title: Association Between Plasma Uric Acid Levels and Cardiorenal Function in Adolescents With Type 1 Diabetes.
abstract: The relationship between plasma uric acid (PUA) and renal and cardiovascular parameters in adolescents with type 1 diabetes (T1D) is not well understood. Our aims in this exploratory analysis were to study the association between PUA and estimated glomerular filtration rate (eGFR), urinary albumin-to-creatinine ratio (ACR), blood pressure, endothelial function, and arterial stiffness in T1D adolescents. These associations were also studied in healthy control (HC) subjects.
  
  
  
  We studied 188 T1D subjects recruited to the Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT) and 65 HC subjects. Baseline PUA, eGFRcystatin C, ACR, blood pressure, flow-mediated dilation (FMD), and carotid-femoral pulse wave velocity (PWV) were measured.
  
  
  
  PUA was lower in T1D vs. HC subjects (242 ± 55 vs. 306 ± 74 μmol/L, respectively; P < 0.0001). Higher PUA was inversely associated with eGFR in T1D subjects (r = -0.48, P < 0.0001) even after correction for baseline clinical demographic characteristics. PUA was not associated with ACR in T1D after adjustment for potential confounders such as eGFR. For cardiovascular parameters, PUA levels did not associate with systolic blood pressure, FMD, or PWV in T1D or HC subjects.
  
  
  
  Even within the physiological range, PUA levels were significantly lower in T1D adolescent patients compared with HC subjects. There was an inverse relationship between PUA and eGFR in T1D, likely reflecting an increase in clearance. There were no associations observed with ACR, blood pressure, arterial stiffness, or endothelial function. Thus, in contrast with adults, PUA may not yet be associated with cardiorenal abnormalities in adolescents with T1D.
authors.affiliation: Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada Division of Nephrology, Department of Medicine, The University Health Network, University of Toronto, Toronto, Canada.
authors.forename: Yuliya
authors.initials: Y
authors.lastname: Lytvyn
authors.affiliation: Division of Endocrinology, Department of Paediatrics and JDRF Canadian Clinical Trial Network SickKids Multicenter Clinical Trial Center, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
authors.forename: Farid H
authors.initials: FH
authors.lastname: Mahmud
authors.affiliation: Division of Endocrinology, Department of Paediatrics and JDRF Canadian Clinical Trial Network SickKids Multicenter Clinical Trial Center, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
authors.forename: Denis
authors.initials: D
authors.lastname: Daneman
authors.affiliation: Division of Endocrinology, Department of Paediatrics and JDRF Canadian Clinical Trial Network SickKids Multicenter Clinical Trial Center, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
authors.forename: Livia
authors.initials: L
authors.lastname: Deda
authors.affiliation: Department of Pediatrics, University of Cambridge, Cambridge, U.K.
authors.forename: David B
authors.initials: DB
authors.lastname: Dunger
authors.affiliation: University College Hospital, London, U.K.
authors.forename: John
authors.initials: J
authors.lastname: Deanfield
authors.affiliation: WellChild Laboratory, Evelina London Children's Hospital, St Thomas' Hospital, London, U.K.
authors.forename: R Neil
authors.initials: RN
authors.lastname: Dalton
authors.affiliation: Division of Endocrinology, Department of Paediatrics and JDRF Canadian Clinical Trial Network SickKids Multicenter Clinical Trial Center, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
authors.forename: Yesmino
authors.initials: Y
authors.lastname: Elia
authors.affiliation: Division of Nephrology, Department of Medicine, The University Health Network, University of Toronto, Toronto, Canada.
authors.forename: Ronnie
authors.initials: R
authors.lastname: Har
authors.affiliation: Division of Cardiology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Bradley
authors.affiliation: Division of Cardiology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
authors.forename: Cameron
authors.initials: C
authors.lastname: Slorach
authors.affiliation: Division of Cardiology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
authors.forename: Wei
authors.initials: W
authors.lastname: Hui
authors.affiliation: Department of Family & Community Medicine, University of Toronto, Toronto, Canada.
authors.forename: Rahim
authors.initials: R
authors.lastname: Moineddin
authors.affiliation: Division of Nephrology, Department of Medicine, The University Health Network, University of Toronto, Toronto, Canada.
authors.forename: Heather N
authors.initials: HN
authors.lastname: Reich
authors.affiliation: Division of Nephrology, Department of Medicine, The University Health Network, University of Toronto, Toronto, Canada.
authors.forename: James W
authors.initials: JW
authors.lastname: Scholey
authors.affiliation: Division of Cardiology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
authors.forename: Luc
authors.initials: L
authors.lastname: Mertens
authors.affiliation: Division of Endocrinology, Department of Paediatrics and JDRF Canadian Clinical Trial Network SickKids Multicenter Clinical Trial Center, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
authors.forename: Etienne
authors.initials: E
authors.lastname: Sochett
authors.affiliation: Division of Nephrology, Department of Medicine, The University Health Network, University of Toronto, Toronto, Canada david.cherney@uhn.ca.
authors.forename: David Z I
authors.initials: DZ
authors.lastname: Cherney
mesh_terms: D000293:Adolescent; D001794:Blood Pressure; D059347:Cardio-Renal Syndrome / Q000097:blood* / Q000150:complications; D002319:Cardiovascular System / Q000503:physiopathology*; D016022:Case-Control Studies; D002648:Child; D003404:Creatinine / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications; D004727:Endothelium / Q000503:physiopathology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D063177:Pulse Wave Analysis; D012709:Serum Albumin / Q000378:metabolism; D014527:Uric Acid / Q000097:blood*; D059289:Vascular Stiffness
chemical_list: D012709:Serum Albumin; D014527:Uric Acid; D003404:Creatinine