The serum uric acid concentration is not causally linked to diabetic nephropathy in type 1 diabetes

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Ahola , A J , Sandholm , N , Forsblom , C , Harjutsalo , V , Dahlstrom , E , Groop , P-H & FinnDiane Study Grp 2017 , ' The serum uric acid concentration is not causally linked to diabetic nephropathy in type 1 diabetes ' , Kidney International , vol. 91 , no. 5 , pp. 1178-1185 . https://doi.org/10.1016/j.kint.2016.11.025

Title: The serum uric acid concentration is not causally linked to diabetic nephropathy in type 1 diabetes
Author: Ahola, Aila J.; Sandholm, Niina; Forsblom, Carol; Harjutsalo, Valma; Dahlstrom, Emma; Groop, Per-Henrik; FinnDiane Study Grp
Other contributor: University of Helsinki, University of Helsinki
University of Helsinki, Clinicum
University of Helsinki, Clinicum
University of Helsinki, University of Helsinki
University of Helsinki, Clinicum







Date: 2017-05
Language: eng
Number of pages: 8
Belongs to series: Kidney International
ISSN: 0085-2538
DOI: https://doi.org/10.1016/j.kint.2016.11.025
URI: http://hdl.handle.net/10138/236993
Abstract: Previous studies have shown a relationship between uric acid concentration and progression of renal disease. Here we studied causality between the serum uric acid concentration and progression of diabetic nephropathy in 3895 individuals with type 1 diabetes in the FinnDiane Study. The renal status was assessed with the urinary albumin excretion rate and estimated glomerular filtration rate (eGFR) at baseline and at the end of the follow-up. Based on previous genomewide association studies on serum uric acid concentration, 23 single nucleotide polymorphisms (SNPs) with good imputation quality were selected for the SNP score. This score was used to assess the causality between serum uric acid and renal complications using a Mendelian randomization approach. At baseline, the serum uric acid concentration was higher with worsening renal status. In multivariable Cox regression analyses, baseline serum uric acid concentration was not independently associated with progression of diabetic nephropathy over a mean follow-up of 7 years. However, over the same period, baseline serum uric acid was independently associated with the decline in eGFR. In the cross-sectional logistic regression analyses, the SNP score was associated with the serum uric acid concentration. Nevertheless, the Mendelian randomization showed no causality between uric acid and diabetic nephropathy, eGFR categories, or eGFR as a continuous variable. Thus, our results suggest that the serum uric acid concentration is not causally related to diabetic nephropathy but is a downstream marker of kidney damage.
Subject: diabetic nephropathy
Mendelian randomization
serum uric acid
type 1 diabetes
MENDELIAN RANDOMIZATION ANALYSIS
METABOLIC SYNDROME
RENAL-FUNCTION
ASSOCIATION
URATE
INSTRUMENTS
TRANSPORTER
PROGRESSION
DISEASE
RISK
3126 Surgery, anesthesiology, intensive care, radiology
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