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

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 ≥ 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 µmol/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 µmol/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.