title: Serum uric acid is related to cardiovascular events and correlates with N-terminal pro-B-type natriuretic peptide and albuminuria in patients with diabetes mellitus.
abstract: BACKGROUND
  Hyperuricemia is a risk factor for cardiovascular events and renal insufficiency. It correlates to intima-media thickness and microalbuminuria. In this study we evaluated uric acid as an independent marker for cardiac events in patients with diabetes.
  
  
  METHODS
  In a prospective observational study we recruited 494 patients with diabetes. Patients were then followed for 12.8 months (mean follow-up) and hospitalizations as a result of cardiac events (ischaemic heart disease, arrhythmias, heart failure) were recorded.
  
  
  RESULTS
  The median duration of diabetes was 11 ± 10.35 years. Patients were in the mean 60 ± 13 years old and mean HbA(1c) was 62 ± 13 mmol/mol (7.8 ± 3.3%). At baseline, mean uric acid was 321.2 ± 101.1 μmol/l (range 101.1-743.5 μmol/l), median N-terminal pro-B-type natriuretic peptide was 92 ± 412 pg/ml and median urinary albumin to creatinine ratio was 8 ± 361 mg/g; Uric acid significantly correlated to N-terminal pro-B-type natriuretic peptide (r = 0.237, P < 0.001) and urinary albumin:creatinine ratio (r = 0.198, P < 0.001). In a Cox regression model, including age, estimated glomerular filtration rate, gender, systolic blood pressure, smoking and alcohol consumption, uric acid was the best predictor of cardiac events (hazard ratio 1.331, confidence interval 1.095-1.616, P = 0.04). However, uric acid lost its prognostic value when the natural logarithm of N-terminal pro-B-type natriuretic peptide was added to the model.
  
  
  CONCLUSIONS
  Serum uric acid is a predictor of cardiac events and correlates to N-terminal pro-B-type natriuretic peptide and albuminuria, underscoring the importance of uric acid as a cardiovascular risk marker in patients with diabetes.
authors: Department of Endocrinology, Medical University of Vienna, Vienna, Austria.
authors: M
authors: M
authors: Resl
authors: M
authors: M
authors: Clodi
authors: S
authors: S
authors: Neuhold
authors: H
authors: H
authors: Kromoser
authors: M
authors: M
authors: Riedl
authors: G
authors: G
authors: Vila
authors: R
authors: R
authors: Prager
authors: R
authors: R
authors: Pacher
authors: G
authors: G
authors: Strunk
authors: A
authors: A
authors: Luger
authors: M
authors: M
authors: Hülsmann
mesh_terms: D000419:Albuminuria / Q000097:blood* / Q000209:etiology; D050197:Atherosclerosis / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; D020097:Natriuretic Peptide, Brain; D010446:Peptide Fragments; D014527:Uric Acid; C517652:hemoglobin A1c protein, human; C109794:pro-brain natriuretic peptide (1-76)