Abstract
Context Hyperuricemia has been considered to increase the risk of stroke, cardiovascular disease and all-cause mortality in type 2 diabetic patients. However, in assessing clinical and pathophysiological development of hyperuricemia, the critical role of the sex steroids axis is underappreciated, particularly concerning the sex specific relations. Objective We aimed to investigate the association between sex hormones and uric acid (UA) concerning the sex specific relations in diabetic adults. Methods 4,460 diabetic participants were enrolled from seven communities in Huangpu and Pudong District, Shanghai, China in 2018 based on METAL study. Participants underwent several checkups, which included the measurement of anthropometric parameters, blood pressure, glucose, lipid profiles, UA and sex hormones including total testosterone (TT), estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH) and dehydroepiandrosterone (DHEA). Results In men, TT and FSH were negatively associated with UA but DHEA was positively associated with UA. E2 and LH were not associated with UA significantly. In postmenopausal women, T, LH and DHEA were all positively associated with UA. E2 and FSH were not significantly associated with UA. These associations were all adjusted for drinking status, smoking status, duration of diabetes, hypertension, dyslipidemia, BMI, HbA1C, HOMA-IR, GFR, aspirin taking and ARBs taking. Conclusions The gender differences were found in the association between sex hormones and UA in diabetic adults. Testosterone might be a biomarker of hyperuricemia in patients with T2DM and the level of UA is suggested to be monitored to prevent hyperuricemia when sex hormone treatment, especially DHEA, is administered.
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