Objective: Evidence pertaining to the associations between hyperuricemia and diabetic microvascular complications is limited and inconclusive. In this study, we aimed to prospectively investigate the independent associations of hyperuricemia and retinopathy, nephropathy and neuropathy in individuals with type 2 diabetes mellitus (T2DM). Methods: This cohort study enrolled 25,094 participants from UK Biobank with T2DM and without microvascular complications at baseline. Hyperuricemia was defined as serum uric acid (SUA) higher than 420 μmol/L. The incidence of diabetic microvascular complications was identified from hospital inpatient records that were coded according to the International Classification of Diseases (ICD)-10 coding system. Multivariable adjusted Cox proportional hazards regression models were used to calculate adjusted hazard ratios (aHR). Results: Among all participants, 3,844 (15.3%) were classified as having hyperuricemia at baseline. During a median follow-up of 14.0 years, 555 (14.4%) individuals with hyperuricemia developed diabetic microvascular complications, compared with 12.6% of individuals without hyperuricemia (P=0.002). In the multivariable-adjusted model accounted for socioeconomic status, lifestyle factors, physical and biochemical measurements, and medication use, when compared with individuals of T2DM who had a normal SUA level, those with hyperuricemia had an 82.9% higher risk of developing diabetic nephropathy (95%CI: 1.41-2.38, P<0.001), and a 30.2% higher risk of diabetic neuropathy (95%CI: 1.06-1.60, P=0.011). However, the association between hyperuricemia and diabetic retinopathy was not statistically significant (aHR:1.070, 95%CI: 0.94-1.22, P=0.320). Conclusions: Hyperuricemia was independently associated with diabetic nephropathy and neuropathy but not retinopathy in individuals with T2DM. These findings underscore the importance of monitoring SUA level in prevention of certain microvascular complications.

Objective: Evidence pertaining to the associations between hyperuricemia and diabetic microvascular complications is limited and inconclusive. In this study, we aimed to prospectively investigate the independent associations of hyperuricemia and retinopathy, nephropathy and neuropathy in individuals with type 2 diabetes mellitus (T2DM). Methods: This cohort study enrolled 25,094 participants from UK Biobank with T2DM and without microvascular complications at baseline. Hyperuricemia was defined as serum uric acid (SUA) higher than 420 μmol/L. The incidence of diabetic microvascular complications was identified from hospital inpatient records that were coded according to the International Classification of Diseases (ICD)-10 coding system. Multivariable adjusted Cox proportional hazards regression models were used to calculate adjusted hazard ratios (aHR). Results: Among all participants, 3,844 (15.3%) were classified as having hyperuricemia at baseline. During a median follow-up of 14.0 years, 555 (14.4%) individuals with hyperuricemia developed diabetic microvascular complications, compared with 12.6% of individuals without hyperuricemia (P=0.002). In the multivariable-adjusted model accounted for socioeconomic status, lifestyle factors, physical and biochemical measurements, and medication use, when compared with individuals of T2DM who had a normal SUA level, those with hyperuricemia had an 82.9% higher risk of developing diabetic nephropathy (95%CI: 1.41-2.38, P<0.001), and a 30.2% higher risk of diabetic neuropathy (95%CI: 1.06-1.60, P=0.011). However, the association between hyperuricemia and diabetic retinopathy was not statistically significant (aHR:1.070, 95%CI: 0.94-1.22, P=0.320). Conclusions: Hyperuricemia was independently associated with diabetic nephropathy and neuropathy but not retinopathy in individuals with T2DM. These findings underscore the importance of monitoring SUA level in prevention of certain microvascular complications.

Aims: To assess the real-world distribution of uncorrected near visual acuity (UCNVA) in patients with highly myopic cataract ,as well as the associated refraction outcomes after cataract surgery. Methods: We conducted a cross-sectional study that included patients who had an axial length (AL) ≥26 mm in at least one eye and had undergone phacoemulsification with monofocal intraocular lens implantation. Three months or later after surgery, UCNVA was measured at a distance of 40 cm using a LogMAR ETDRS near visual acuity tumbling E chart. Other examinations carried out included non-cycloplegic autorefraction and measurement of best-corrected distance visual acuity (BCDVA). Multiple logistic regression was performed to identify the risk factors for near visual impairment (UCNVA < 20/40). Results: A total of 664 patients (664 eyes) were included in the study. The mean AL was 29.05±2.31 mm, and the postoperative spherical equivalent was -2.51±1.12D. Among these eyes, 319 eyes (48.04%) had a UCNVA of ≥ 20/40 and 518 eyes (78.01%) had a BCDVA ≥ 20/40. The risk factors for a UCNVA of less than 20/40 included postoperative astigmatism greater than 1D (-2 to -1D, odds ratio [OR]: 2.00, 95% confidence interval [CI]: 1.24 to 3.22; < -2D, OR: 4.27, 95% CI: 1.88 to 9.66), a postoperative spherical equivalent outside the range of -3.5 to -1.5D (OR: 4.17 to 19.73), and a BCDVA less than 20/40 (OR: 5.44, 95% CI: 3.14 to 9.42). Conclusions: To achieve an optimal UCNVA in patients with highly myopic cataract, it is recommended to set the target refraction between -3.5 and -1.5 D and to keep the postoperative residual astigmatism below 1D.

Aims: To assess the real-world distribution of uncorrected near visual acuity (UCNVA) in patients with highly myopic cataract ,as well as the associated refraction outcomes after cataract surgery. Methods: We conducted a cross-sectional study that included patients who had an axial length (AL) ≥26 mm in at least one eye and had undergone phacoemulsification with monofocal intraocular lens implantation. Three months or later after surgery, UCNVA was measured at a distance of 40 cm using a LogMAR ETDRS near visual acuity tumbling E chart. Other examinations carried out included non-cycloplegic autorefraction and measurement of best-corrected distance visual acuity (BCDVA). Multiple logistic regression was performed to identify the risk factors for near visual impairment (UCNVA < 20/40). Results: A total of 664 patients (664 eyes) were included in the study. The mean AL was 29.05±2.31 mm, and the postoperative spherical equivalent was -2.51±1.12D. Among these eyes, 319 eyes (48.04%) had a UCNVA of ≥ 20/40 and 518 eyes (78.01%) had a BCDVA ≥ 20/40. The risk factors for a UCNVA of less than 20/40 included postoperative astigmatism greater than 1D (-2 to -1D, odds ratio [OR]: 2.00, 95% confidence interval [CI]: 1.24 to 3.22; < -2D, OR: 4.27, 95% CI: 1.88 to 9.66), a postoperative spherical equivalent outside the range of -3.5 to -1.5D (OR: 4.17 to 19.73), and a BCDVA less than 20/40 (OR: 5.44, 95% CI: 3.14 to 9.42). Conclusions: To achieve an optimal UCNVA in patients with highly myopic cataract, it is recommended to set the target refraction between -3.5 and -1.5 D and to keep the postoperative residual astigmatism below 1D.