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Association between long-term serum uric acid variability and diabetic retinopathy: A prospective study in patients
Qian Zhu1, Hanying Wang1, Yuan Qu1
1Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China; Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China.
Aims:
To evaluate the association between serum uric acid (SUA) variability and the development and/or severity of diabetic retinopathy (DR) in patients with Type 1 and Type 2 diabetes mellitus (DM).
Methods:
A prospective study was conducted at Shanghai General Hospital, involving 730 DM patients without proliferative diabetic retinopathy at baseline. Each participant was followed for at least one year, with multiple DR assessments via fundus photography and SUA measurements. Average real variability (ARV) was calculated for each patient to assess SUA fluctuations, accounting for varying follow-up frequencies and visit numbers.
Results:
The Kaplan-Meier survival analysis showed that the development and progression of DR were more likely to occur in the group scored higher in SUA ARV, with a Log-rank p-value of 0.0055. Cox regression with Backward Stepwise Selection of variables showed that the hazard ratios in patients with the 3rd and 4th quantile of ARV are 2.2 (p = 0.008, 95 % CI: 1.2206∼3.8201) and 2.74 (p = 0.017, 95 % CI: 1.1339∼3.7255) for DR worsening compared to patients in the first quantile.
Conclusion:
High long-term variability is significantly associated with the development and worsening of DR in DM patients, suggesting the importance of the benefits of continuous serum uric acid control.
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