The Association between Serum Uric Acid and Peripheral Neuropathy in Patients with Type 2 Diabetes Mellitus: A Multicenter Nationwide CrossSectional Study

Abstract

Background: The role of uric acid in the development of diabetic peripheral neuropathy remains unclear. This study aimed to determine the association between uric acid and peripheral neuropathy among type 2 diabetes mellitus (T2DM) patients. Methods: We conducted a nationwide cross-sectional study based on the diabetes and hypertension study of the Medical Research Network of the Consortium of Thai Medical Schools. Adult T2DM patients from 831 public hospitals in Thailand were evaluated. The serum uric acid level was categorized into five groups based on quintiles (<4.4, 4.4-5.3, 5.3-6.2, 6.2-7.3, and >7.3 mg/dL). A multivariate logistic regression model was used to assess the independent association between serum uric acid level and peripheral neuropathy. Results: In total, 7,511 T2DM patients with available data about serum uric acid levels were included in the analysis. The mean age of the participants was 61.7±10.9 years, and approximately 35.6% were men. The prevalence rate of peripheral neuropathy was 3.0%. Moreover, the prevalence rates of peripheral neuropathy stratified according to uric acid levels <4.4, 4.4-5.3, 5.3-6.2, 6.2-7.3, and >7.3 mg/dL were 2.5%, 2.8%, 2.4%, 2.5%, and 4.7%, respectively. A serum uric acid level ≥7.3 mg/dL was found to be associated with an increase in odds ratio (1.54; 95% confidence interval, 1.02-2.32) for peripheral neuropathy compared with a serum uric acid level <4.4 mg/dL. Conclusion: Serum uric acid level is independently associated with peripheral neuropathy in T2DM patients, and elevated serum uric acid levels should be considered a risk factor for diabetic peripheral neuropathy in clinical practice.

Prevalence and Determinants of Diabetic Peripheral Neuropathy/Foot Syndrome in a rural population of North India

“…About 42.0% of diabetic patients were found to be suffering from peripheral neuropathy. This was similar to the ndings of other studies on diabetic peripheral neuropathy (DPN) [10], [13][14][15][16].However, this was in contrast to the ndings of Kaewput et al [17] and Perrin et al [18] in which prevalence ranged from 3.0% to 16.6%. The possible reasons for this variation could be different study settings and different classi cation used to diagnose DPN in these studies.…”

The association between serum uric acid and diabetic complications in patients with type 2 diabetes mellitus by gender: a cross-sectional study

“…In contrast to DN, neither DR nor DPN was found associated with SUA levels, which was consistent with the previous reports ( Xia et al, 2020 ). On the contrary, a multicenter cross-sectional study in Thailand concludes that SUA is independently associated with peripheral neuropathy in T2DM patients, and elevated SUA should be considered a risk factor for DPN in clinical practice ( Kaewput et al, 2020 ).Two explanations are suggested for the controversial findings. Firstly, the prevalence of DR and DPN were less than 12% in the current sectional-study, far below the average levels which are 20.8% and 20% for DR and DPN respectively in Asian people ( IDF, 2019 ).…”

Supplemental Information 2: Raw data

“…In contrast to DN, neither DR nor DPN was found associated with SUA levels, which was consistent with the previous reports (Xia et al, 2020). On the contrary, a multicenter cross-sectional study in Thailand concludes that SUA is independently associated with peripheral neuropathy in T2DM patients, and elevated SUA should be considered a risk factor for DPN in clinical practice (Kaewput et al, 2020).Two explanations are suggested for the controversial findings. Firstly, the prevalence of DR and DPN were less than 12% in the current sectional-study, far below the average levels which are 20.8% and 20% for DR and DPN respectively in Asian people (IDF, 2019).…”