Correlation between serum uric acid and thrombelastogram in patients with type 2 diabetes

Abstract

Objective To detect the coagulation status of type 2 diabetic patients with different levels of serum uric acid by thrombelastogram. Methods A total of 208 inpatients with type 2 diabetes, from the Department of Endocrinology of the Second Affiliated Hospital of Nanjing Medical University from February 2016 to December 2017, were divided into normal serum uric acid group (n=108) and hyperuricemia group (HUA group, n=100) according to their serum uric acid level. Another 102 healthy subjects were selected as normal control group (NC group). The thrombelastogram as well as serum lipid, renal function and conventional coagulation etc were tested. The correlation of serum uric acid and thrombelastogram parameters was analyzed by Pearson partial correlation analysis. Results Compared with NC group, both normal serum uric acid group and HUA group showed a hypercoagulable tendency, including a decrease in reaction time (R), coagulation time (K) (F=29.30, 12.63, all P<0.001), and an increase in angle, maximum amplitude (MA), and fibrinogen (F=12.52, 13.63, 13.23, all P<0.001). Compared with normal uric acid group, K in HUA group was lower, whereas angle, MA and fibrinogen were higher (all P<0.05). HUA group was further divided into four groups according to gender and uric acid level. The results showed that compared with A1 group (male<440.5 μmol/L), R and K were decreased, and angle and MA were increased in A2 group (male≥440.5 μmol/L, t=3.46, 2.29, -2.52, -2.34, all P<0.05). Compared with B1 group (female<452.5 μmol/L), K was decreased, angle and MA were increased in B2 group (female≥452.5 μmol/L, t=2.56, -2.32, -2.07, all P<0.05). There were no statistically significant differences in platelet counts in all groups. Pearson partial correlation analysis revealed that serum uric acid was negatively correlated with R and K (r=-0.199, -0.284, all P<0.05), and positively correlated with angle and MA (r=0.269, 0.347, all P<0.01) after controlling age, gender, creatinine, total cholesterol, triglycerides, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, hypertension, coronary heart disease and cerebral infarction. Conclusion Patients with type 2 diabetes have hypercoagulable state, and serum uric acid may be associated with hypercoagulability in type 2 diabetic patients. Key words: Type 2 diabetes mellitus; Hyperuricemia; Thrombelastogram; Hypercoagulability