Plasma uric acid concentrations represent the degree of metabolic control and diabetic complications in type 2 diabetes

Yun, Jung Won; Mook, Kang Jeung; Lee, Won Young; Kim, Sun Woo

Abstract

BACKGROUND: Several epidemiologic studies have shown that increased uric acid is a risk factor of cardiovascular mortality. Elevated serum uric acid is also a feature of insulin resistance. However, increased or decreased levels of uric acid have been variably reported in diabetes and impaired glucose tolerance. The aim of the present study is to evaluate the relation between uric acid and metabolic parameters and chronic complications in type 2 diabetes.
METHODS
Total 387 patients with type 2 diabetes were evaluated and divided according to their uric acid level in quartiles. Plasma glucose, lipid profiles, blood pressure, C-peptide levels and complications including nephropathy and retinopathy were compared between four groups according to plasma uric acid levels. Patients were divided as follows : Quartile 1 (<3.7 mg/dL, n=94), Quartile 2 (>or=3.7 mg/dL and < 4.5 mg/dL, n=96), Quartile 3 (>or=4.5 mg/dL and < 5.4 mg/dL, n=101), Quartile 4 (>or=5.4 mg/dL, n=96).
RESULTS
Patients within the highest quartile showed significantly longer duration of diabetes, higher prevalence of retinopathy and higher blood pressure, higher level of triglyceride, creatinine and C-peptide (p<0.05). Patients within the lowest quartile showed significantly higher concentrations of fasting plasma glucose, postprandial glucose and HbA1c (p<0.05). In the multiple regression analysis after adjustment for age, sex, duration of diabetes, a positive correlation was found between uric acid levels and creatinine (beta=0.245, p<0.01), triglyceride (beta=0.127, p<0.05), diastolic blood pressure (beta=0.156, p<0.05) and percentage of proliferative diabetic retinopathy (beta=0.141, p<0.05). After readjustment for age, sex, duration of diabetes and creatinine, the strong predictor of uric acid was triglyceride levels (beta=0.161, p<0.05) and diastolic pressure (beta=0.227, p<0.05).
CONCLUSION
In type 2 diabetes, elevated uric acid level was related with the components of insulin resistance syndrome and the degree of microvascular complications.