Uric acid, renal function and risk of hypoglycaemia in Chinese type 2 diabetes patients.
This study aimed to explore independent associations between serum uric acid and hypoglycaemia, and whether mildly increased serum uric acid exacerbated the association between mild decline in estimated glomerular filtration rate (eGFR) and hypoglycaemia.



A cross-sectional survey of 6713 inpatients with type 2 diabetes and eGFR ≥60 mL/min/1.73 m2and admitted to 81 tertiary care hospitals in China was conducted. Self-reported asymptotic hypoglycaemia with plasma glucose ≤3.9 mmol/L, hypoglycaemia episodes with symptoms in 1 month or hypoglycaemia that needed assistance from other people in 3 months before hospitalization was used to define hypoglycaemia. Binary logistic regression was used to estimate odds ratios of serum uric acid for hypoglycaemia. Three measures, that is, relative excess risk due to interaction (RERI), attributable proportion due to interaction and synergy index (S) were used to estimate the effect of mildly decreased eGFR on the association of serum uric acid with hypoglycaemia.



Serum uric acid was associated with hypoglycaemia in an ordinal manner (P for trend <0.01) with an odds ratio of top quartile versus the lowest quartile up to 3.03 (95% confidence interval: 2.13-4.32). The odds ratio of serum uric acid levels ≥ versus <283 µmol/L (i.e. the median) was 1.98 (95% confidence interval:1.58-2.48). Serum uric acid levels ≥ versus <283 µmol/L greatly enhanced the association between mild decline in eGFR (eGFR < 90 mL/min/1.73 m2) and hypoglycaemia from 0.94 (0.36-2.43) to 3.90 (2.55-5.95), with a significant additive interaction (P < 0.05 for RERI, AP and S).



Mildly increased serum uric acid was associated with increased risk of hypoglycaemia and enhanced the association between mildly decreased eGFR and hypoglycaemia in type 2 diabetes. Copyright © 2016 John Wiley & Sons, Ltd.
Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
Yanfeng
Y
Ren
Department of Endocrinology, Peking University People's Hospital, Beijing, China.
Linong
L
Ji
Department of Endocrinology, Chinese PLA General Hospital, Beijing, China.
Yiming
Y
Mu
Department of Endocrinology, Peking University Third Hospital, Beijing, China. tpho66@bjmu.edu.cn.
Tianpei
T
Hong
Department of Endocrinology, The Fourth Military Medical University Xi Jing Hospital, Xi'an, China.
Qiuhe
Q
Ji
Department of Endocrinology, Beijing Hospital, Beijing, China.
Lixin
L
Guo
Department of Endocrinology, Changhai Hospital of Shanghai, Shanghai, China.
Qin
Q
Huang
Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China. yangxilin@tmu.edu.cn, yxl@hotmail.com.
Xilin
X
Yang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*; D055815:Young Adult
D014527:Uric Acid
Chinese; estimated glomerular filtration rate; hypoglycaemia; serum uric acid; type 2 diabetes