Sudomotor dysfunction prevalence declined across increasing serum uric acid-to-creatinine ratio (SUA/Cr) tertiles in patients with type 2 diabetes mellitus (T2DM). 

In a single-center cross-sectional study published in Diabetes, Metabolic Syndrome and Obesity, 781 inpatients with T2DM were evaluated to examine the relationship between SUA/Cr and sudomotor function. Participants were categorized into tertiles according to SUA/Cr levels. Sudomotor function was assessed using SUDOSCAN to measure electrochemical skin conductance (ESC) of the hands (HESC) and feet (FESC). Sudomotor dysfunction was defined as HESC or FESC ≤60 μS.

The prevalence of sudomotor dysfunction decreased across increasing SUA/Cr tertiles (65.0%, 57.6%, and 48.9%, respectively). Lower SUA/Cr levels were significantly associated with higher prevalence of sudomotor dysfunction (p<0.001). After adjustment for potential confounders across three multivariable models, decreased SUA/Cr remained independently associated with sudomotor dysfunction (OR 1.646, 95% CI 1.088-2.489; p=0.018). Subgroup analyses stratified by age, sex, glycated hemoglobin A1c, body mass index, and duration of diabetes showed consistent findings, with no significant interactions observed (all p for interaction >0.05).

These findings demonstrate an independent association between the SUA/Cr ratio and sudomotor dysfunction in patients with T2DM.