Abstract
Hyperuricemia has been associated with hypertension, diabetes mellitus, and metabolic syndrome. We studied the association between hyperuricemia and glycemic status in a nonrandomized sample of primary care patients. This was a cross-sectional study of adults ≥20 years old who were members of a community-based health care program. Hyperuricemia was defined as a value >7.0 mg/dL for men and >6.0 mg/dL for women. The sample comprised 720 participants including controls (n=257) and patients who were hypertensive and euglycemic (n=118), prediabetic (n=222), or diabetic (n=123). The mean age was 42.4±12.5 years, 45% were male, and 30% were white. The prevalence of hyperuricemia increased from controls (3.9%) to euglycemic hypertension (7.6%) and prediabetic state (14.0%), with values in prediabetic patients being statistically different from controls. Overall, diabetic patients had an 11.4% prevalence of hyperuricemia, which was also statistically different from controls. Of note, diabetic subjects with glycosuria, who represented 24% of the diabetic participants, had a null prevalence of hyperuricemia, and statistically higher values for fractional excretion of uric acid, Na excretion index, and prevalence of microalbuminuria than those without glycosuria. Participants who were prediabetic or diabetic but without glycosuria had a similarly elevated prevalence of hyperuricemia. In contrast, diabetic patients with glycosuria had a null prevalence of hyperuricemia and excreted more uric acid and Na than diabetic subjects without glycosuria. The findings can be explained by enhanced proximal tubule reabsorption early in the course of dysglycemia that decreases with the ensuing glycosuria at the late stage of the disorder.
Highlights
Elevated serum uric acid is an independent predictor of vascular complications and mortality in type 2 diabetes mellitus patients [1] and is associated with excess risk for development of diabetes [2,3].The association between hyperuricemia and cardiovascular disease has been observed since the nineteenth century [4]
We evaluated the association between uric acid and glycemic status in a nonrandomized sample of members of a community-based health care program
Some studies have suggested that diabetics, especially those recently diagnosed, tend to have lower serum uric acid than prediabetic and normoglycemic patients [12,13]
Summary
Elevated serum uric acid is an independent predictor of vascular complications and mortality in type 2 diabetes mellitus patients [1] and is associated with excess risk for development of diabetes [2,3].The association between hyperuricemia and cardiovascular disease has been observed since the nineteenth century [4]. Several studies have reported hyperuricemia as a risk factor for development of diabetes mellitus, especially in the context of insulin resistance, others have suggested that patients with recently diagnosed diabetes tend to have lower serum uric acid than prediabetic or normoglycemic ones [12,13]. Based on this information, we evaluated the association between uric acid and glycemic status in a nonrandomized sample of members of a community-based health care program
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