independent association of uric acid levels with peripheral arterial disease in Taiwanese patients with Type 2 diabetes.
OBJECTIVE
Hyperuricaemia may be a risk factor for atherosclerotic disease. Its association with peripheral arterial disease (PAD) has not been studied in Taiwanese patients with Type 2 diabetes.


METHODS
Uric acid (UA) levels and PAD were evaluated in 508 Taiwanese outpatients with Type 2 diabetes (210 men, 298 women; mean age +/- sd, 63.8 +/- 10.6 years). PAD was diagnosed when the ankle-brachial index was < 0.9. Patients with an ankle-brachial index of > or = 1.3 were excluded because of possible medial arterial calcification. Potential confounding variables with P < 0.10 were adjusted for in multivariate analyses.


RESULTS
In univariate analyses, UA levels were higher in patients with PAD than in those without PAD (345.0 +/- 95.2 vs. 309.3 +/- 89.2 micromol/l; P < 0.0005). Prevalences of PAD for quintiles of UA levels were 6.8, 8.9, 10.2, 13.1 and 16.5%, respectively (P-trend < 0.05). With UA level as a continuous variable, the multivariate-adjusted odds ratio (95% confidence interval) for PAD was 1.005 (1.001-1.008) (P < 0.01). The optimal cut-off point for UA as determined by the receiver operating characteristic curve was 264.7 micromol/l. The sensitivity and specificity at this cut-off point was 82.6 and 33.3%, respectively. The area under curve was 0.60 (95% confidence interval: 0.53-0.68). The multivariate-adjusted odds ratio for PAD for UA above this level was 2.736 (1.239-6.043) (P < 0.05). The results after excluding 56 cases using diuretics were similar.


CONCLUSIONS
Elevated uric acid level is a significant and independent risk factor for PAD in Taiwanese patients with Type 2 diabetes.
Tseng
C-H
CH
Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7 Chung-Shan South Road, Taipei, Taiwan. ccktsh@ms6.hinet.net
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000097:blood / Q000208:ethnology / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000208:ethnology; D003925:Diabetic Angiopathies / Q000097:blood / Q000208:ethnology / Q000209:etiology*; D005260:Female; D006801:Humans; D033461:Hyperuricemia / Q000150:complications* / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000097:blood / Q000208:ethnology / Q000209:etiology*; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D014527:Uric Acid / Q000097:blood
D014527:Uric Acid