Serum uric acid levels are associated with obesity but not cardio-cerebrovascular events in Chinese inpatients with type 2 diabetes

Ming-Yun Chen,Ting-Ting Li,Lian-Xi Li,Cui-Chun Zhao,Yue Zhu,Wei-Ping Jia,Yu-Qian Bao,Tian-Pei Yu

doi:10.1038/srep40009

Abstract

We aim to explore the associations between serum uric acid (SUA) and obesity and cardio-cerebrovascular events (CCEs) in Chinese inpatients with type 2 diabetes mellitus (T2DM). 2 962 inpatients with T2DM were stratified into quartile based on SUA concentrations. There were significant increases in the prevalence of both obesity (32.6%, 41.9%, 50.1%, and 62.8%, respectively, p < 0.001 for trend) and severe obesity (0.4%, 0.6%, 0.8%, and 1.3%, respectively, p < 0.001 for trend) across the SUA quartiles. A fully adjusted multiple logistic regression analysis revealed that SUA quartiles were independently associated with the presence of obesity (p < 0.001). The prevalence of CCEs was significantly higher in the obese diabetics than in the nonobese diabetics (16.8% vs. 13.2%, p = 0.027). After controlling for multiple confounding factors, BMI levels were also significantly correlated with the presence of CCEs (p = 0.020). However, there was no significant association of SUA quartiles/SUA levels with the presence of CCEs in T2DM. This study suggested that SUA levels were independently associated with obesity but not with CCEs in patients with T2DM. In selected populations such as subjects with T2DM, the role of uric acid in cardiovascular complications might be attributable to other cardiovascular risk factors, such as obesity.

Highlights

In recent decades, the epidemic of hyperuricemia, obesity, cardiovascular and cerebrovascular diseases, which have cast heavy health and economic burden to the world[1,2], have attained increasing recognition
All patients were interviewed to obtain their history of hypertension (HTN), cardio-cerebrovascular events (CCEs), medicine use including metformin, lipid-lowering drugs (LLDs), antihypertensive agents (AHAs) and insulin or insulin analogues (IIAs), alcohol consumption and smoking habits
After adjustment for age and sex, prevalence of HTN, rate of use of metformin and IIAs and LLD and AHAs, SBP, DBP, Body mass index (BMI), waist-to-hip ratio (WHR), FCP, 2 h PCP, total triglycerides (TTG), total cholesterol (TC), ALT, Cr and 24 h urinary albumin excretion (UAE) progressively increased across the serum uric acid (SUA) quartiles

Summary

Introduction

The epidemic of hyperuricemia, obesity, cardiovascular and cerebrovascular diseases, which have cast heavy health and economic burden to the world[1,2], have attained increasing recognition. Substantial uncertainties on the importance of SUA in the prediction and evaluation of cardio-cerebrovascular risk remain, because uric acid is strongly linked to other cardiovascular risk factors such as obesity, hypertension, diabetes mellitus, and metabolic syndromes, which may contribute to increased cardiovascular risk and mortality. The British Regional Heart Study, a large prospective study including 7 735 men, showed that SUA was positively associated with risk for major coronary heart disease events. A variety of studies have examined the relationship between SUA and cardiovascular risk in different populations, but few studies have focused on the associations between SUA and obesity and cardio-cerebrovascular events (CCEs) in Chinese patients with Type 2 diabetes mellitus (T2DM). The aims of this study were to examine the associations between SUA and obesity and CCEs in hospitalized Chinese patients with type 2 diabetes

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Conclusion