Serum uric acid level as a marker associated with microalbuminuria in pediatric patients with type 1 diabetes mellitus.

Type 1 diabetes mellitus (T1DM) is a common chronic disease in children and adolescents. Diabetic kidney disease (DKD) is one of its most serious microvascular complications. Serum uric acid (SUA) has been associated with an increased risk of DKD. The aim of this study was to evaluate the association between SUA levels and the presence of microalbuminuria, an important and early marker of DKD, in pediatric patients with T1DM. This retrospective study included 138 pediatric patients who were followed up with a diagnosis of T1DM for at least 1 year. Patients were divided into two groups, normoalbuminuric and microalbuminuric, according to the urine albumin/creatinine ratio (uACR) and were also divided into two groups according to SUA levels, < 3.98 mg/dL and ≥ 3.98 mg/ dL. The mean SUA level of 138 patients with T1DM was 3.85 ± 1.0 mg/dL. The mean SUA level was significantly higher in the microalbuminuria group compared to the normoalbuminuria group. ROC curve analysis revealed that mean SUA level at a cut-off of 3.98 mg/dL was associated with the presence of albuminuria, with an AUC of 0.66 (p: 0.008, 95% CI [0.56-0.76]) yielding 63% sensitivity and 65% specificity. The rate of microalbuminuria was found to be 3.06 times significantly higher among patients with SUA level of ≥ 3.98 mg/dL (p = 0.008, OR 3.06, 95% CI [1.31-7.13]).

conclusionsThe mean SUA level was significantly higher in the microalbuminuria group and the rate of microalbuminuria is higher in patients with T1DM when SUA was ≥ 3.98 mg/dL. These findings indicate a potential link between elevated SUA levels and early renal involvement in pediatric T1DM, though the proposed cut-off should be interpreted with caution. WHAT IS KNOWN: • Serum uric acid levels have been associated with an increased risk of developing DKD and development of albuminuria has been linked to higher SUA levels in patients with diabetes. WHAT IS NEW: • The mean SUA level demonstrated a moderate discriminative ability for microalbuminuria, with an AUC of 0.66 (p = 0.008, 95% CI [0.56-0.76]), providing 63% sensitivity and 65% specificity at a cut-off value of 3.98 mg/dL. • The rate of microalbuminuria is 3.06 times higher in pediatric patients with T1DM when SUA is ≥ 3.98 mg/dL. • Considering the ongoing debate regarding the definition of elevated SUA levels even in healthy individuals, the proposed cut-off may serve as a preliminary reference for future studies exploring risk assessment and follow-up in this population.