Levels of serum uric acid at admission for hypoglycaemia predict 1-year mortality
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Hypoglycaemia represents a critical burden with clinical and social consequences in the management of diabetes. Serum uric acid (SUA) has been associated with cardiovascular diseases (CVD), but no conclusive findings are available nowadays in patients suffering from hypoglycaemia. We investigated whether SUA levels at the time of hypoglycaemia could predict all-cause mortality after 1-year follow-up.
In total, 219 patients admitted to the Emergency Department (ED) of Ospedale Policlinico S. Martino of Genoa (Italy) have been enrolled between January 2011 and December 2014. The primary endpoint of the study consisted in determining whether SUA levels at the time of ED admission could predict the occurrence of death after 1 year.
The majority of patients were diabetic, especially type 2. CVD and chronic kidney disease were prevalent comorbidities. By a cut-off value obtained by the receiver operating characteristic curve analysis, a Kaplan–Meier analysis demonstrated that patients with SUA levels > 5.43 mg/dL were more prone to death after 1 year compared to those with lower SUA levels. The risk of death increased with high SUA levels both in the univariate and the multivariate models including estimated glomerular filtration rate, C-reactive protein, type of diabetes, and age-adjusted Charlson comorbidity index.
SUA could be useful as a predictor of 1-year mortality in hypoglycaemic patients, irrespective of severe comorbidities notably increasing the risk of death in these frail patients.
KeywordsSerum uric acid Cardiovascular disease Hypoglycaemia Diabetes mellitus Mortality Frailty
This study has been supported by a grant from the European Commission (FP7-INNOVATION I HEALTH-F2-2013-602114; Athero-B-Cell: Targeting and exploiting B cell function for treatment in cardiovascular disease) and a grant from the Swiss National Science Foundation to Dr. F. Montecucco (#310030_152639/1).
FG, GS, and RC collected data; AB, RC, and FM designed the study; AB, FC, LL, and FM performed statistical analyses; AB, FM, and RC prepared the manuscript. LL, FD, DM, and RC gave suggestions to enhance the manuscript. All authors approved the final version of the manuscript. AB is the guarantor of this work and, as such, has full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Compliance with ethical standards
Conflict of interest
The study has been approved by the local Ethics Committee in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
Informed consent was obtained from all patients and/or their relatives at the time of their inclusion in the study.