title: Decreased urine uric acid excretion is associated with diabetic retinopathy but not with lower limb atherosclerosis in hospitalized patients with type 2 diabetes.
abstract: OBJECTIVE
  To explore the associations between urine uric acid excretion (UUAE) and diabetic retinopathy (DR)/lower limb atherosclerotic lesions in hospitalized Chinese patients with type 2 diabetes.
  
  
  METHODS
  This cross-sectional study was conducted in 2529 hospitalized Chinese patients with type 2 diabetes. UUAE was determined enzymatically using a single 24-h urine collection. The subjects were stratified into quartile based on UUAE levels. DR was determined by digital fundus photography. Lower limb atherosclerotic lesions were assessed by Doppler ultrasound. Both DR and lower limb atherosclerosis were compared among the UUAE quartile groups, respectively.
  
  
  RESULTS
  There was a significant decrease in the prevalence of DR in patients across the UUAE quartiles after adjustment for sex, age and diabetic duration (35.0%, 30.7%, 26.1%, and 21.5%, respectively, p = 0.000001 for trend). A fully adjusted multiple logistic regression analyses revealed that UUAE quartiles were markedly inversely associated with the presence of DR (p = 0.030). The prevalence of lower limb plaque (73.9% vs. 62.6%, p = 0.000044) and stenosis (16.3% vs. 9.7%, p = 0.000015) was markedly higher in the diabetics with DR than in those without DR. However, there was no statistical association between the UUAE and lower limb atherosclerotic lesions in type 2 diabetes.
  
  
  CONCLUSIONS
  Decreased UUAE was an independent risk factor for DR but not for lower limb atherosclerosis in hospitalized Chinese patients with type 2 diabetes. In selected populations, such as those with type 2 diabetes, the role of uric acid in atherosclerosis may be result from other concomitantly atherosclerotic risk factors, such as DR.
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, 600 Yishan Road, Shanghai 200233, China. Electronic address: lilx@sjtu.edu.cn.
authors.forename: Lian-Xi
authors.initials: LX
authors.lastname: Li
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, 600 Yishan Road, Shanghai 200233, China.
authors.forename: Jun-Xi
authors.initials: JX
authors.lastname: Lu
authors.affiliation: Department of Medical Record Management, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China.
authors.forename: Hai-Ping
authors.initials: HP
authors.lastname: Shuai
authors.affiliation: Department of Medical Record Management, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China.
authors.forename: Hui-Fen
authors.initials: HF
authors.lastname: Xia
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, 600 Yishan Road, Shanghai 200233, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Zhang
authors.affiliation: Department of VIP, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China.
authors.forename: Jun-Wei
authors.initials: JW
authors.lastname: Wang
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, 600 Yishan Road, Shanghai 200233, China.
authors.forename: Ming-Yun
authors.initials: MY
authors.lastname: Chen
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, 600 Yishan Road, Shanghai 200233, China.
authors.forename: Ting-Ting
authors.initials: TT
authors.lastname: Li
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, 600 Yishan Road, Shanghai 200233, China.
authors.forename: Yu-Qian
authors.initials: YQ
authors.lastname: Bao
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, 600 Yishan Road, Shanghai 200233, China. Electronic address: wpjia@sjtu.edu.cn.
authors.forename: Wei-Ping
authors.initials: WP
authors.lastname: Jia
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D015415:Biomarkers; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D003251:Constriction, Pathologic; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000652:urine*; D003930:Diabetic Retinopathy / Q000150:complications / Q000652:urine*; D018450:Disease Progression; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007297:Inpatients; D007866:Leg / Q000098:blood supply / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D058729:Peripheral Arterial Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000652:urine*; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D018608:Ultrasonography, Doppler; D014527:Uric Acid / Q000097:blood / Q000652:urine*
chemical_list: D015415:Biomarkers; D014527:Uric Acid
keywords: Atherosclerosis; Diabetic retinopathy; Type 2 diabetes; Uric acid; Urine uric acid excretion