Uric acid, renal function and risk of hypoglycaemia in Chinese type 2 diabetes patients

Ren, Yudong; Ji, Linong; Mu, Yiming; Hong, Tianpei; Ji, Qiuhe; Guo, Lixin; Huang, Qin; Yang, Xilin

doi:10.1002/dmrr.2809

Cited by 6 publications

(4 citation statements)

References 36 publications

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“…The complicated pharmacokinetics of antidiabetic drugs leads to difficulties in glycaemic control in chronic kidney disease patients [5]. Indeed, the existence of impaired renal function is an important risk factor for severe hypoglycaemia [6], which is partly due to impaired gluconeogenesis in the kidney [7]. Additionally, both decreased glucose filtration and increased inflammation-induced insulin resistance result in hyperglycaemia in patients with kidney disease [8].…”

Section: Introductionmentioning

confidence: 99%

Effects of physical activity on the progression of diabetic nephropathy: a meta-analysis

2021

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Background: Diabetic nephropathy (DN) is an important microvascular complication of diabetes. Physical activity (PA) is part of a healthy lifestyle for diabetic patients; however, the role of PA in DN has not been clarified. Our aim was to conduct a meta-analysis to explore the association between PA and DN risk. Methods: PubMed, Embase, Cochrane Library and Web of Science were systematically searched for articles examining PA in diabetic patients and its effect on renal function. Standardized mean differences (SMDs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. The study protocol is registered with PROSPERO (CRD42020191379). Results: A total of 38991 participants were identified from 18 studies. The results indicated that PA was associated with increases in the glomerular filtration rate (SMD = 0.01, 95% CI = [0.02–0.17]) and decreases in the urinary albumin creatinine ratio (SMD = −0.53, 95% CI: −0.72 to −0.34), rate of microalbuminuria (OR = 0.61, 95% CI = [0.46–0.81]), rate of acute kidney injury (OR = 0.02, 95% CI = [0.01–0.04]), rate of renal failure (OR = 0.71, 95% CI = [0.52–0.97]) and risk of DN in patients with Type 1 diabetes (OR = 0.67, 95% CI = [0.51–0.89]). Conclusions: This meta-analysis indicated that PA is effective for improving DN and slowing its progression; however, more high-quality randomized controlled trials are required on this topic.

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Section: Introductionmentioning

confidence: 99%

Effects of physical activity on the progression of diabetic nephropathy: a meta-analysis

2021

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“…Moderate hyperuricaemia has been demonstrated to increase not only the risk of hypoglycaemia but also the prevalence of cardiac conduction defects in patients with T2D . The conduction defects associated with hyperuricaemia may provide an arrhythmogenic substrate for arrhythmic SCA .…”

Section: Discussionmentioning

confidence: 99%

Hypoglycaemic episodes increase the risk of ventricular arrhythmia and sudden cardiac arrest in patients with type 2 diabetes—A nationwide cohort study

Hsieh

Liao

et al. 2019

Diabetes Metabolism Res

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Background:The impact of hypoglycaemic episode (HE) on the risk of ventricular arrhythmia (VA) and sudden cardiac arrest (SCA) remains unclear. We hypothesized that HE increases the risk of both VA and SCA and that glucose-lowering agents causing HE also increase the risk of VA/SCA in patients with type 2 diabetes (T2D).Methods: Patients aged 20 years or older with newly diagnosed T2D were identified using the Taiwan National Health Insurance Database. HE was defined as the presentation of hypoglycaemic coma or specified/unspecified hypoglycaemia. The control group consisted of T2D patients without HE. The primary outcome was the occurrence of VA (including ventricular tachycardia and fibrillation) and SCA during the defined follow-up periods. A multivariate Cox hazards regression model was used to evaluate the hazard ratio (HR) for VA or SCA.Results: A total of 54 303 patients were screened, with 1037 patients with HE assigned to the HE group and 4148 frequency-matched patients without HE constituting the control group. During a mean follow-up period of 3.3 ± 2.5 years, 29 VA/SCA events occurred. Compared with the control group, HE group had a higher incidence of VA/SCA (adjusted HR: 2.42, P = .04). Patients who had used insulin for glycaemic control showed an increased risk of VA/SCA compared with patients who did not receive insulin (adjusted HR: 3.05, P = .01).

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“…High serum uric acid (SUA) is associated with the increased risk of the development of chronic kidney disease in T2D 46 . In addition to chronic kidney disease, some studies reported that the elevated levels of SUA were associated with hypertension, coronary heart disease, and stroke 47 , 48 .…”

Section: Discussionmentioning

confidence: 99%

Targeted metabolome profiling by dual-probe microdialysis sampling and treatment using Gardenia jasminoides for rats with type 2 diabetes

Wang

Liu

et al. 2017

Sci Rep

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Diabetes causes a variety of end-stage organ complications, including diabetic nephropathy. Metabolomics offers an approach for characterizing biofluid metabolic changes, but studies focusing on diabetic nephropathy are limited due to the loss of tissue-specific metabolic information. A microdialysis application for the sampling of intact endogenous metabolites has been developed, utilizing two probes simultaneously inserted into the kidney tissues and jugular vein of rats with type 2 diabetes. The comprehensive and quantitative analysis of 20 diagnostic biomarkers closely realated to type 2 diabetes and its complications were performed. Results indicated that amino acid and nucleotide levels were lower in diabetic rats, revealing that the metabolic pathways of amino acid, as well as purine and pyrimidine, were disturbed. Targeted metabolomics using mass spectrometry was performed to find potential therapeutic biomarkers and related metabolic pathways of Gardenia jasminoides (G. jasminoides) for treating diabetes. Results suggested that seven biomarkers in the kidney and five biomarkers in the blood were related to G. jasminoides. In addition, the marked perturbations of pathways were regulated after treatment with G. jasminoides, including amino acid metabolism and purine metabolism. These biomarkers and metabolic pathways provided new understanding for molecular mechanisms of G. jasminoides for treating diabetes and its complications.

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Uric acid, renal function and risk of hypoglycaemia in Chinese type 2 diabetes patients

Abstract: Background 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.

Cited by 6 publications

References 36 publications

Effects of physical activity on the progression of diabetic nephropathy: a meta-analysis

Effects of physical activity on the progression of diabetic nephropathy: a meta-analysis

Hypoglycaemic episodes increase the risk of ventricular arrhythmia and sudden cardiac arrest in patients with type 2 diabetes—A nationwide cohort study

Targeted metabolome profiling by dual-probe microdialysis sampling and treatment using Gardenia jasminoides for rats with type 2 diabetes

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