The study of the correlation between serum uric acid and insulin resistance in middle-aged and elderly hospitalized patients with type 2 diabetes

Abstract

Objective To study the relationship between serum uric acid and insulin resistance in type 2 diabetic patients Methods A total of 728 middle-aged and elderly type 2 diabetic patients were recruited and the anthropometric, clinical and biochemical parameters and fasting serum C-peptide were measured and retrospectively studied.All patients were divided into groups based on the levels of uric acid and on metabolic syndrome diagnosis or not. Results Among a total of 728 patients, the proportion of hyperuricemia was 26.9%(196 /728), and metabolic syndrome(MS)was 64.6%.The levels of body mass index(BMI), waist circumference(WC), systolic pressure(SBP), diastolic pressure(DBP), triglyceride(TG), fasting C-peptide, HOMA(C-Peptide)were significantly higher in hyperuricemia group than in normal uric acid group, while the level of HDL was lower in hyperuricemia group than in normal uric acid group.The proportion of MS was statistically higher in hyperuricemia group(81.6%)than in normal uric acid group(58.3%, P<0.05). Groups Ⅰ, Ⅱ, Ⅲ, Ⅳ-the four quartiles of serum uric acid from low-to high-level were correlated with MS component number of 2.1±1.0, 3.1±1.1, 3.3±1.2, 3.7±0.8, separately, and with HOMA(CP)of 3.7±0.8, 3.7±0.8, 4.0±0.6, 4.1±0.9, separately(all P<0.05). When all patients were divided into groups based on with or without MS, the level of uric acid in MS group was(377.3±43.5)μmol/L, and the proportion of hyperuricemia was 34.0%(160/470), and HOMA(CP)was 3.90±0.72, all were significantly higher than those of non-MS group[(318.2±47.9)μmol/L, 14.0%(36/258), 3.64±0.67]. The levels of serum uric acid in groups with 1-5 components of MS were(285.0±62.8)μmol/L, (335.7±62.7)μmol/L, (367.1±45.0)μmol/L, (377.9±40.2)μmol/L, (389.8±46.6)μmol/L, and HOMA(CP)was 3.6±0.6, 3.7±0.7, 3.9±0.8, 3.9±0.7, 4.3±0.7 separately(P<0.05). Serum uric acid was positively correlated with age, WC, BMI, TG, SBP, fasting C-peptide, and HOMA(CP), while negatively correlated with glycosylated hemoglobin(HbA1C), high density lipoprotein cholesterol(HDL-C). Binary logistic regression showed that the OR value of MS was 1.033 with the increase of serum uric acid, and 95%CI: 1.026-1.041, P<0.05. Conclusions Serum uric acid is correlated with insulin resistance in middle-aged and elderly hospitalized patients with type 2 diabetes.Hyperuricemia might be a new risk factor for MS. Key words: Diabetes, type 2; Hyperuricemia; Metabolic syndrome X