Serum uric acid levels are associated with obesity but not cardio-cerebrovascular events in Chinese inpatients with type 2 diabetes

Abstract

We aim to explore the associations between serum uric acid (SUA) and obesity and cardio-cerebrovascular events (CCEs) in Chinese inpatients with type 2 diabetes mellitus (T2DM). 2 962 inpatients with T2DM were stratified into quartile based on SUA concentrations. There were significant increases in the prevalence of both obesity (32.6%, 41.9%, 50.1%, and 62.8%, respectively, p < 0.001 for trend) and severe obesity (0.4%, 0.6%, 0.8%, and 1.3%, respectively, p < 0.001 for trend) across the SUA quartiles. A fully adjusted multiple logistic regression analysis revealed that SUA quartiles were independently associated with the presence of obesity (p < 0.001). The prevalence of CCEs was significantly higher in the obese diabetics than in the nonobese diabetics (16.8% vs. 13.2%, p = 0.027). After controlling for multiple confounding factors, BMI levels were also significantly correlated with the presence of CCEs (p = 0.020). However, there was no significant association of SUA quartiles/SUA levels with the presence of CCEs in T2DM. This study suggested that SUA levels were independently associated with obesity but not with CCEs in patients with T2DM. In selected populations such as subjects with T2DM, the role of uric acid in cardiovascular complications might be attributable to other cardiovascular risk factors, such as obesity.

Figure 1. Comparison of obesity between the SUA quartile groups.

Underweight was defined as a BMI below 18.5 kg/m², overweight as a BMI between 23 to 24.9 kg/m², and obesity as BMI above 25 kg/m². Mild obesity was defined as BMI 25–30 kg/m², moderate obesity as BMI 30–35 kg/m², and severe obesity as BMI above 35 kg/m². (A) Comparison of the prevalence of obesity among the four SUA quartile groups after controlling for age, sex and duration of diabetes. (B) Comparison of the prevalence of severe obesity among the four SUA quartile groups after controlling for age, sex and DD. (C) Comparison of SUA levels according to BMI after adjusting for age, sex and DD. (D) Comparison of SUA levels according to obesity degree after adjusting for age, sex and DD.

Figure 2. Correlation between SUA levels and BMI.

R = 0.278, P < 0.001.

Figure 3. Comparison of CCEs.

Obesity was defined as BMI above 25 kg/m². (A) Comparison of the prevalence of cardio-cerebrovascular events among the four SUA quartile groups after controlling for age, sex and DD, HTN, smoking, and alcohol drinking. (B) Comparison of the prevalence of cardio-cerebrovascular events between the patients with and without obesity after controlling for age, sex and DD, HTN, smoking, and alcohol drinking.