AUTHOR=Xu Lu , Sun Hang , Liu Lili , Zhan Siyan , Wang Shengfeng , Lv Xiaozhen , Song Yongfeng 

TITLE=The Effects of Cardiometabolic Factors on the Association Between Serum Uric Acid and Chronic Kidney Disease in Chinese Middle-Aged and Older Population: A Mediation Analysis

JOURNAL=Frontiers in Endocrinology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2021.702138

DOI=10.3389/fendo.2021.702138

ISSN=1664-2392

ABSTRACT=<sec><title>Introduction</title><p>To explore whether dyslipidemia, hyperglycemia or hypertension has mediating effect on the association between serum uric acid (SUA) and the development of chronic kidney disease (CKD).</p></sec><sec><title>Methods</title><p>We conducted a mediation analysis to explore the potential mediating effects of systolic blood pressure (SBP), diastolic blood pressure (DBP), blood glucose, triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) on the association between SUA and estimated glomerular filtration rate (eGFR). The data were obtained from China Health and Retirement Longitudinal Study (CHARLS), covering 5,762 individuals.</p></sec><sec><title>Results</title><p>SUA had a negative dose-response total effect on eGFR (<italic>β</italic> -3.11, 95% CI -3.40 to -2.82, <italic>P</italic>-value&lt;0.001). The linear regression between SUA and seven potential mediators indicated that blood glucose (<italic>β</italic> 0.80, 95% CI 0.18 to 1.42, <italic>P</italic>-value=0.012), TG (<italic>β</italic> 10.01, 95% CI 8.22 to 11.79, <italic>P-</italic>value&lt;0.001), TC (<italic>β</italic> 2.64, 95% CI 1.83 to 3.45, <italic>P</italic>-value&lt;0.001), HDL-C (<italic>β</italic> -0.27, 95% CI -0.52 to -0.02, <italic>P-</italic>value=0.034) and LDL-C (<italic>β</italic> 1.15, 95% CI 0.49 to 1.80, <italic>P</italic>-value=0.001) all had significant dose-response association with SUA, but SBP and DBP showed no significant association with SUA. In terms of the association between potential mediators and eGFR, only TG (<italic>β</italic> 0.003, 95% CI -0.001 to 0.01, <italic>P</italic>-value=0.117) and HDL-C (<italic>β</italic> 0.01, 95% CI -0.02 to 0.04, <italic>P</italic>-value=0.444) did not have significant linear association with eGFR. The linear regression showed that SUA was directly associated with eGFR (<italic>P-</italic>value&lt;0.001).</p></sec><sec><title>Conclusions</title><p>This study supported that the association between SUA and the risk of CKD was not mediated by hypertension, hyperglycemia or dyslipidemia.</p></sec>