Relationship between serum uric acid and ventricular diastolic dysfunction in type 2 diabetes mellitus patients

Abstract

Objective: To investigate the correlation of serum uric acid (SUA) levels with ventricular diastolic dysfunction (DD) in the diabetic population.

Methods: Clinical data from 702 patients with type 2 diabetes mellitus (T2DM), including 394 males and 308 females, were retrospectively analyzed in this study. The data included demographic characteristics, biochemical test results, and echocardiography findings. Univariate and multivariate logistic regression analyses were performed to assess the association between SUA and DD. Additionally, the diagnostic efficacies of SUA and the multivariate logistic regression model (Logit P) for DD were evaluated using receiver operating characteristic (ROC) curves.

Results: Compared to T2DM patients with normal diastolic function, those with DD had a higher prevalence of hypertension, older age, longer diabetes duration, elevated levels of low-density lipoprotein cholesterol (LDL-c), total cholesterol (TC), blood urea nitrogen (BUN), SUA, and hemoglobin A1c (HbA1c), as well as lower levels of 1,5-anhydroglucitol (1,5-AG) and estimated glomerular filtration rate (eGFR) (P<0.05). As indicated by the Logistic regression analysis, gender, age, and SUA were independent risk factors for DD (P<0.05). Women had a 47.8% lower risk of DD compared to men [95% CI (0.318-0.718)]. The risk of DD increased by 6.8% for each one-year rise in age [OR 1.068, 95% CI (1.051-1.085)] and by 0.5% for each 1 mmol/L increase in SUA [OR 1.005, 95% CI (1.003-1.007)]. The regression model incorporating sex, age, and SUA exhibited an area under the curve (AUC) of 0.753 (95% CI 0.712-0.794) for diagnosing DD, with a sensitivity of 65.65% and specificity of 78.65%.

Conclusions: Gender, age, and SUA were independent factors influencing the development of DD in T2DM patients. Among them, SUA is the only modifiable factor. Early and long-term control of SUA levels is essential to reduce the risk of DD in T2DM patients.

Keywords: Cardiac diastolic dysfunction; logistic regression; serum uric acid; type 2 diabetes.

Figure 1

Correlation of SUA with echocardiographic parameters. A: Correlation between SUA and LVST; B: Correlation of SUA with LVPW; C: Correlation between SUA and E/A; D: Correlation of SUA with E/E’; SUA: serum uric acid; IVST: end diastolic ventricular septal thickness; LVPW: left ventricular posterior wall thickness; E: early diastolic mitral valve orifice blood flow velocity; A: late diastolic mitral flow velocity; E’: early diastolic bicuspid velocity of lobe ring motion.

Figure 2

Predictive significance of serum uric acid and regression model for cardiac DD in type 2 diabetes patients using ROC curve analysis. Note: ROC: receiver operating characteristic; DD: diastolic dysfunction.