Plasma urate in diabetes: relationship to glycaemia, glucose disposal, microvascular complications and the variations following oral glucose

Abstract

In order to provide further insights into the conflicting reports of associations between diabetes and uric acid metabolism, we studied 175 adult diabetic patients (56 IDDM, 119 NIDDM) and 114 matched control subjects. Plasma uric acid (PUA) concentrations were not significantly different between diabetic and control subjects, despite increased urinary urate in diabetic patients. There were no significant associations, in diabetic patients, between PUA and (i) type of diabetes, (ii) glycaemic control, (iii) retinopathy and (iv) proteinuria. Plasma urate did not correlate with the KG constant for glucose disposal rate during IVGTT, thus indicating that PUA may not be related to insulin action. In a separate study, PUA rose sharpby, peaking at 30 min, and fell subsequently in both newly diagnosed NIDDM patient ( n = 20) and subjects with impaired glucose tolerance ( n = 15) in response to standard OGTT, in contrast to normal controls ( n = 35) in whom PUA rose gradually to a peak at 120 min. Mean rise in PUA from baseline to peak was significant ( P < 0.05) in the diabetic group only. These differences in PUA response during an OGTT between subjects with abnormal glucose metabolism and normal controls may be a feature in the metabolic evolution of diabetes and need further investigation.