Serum Uric Acid-to-Creatinine Ratio Is Independently Associated with Sudomotor Dysfunction in Type 2 Diabetes: A Cross-Sectional Study

Purpose: This study investigated the association between the serum uric acid-to-creatinine ratio (SUA/Cr) and sudomotor dysfunction in patients with type 2 diabetes mellitus. Patients and Methods: This was a single-center, inpatient, cross-sectional study. A total of 781 participants were classified into three tertiles based on their SUA/Cr. The electrochemical conductivity (ESC) of sweat obtained from the hands and feet was measured using SUDOSCAN to assess sudomotor function. Mean ESC values for the hands (HESC) and feet (FESC) were computed independently. Sudomotor dysfunction was defined as HESC or FESC ≤ 60 μS. Statistical analyses were performed using SPSS 25.0, involving one-way ANOVA, Kruskal–Wallis test, chi-square test, Spearman correlation coefficient, binary/multivariable logistic regression (with three adjusted models), and subgroup analysis, with statistical significance defined as p < 0.05. Results: The prevalence of sudomotor dysfunction in the first, second, and third tertiles of SUA/Cr was 65.0%, 57.6%, and 48.9%, respectively. Patients with lower SUA/Cr levels exhibited a markedly increased risk of sudomotor dysfunction compared to those with higher SUA/Cr levels (p < 0.001). After adjusting for potential confounders, the association between decreased SUA/Cr ratio and sudomotor dysfunction risk remained significant (OR=1.646, 95% CI: 1.088– 2.489, p = 0.018). Subgroup analyses by age, sex, glycated hemoglobin A1c, body mass index, and duration of diabetes confirmed the robustness of the relationship between SUA/Cr and the risk of diabetic peripheral neuropathy (all interactions p > 0.05). Conclusion: The SUA/Cr ratio is independently associated with sudomotor dysfunction in patients with type 2 diabetes mellitus.