Abstract
This study investigated the influence of glycemic control on fractional uric acid excretion and the concentration of C-reactive protein (CRP) in type 2diabetes mellitus. A total of 120 subjects consisting of 76 confirmed diabetic patients, as cases and 44 apparently healthy volunteers served as control, participated in the study. Venous blood and early morning urine were obtained for estimations of CRP, uric acid and creatinine concentrations. The results showed that serum C-reactive protein concentrations were significantly higher in diabetics than in non-diabetic control (p = 0.000) however, serum uric acid, creatinine and uric acid: creatinine ratio were similar in both groups (p = 0.401, p = 0.248, p = 0.141 respectively). The fractional excretion of uric acid in diabetics was also significantly higher than non-diabetics. Among the diabetics, patients with positive HbA1c (poorly controlled diabetics) had significantly higher concentration of C – reactive protein (p = 0.05) and fasting plasma glucose than those with negative HbA1c (better controlled diabetics). However, fractional excretion of uric acid was not significantly different in the HbA1c positive and the negative patients. Pearson bivariate correlation analysis showed that glycated hemoglobin (HbA1c) related positively and significantly with C – reactive protein among the diabetics (r = 0.333, p = 0.003) but did not show significant relationship with concentrations of uric acid in serum and urine as well as with fractional excretion of uric acid. Binary logistic regression analysis also showed that a unit increment in the odds of positive HbA1c (HbA1c ? 6.5) was significantly associated with 1.7-fold increment in C – reactive protein concentrations (CI = 95%, Odd ratio = 1.7, p = 0.015). However, the concentrations of CRP in diabetic patients were observed to correlate significantly with serum uric acid (r = 0.306, p = 0.048), urine uric acid (r = 0.397, p = 0.000) and serum uric acid:creatinine ratio (r = 0.338, p = 0.012); but there was no significant correlation with fractional excretion of uric acid. It can be concluded that the concentration and excretion of uric acid were not significantly affected by glycemic control, however, adequate control of glucose level was observed to modulate the concentration of C-reactive protein.
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