Independent association of uric acid levels with peripheral arterial disease in Taiwanese patients with Type 2 diabetes

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Abstract
[[abstract]]Aims Hyperuricaemia may be a risk factor for atherosclerotic disease. Its association with peripheral arterial disease (PAD) has not been studied in Taiwanese patients with Type 2 diabetes. Methods Uric acid (UA) levels and PAD were evaluated in 508 Taiwanese outpatients with Type 2 diabetes (210 men, 298 women; mean age +/- SD, 63.8 +/- 10.6 years). PAD was diagnosed when the ankle-brachial index was < 0.9. Patients with an ankle-brachial index of greater than or equal to 1.3 were excluded because of possible medial arterial calcification. Potential confounding variables with P < 0.10 were adjusted for in multivariate analyses. Results In univariate analyses, UA levels were higher in patients with PAD than in those without PAD (345.0 +/- 95.2 vs. 309.3 +/- 89.2 mumol/l; P < 0.0005). Prevalences of PAD for quintiles of UA levels were 6.8, 8.9, 10.2, 13.1 and 16.5%, respectively (P-trend < 0.05). With UA level as a continuous variable, the multivariate-adjusted odds ratio (95% confidence interval) for PAD was 1.005 (1.001-1.008) (P < 0.01). The optimal cut-off point for UA as determined by the receiver operating characteristic curve was 264.7 mumol/l. The sensitivity and specificity at this cut-off point was 82.6 and 33.3%, respectively. The area under curve was 0.60 (95% confidence interval: 0.53-0.68). The multivariate-adjusted odds ratio for PAD for UA above this level was 2.736 (1.239-6.043) (P < 0.05). The results after excluding 56 cases using diuretics were similar. Conclusions Elevated uric acid level is a significant and independent risk factor for PAD in Taiwanese patients with Type 2 diabetes