Abstract
Currently serum uric acid is not considered a metabolic biomarker in diabetes. The purpose of the current study was to find the significant associations, correlations and to develop regression models between uric acid, HbA1c, and serum insulin among diabetic patients. The study enrolled type-1 and type-2 diabetic patients for 30 months. For HbA1c and uric acid, patients were divided into two groups: HbA1c＜7% or HbA1c≥7%, UA＜6.5 mg/dl or UA≥6.5mg/dl, respectively. For measurement of insulin levels, patients on diet/metformin only were selected. Data for 1205 patients were analyzed which included 754 (62.6%) males, 451 (37.4%) females, 92 (7.6%) type-1, and 1113 (92.4%) type-2diabetic subjects. For the group HbA1c＜7%, uric acid levels were higher (mean 5.8±4.7) as compared to HbA1c＞7% (mean 4.8±1.5); for the group UA＜6.5 mg/dl, serum insulin levels were lower (mean 39±15.7) as compared to the group with UA≥6.5 mg/dl (mean 73.4±20.5). Uric acid was significantly and inversely correlated with HbA1c (r=-0.13, p-value＜0.0001) and positively correlated with serum insulin (r=0.293, p-value=0.005). Regression models for uric acid and HbA1c was found to be HbA1c=10.235+(-0.094×uric acid); p-value＜0.000 and for uric acid with insulin was observed to be Serum insulin=-9.650+(11.595×uric acid); p-value 0.005. Higher levels of uric acid are associated with lower HbA1c both in type-1 and type-2 diabetic patients. Uric acid is involved in the augmentation of insulin secretion in type-2 subjects.
Highlights
Introduction and BackgroundCurrently, diabetes is considered a major health problem with increasing prevalence, and leading cause of morbidity, mortality and vast complications (King et al 1998; Chen et al 2002; Sheetz and King 2002; Mathers and Loncar 2006)
Hyperuricemia has been implicated as a strong causative factor for the development of insulin resistance indicating its involvement in hyperinsulinemia and independent risk factor for future development of type-2 diabetes mellitus (Vuorinen-Markkola et al 1994)
Under these observations including hyperglycemia, HbA1c levels should be high and as well as those of serum uric acid, which was not the case in our study
Summary
Introduction and BackgroundCurrently, diabetes is considered a major health problem with increasing prevalence, and leading cause of morbidity, mortality and vast complications (King et al 1998; Chen et al 2002; Sheetz and King 2002; Mathers and Loncar 2006). Landmark and historical research trials have shown a positive association between impaired glycemic control (hyperglycemia) and the risk of CHD (coronary heart disease) and other diabetes complications such as nephropathy (Nathan et al 1995; Wei et al 1998; Turner et al 1998). HbA1c is a standard methodology in diabetology clinics, which measures patient’s glycemic control for the past 2-3 months (Little et al 2001; Berg et al 2008). Emerging data suggest that uric acid is implicated as a risk factor and cause of numerous disease states such as gout, hypertension, type-2 diabetes, cardiovascular and renal disease (Fang and Alderman 2000; Kang et al 2002; Nakanishi et al 2003; Alper et al 2005; Bos et al 2006; Johnson et al 2009)
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