Study of serum uric acid levels in type 2 diabetes mellitus in tertiary care hospital in south Gujarat
Keywords:Serum uric acid, Diabetes mellitus, HBA1c
Background: The need for early indicators of diabetic complications is essential to prevent late complications and their deleterious effects. There is a need for sensitive serum markers that are associated with diabetes and its complications. Estimation of these parameters helps in early intervention, thereby delaying the chronic complications of diabetes in the early stages. Hyperuricemia has been shown to be linked to a number of diseases and conditions including gout, hypertension, cardiovascular disease, myocardial infarction, stroke and renal disease. Uric acid has long been associated with delayed complications of diabetes mellitus. This study was conducted on 357 patients of diabetes mellitus to investigate the significance of serum uric acid levels and its correlation with it.
Methods: This is an observational cross-sectional study carried out amongst 357 patients with T2DM attending out-patient department as well as indoor patients under medicine department at Surat Municipal Institute of Medical Education and Research (SMIMER) Hospital, of south Gujarat.
Results: There is highly significant association seen between HbA1c (glycated hemoglobin) and uric acid levels in present study (p<0.001). There is significant association seen between fasting blood sugar (FBS) levels and uric acid levels in the study (p=0.0253).
Conclusions: There is increase in uric acid levels in diabetic patients with increased levels of HbA1c. Thus, serum uric acid may serve as a potential biomarker of the deterioration of glucose metabolism.
Leslie RD, Palmer J, Schloot NC, Lernmark A. Diabetes at the crossroads: relevance of disease classification to pathophysiology and treatment. Diabetologia. 2016;59:13-20.
Johnson RJ, Kang DH, Feig D. Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension. 2003;41(6):1183-90.
Kang DH, Park SK, Lee IK, Johnson RJ. Uric acid-induced C-reactive protein expression: implication on cell proliferation and nitric oxide production of human vascular cells. Journal of the American Society of Nephrology. 2005;16(12):3553-62.
Maahs DM, Caramori L, Cherney DZI. Uric acid lowering to prevent kidney function loss in diabetes: the preventing early renal function loss (PERL) allopurinol study. Current Diabetes Reports. 2013;13(4):550-9.
Yu MA, Sanchez-Lozada LG, Johnson RJ. Oxidative stress with an activation of the renin-angiotensin system in human vascular endothelial cells as a novel mechanism of uric acid-induced endothelial dysfunction. Journal of Hypertension. 2010;28(6):1234-42.
Matsuoka T, Kajimoto Y, Watada H. Glycation-dependent, reactive oxygen species-mediated suppression of the insulin gene promoter activity in HIT cells. Journal of Clinical Investigation. 1997;99(1):144-50.
Hsueh WA, Lyon C.J, Quiñones MJ. Insulin resistance and the endothelium. The American Journal of Medicine. 2004;117(2):109-17.
Zoccali C, Maio R, Mallamaci F, Sesti G, Perticone F. Uric acid and endothelial dysfunction in essential hypertension. Journal of the American Society of Nephrology. 2006;17(5):1466-71.
Johnson RJ, Nakagawa T, Sanchez-Lozada LG. Sugar, uric acid, and the etiology of diabetes and obesity. Diabetes. 2013;62(10):3307-15.
Erdogan D, Gullu H, Caliskan M. Relationship of serum uric acid to measures of endothelial function and atherosclerosis in healthy adults. International Journal of Clinical Practice. 2005;59(11):1276-82.
Tassone EJ, Cimellaro A, Perticone M. Uric acid impairs insulin signaling by promoting Enpp1 binding to insulin receptor in human umbilical vein endothelial cells. Frontiers in Endocrinology. 2018;9(98).
Perticone F, Maio R, Sciacqua A. Endothelial dysfunction and C-reactive protein are risk factors for diabetes in essential hypertension. Diabetes. 2008;57(1):167-71.
Baldwin W, McRae S, Marek G. Hyperuricemia as a mediator of the proinflammatory endocrine imbalance in the adipose tissue in a murine model of the metabolic syndrome. Diabetes. 2011;60(4):1258-69.
Spiga R, Marini MA, Mancuso E. Uric acid is associated with inflammatory biomarkers and induces inflammation via activating the NF-κB signaling pathway in HepG2 cells. Arteriosclerosis, Thrombosis, and Vascular Biology. 2017;37(6):1241-9.
Rao S, Sahayo BJ. A study of serum uric acid in diabetes mellitus and prediabetes in a south Indian tertiary care hospital. Journal of Health and Allied Sciences NU. 2012;2(02):18-23.
Talwar T, Tanwar L, Gupta M, Singal KK. Study of serum uric acid level in type 2 diabetes mellitus patients. Journal of Dental and Medical Sciences. 2017;16(10):83-9.
Shirsath A, Patil VC, Mane M, Patil S. A Study of Serum Uric Acid Levels in Type 2 Diabetes Mellitus Subjects: A Cross Sectional Study. International Journal of Contemporary Medical Research. 2019;6(1):A21-4.
Sidhu GK, Oza R, Khubchandani AS, Prajapati B. Assessment of serum uric acid levels in Type 2 diabetes mellitus patients. Int J Med Sci Public Health. 2017;6.
Grover A, Mowar AB, Johri S. Prevalence of hyperuricemia in newly diagnosed type 2 diabetes mellitus patients. Int J Adv Med. 2019;6:276-8.
Datta D, Giri VP. A retrospective study on prevalence of hyperuricemia in patients with hypertension and type 2 diabetes mellitus from a teaching hospital of west Uttar Pradesh, India. Int J Basic Clin Pharmacol. 2019;8:206-10.
Marwah SA, Mehta MD, Pandya AK. A study of the correlation between altered blood glucose and serum uric acid levels in diabetic patients. J. Evid. Based Med. Healthc. 2020;7(27):1261-4.
Oshin M, Mohanan J, Kumar MK, Kannan R, Shankar G, Damodharan J, et al. A study of clinical profile and complications in patients with type 2 diabetes mellitus in a tertiary care centre. Int J Adv Med. 2019;6:279-83.
Barma PD, Ranabir S, Prasad L, Singh TP. Clinical and biochemical profile of lean type 2 diabetes mellitus. Indian journal of endocrinology and metabolism. 2011;15(1):S40.