Transcript
8/20/2019 Association of Serum Uric Acid
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Journal English
Woro Hapsari WahyuningrumSylvia Rachmayati / Nina
Tristina15th A ril 2014
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Various actors !
Ag"# poor glyc"miccontrol# hyp"rt"nsion
an$ smo%ing
&asic rol" !
• 'n(ammation• )n$oth"lial
$ysunction
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The objective of the study wasto nd an association betweenserum uric acid level andproteinuria level in Type 2Diabetic patients
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A cross sectional study (2!!" n # $ %oth gender
Age range & '!)! yo *ith type 2 diabetic +atients, %* was stable - . months /istory of gout (" Treated with allopurinol ("
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%ody 0ass 1nde +atient,s history 3urrent medication
1nsulin doses Tobacco use 4amily medical history
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5erum creatinine6ric acid/emoglobin A!c (/bA!c"
2' 7h proteinuria
4astingstate
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8esults were epressed as mean 9: 5D
3onsidered as statistically signicant when two;sided P < 0.05
Independent‑samples t-test
comparison variables between male <female
5pearman,s rho coe=cient correlation test
correlation of %01 with serum uric acid
+artial correlation coe=cient test
correlation of protenuria with serum uric aci
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n # $ T2D patients
5e &
age range& '!)! years>
*"mal"
+al"
?$@ B '2@. B
+"an S,
Age ? years )@. years
5erumcreatinin
@C) mg:d @2) mg:d
5erum uricacid
'@? mg:d @!? mg:d
+roteinuria .)) mg:day 2)@ mg:day
(median # ..@?m da
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female maleVS
5erum uric
acid/bA!c
3reatinine
- . 005
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%01 5erum6ric acid
5ignicant
positiveassociation
r 042 -
0001
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proteinuria5erum
6ric acid
5ignicantpositiveassociation
r 04
- 3 0001
At"r a$usm"nt or
"ight
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%01 5erum6ric acid
5ignicantpositive
association
r 042 - 0001
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The etiology of D is comple <remains to be claried
+resently> diabetes is the leading cause
of end;stage renal disease in the mostparts of the world
Although the progression of Fidney
disease can be halted partially>D is still regarded as an irreversible <progressive disease
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1t has to be essential to nd thepathophysiological mechanisms thatleads to the development and
progression of D 1n this study> was found thesignicant positive association of
serum uric acid with level ofproteinuria> when adjusted for weight
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+revious study◦ /yperuricemia and its association with obesity
and various components of metabolicsyndrome have been documented
◦ /yperuricemia is also prevalent in patientswith chronic renal failure
◦ hyperuricemia may have a pathogenic role in
the development and progression of chronicrenal failure> rather than simply reGectingdecreased renal uric acid ecretion
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+revious study◦ 1n diabetic patients> serum uric acid early in
the course of diabetes is signicantlyassociated with later development of
persistent macroalbuminuria◦ 1t was shown that Fidney damage in
hyperuricemic rats is not dependent onblood pressure and instead involves therenin7angiotensin system (8A5"
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+revious study◦ An association between serum uric acid <
early loss of renal function has been shown inpatients with type ! diabetes
◦ 1n the study (4uFui et al) positive
correlation of serum uric acid and urinaryalbumin ecretion in .'. men with type 2diabetes mellitus was shown
concluded that serum uric acid concentration
is associated with microalbuminuria andsubclinical atherosclerosis in men with type 2diabetes mellitus
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+revious study◦ in a study on Chinese diabetic patients>
found that hyperuricemia was signicantlyassociated with abnormal albuminuria inpatients without diuretics or use of
uricosuric agents or alcohol concluded that hyperuricemia were
signicantly related to the presence of
albuminuria in patients with diabetes◦ Elevated level of serum uric acid can lead to
low;grade Fidney injury without depositionof uric acid crystals in animal models
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+revious study◦
hyperuricemia in rats induced arteriolopathy ofpreglomerular vessels> resulting in &
impaired autoregulation
glomerular hypertension
endothelial dysfunction 1t was found that microvascular disease in hyperuricemic rats occursindependent of blood pressure and isdependent on activation of thesystemic < local 8A5 < inhibition ofendothelial nitric oide
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+revious study
◦(Hbermayr et al) serum uric
acid was found to be &
a predictor of new onset Fidneydisease
independent of other risF factors
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This study &
5erum uric acid had a signicantpositive association with D
hypothesiIed that serum uric acid
plays a pathological role in thedevelopment of D in T2D
5uggestion studying of the eect of
lowering uric acid with allopurinol onrenal function in D patients in future@
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/ighest Kuality Lreatest Kuantity argest Mariety
3onsistent +rofessionalism Misually Appealing
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/ighest Kuality Lreatest Kuantity argest Mariety
3onsistent +rofessionalism Misually Appealing
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/ighest Kuality Lreatest Kuantity argest Mariety
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/ighest Kuality Lreatest Kuantity argest Mariety
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/ighest Kuality Lreatest Kuantity argest Mariety
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/ighest Kuality Lreatest Kuantity argest Mariety
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