We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Uric acid predicts long‐term cardiovascular risk in type 2 diabetes but does not mediate the benefits of fenofibrate: The FIELD study.
- Authors
Cao, Jacob Y.; Waldman, Boris; O'Connell, Rachel; Sullivan, David R.; Scott, Russell S.; Aryal, Nanda; Gebski, Val; Marschner, Ian; Taskinen, Marja‐Riitta; Simes, John R.; McGill, Neil; Jenkins, Alicia J.; Keech, Anthony C.
- Abstract
Aim: To explore the relationship between baseline uric acid (UA) levels and long‐term cardiovascular events in adults with type 2 diabetes (T2D) and to determine whether the cardioprotective effects of fenofibrate are partly mediated through its UA‐lowering effects. Methods: Data from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial were utilized, comprising 9795 adults with T2D randomly allocated to treatment with fenofibrate or matching placebo. Plasma UA was measured before and after a 6‐week, active fenofibrate run‐in phase in all participants. Cox proportional hazards models were used to explore the relationships between baseline UA, pre‐to‐post run‐in reductions in UA and long‐term cardiovascular outcomes. Results: Mean baseline plasma UA was 0.33 mmol/L (SD 0.08). Baseline UA was a significant predictor of long‐term cardiovascular events, with every 0.1 mmol/L higher UA conferring a 21% increase in event rate (HR 1.21, 95% CI 1.13‐1.29, P <.001). This remained significant after adjustment for treatment allocation, cardiovascular risk factors and renal function. The extent of UA reduction during fenofibrate run‐in was also a significant predictor of long‐term cardiovascular events, with every 0.1 mmol/L greater reduction conferring a 14% lower long‐term risk (HR 0.86, 95% CI 0.76‐0.97, P =.015). This effect was not modified by treatment allocation (Pinteraction =.77). Conclusions: UA is a strong independent predictor of long‐term cardiovascular risk in adults with T2D. Although greater reduction in UA on fenofibrate is predictive of lower cardiovascular risk, this does not appear to mediate the cardioprotective effects of fenofibrate.
- Subjects
URIC acid; TYPE 2 diabetes; CARDIOVASCULAR diseases risk factors; PROPORTIONAL hazards models; FIELD research; FENOFIBRATE
- Publication
Diabetes, Obesity & Metabolism, 2020, Vol 22, Issue 8, p1388
- ISSN
1462-8902
- Publication type
Article
- DOI
10.1111/dom.14046