Title: A Cross Sectional Study Showing Association of Serum Uric Acid in Pre-Diabetic and Diabetic Indian Population

Authors: Pushpalata Sachan, Dr R.S. Gangwar, Dr M.L. Patel, Dr M.M.Khan, Dr Indu Pisharody

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i1.128

Abstract

Background: Diabetes is a huge burden worldwide and India is only second to China in prevalence of Diabetes. Recent studies showed that the prevalence of Diabetes and Pre-diabetes (IGT) is rapidly increasing, especially in urban population. Serum uric acid level varies in various stages of glucose homeostasis. The present study is coined to show the association of serum uric acid level with Diabetic and Pre-diabetic stage of glucose homeostasis.

Methods:  This is a cross sectional observational study and enrolled total 79 subjects from medicine OPD during one year duration.  On the basis of American Diabetic Association (ADA) guidelines 2010 among 79 subjects, 16 subjects were assigned as pre-diabetic and 63 as diabetic.  Estimation of   Serum uric acid  was  done by using MERK Kit with the help of semi-automated analyzer. The quantitative parametric datas were analysed by student “t” test whereas non parametric datas by Mann- whitney U test. The categorical datas were analysed by Chi square test.

Results: The Serum uric acid level in diabetic group was 5.79± 1.87 mg/dl (mean± SD) whereas in pre-diabetic group was 10.84± 2.84 mg/dl (mean± SD). So it is significantly lower in diabetics as compared to pre-diabetic. (p<0.001)

Conclusion: The present study suggests that that serum uric acid level is significantly higher in pre-diabetic group and may play a significant role in progression of Diabetes.

Keywords: Diabetes, Pre-diabetes, Serum Uric Acid.

References

  1. Guariguata, D.R. Whiting, I. Hambleton, J. Beagley, U. Linnenkamp, J.E. Shaw. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes research and clinical practice. 2014;103:137- 149.
  2. Anjana, R.M., Pradeepa, R., Deepa, M., Datta, M., Sudha, V. and Unnikrishnan, R. Prevalence of diabetes and Pre-diabetes (impaired fasting glucose and/or impaired glucose tolerance) in urban and rural India: phase I results ICMR-INDIAB study. Diabetologia. 2011; 54:30, 22-7.
  3. Ishizaka N, Ishizaka Y, Toda E, Nagai R, Yamakado M. Association between serum uric acid, metabolic syndrome, and carotid atherosclerosis in Japanese individuals.  Arterioscler Thromb Vasc Biol. 2005; 25: 1038–44.
  4. Shankar, R. Klein, B. E. K. Klein, and F. J. Nieto, “The association between serum uric acid level and long-term incidence of hypertension: population-based cohort study,” Journal of Human Hypertension 2006; 20 : 937–45
  5. Klein, B. E. Klein, J. C. Cornoni, J. Maready, J. C. Cassel, and H. A. Tyroler, “Serum uric acid. Its relationship to coronary heart disease risk factors and cardiovascular disease, Evans County, Georgia,” Archives of Internal Medicine.1973; 132:401–10. 
  6. W. Yoo, K. C. Sung, H. S. Shin et al., “Relationship between serum uric acid concentration and insulin resistance and metabolic syndrome.” Circulation Journal. 2005; 69: 928–33. 
  7. Dehghan, M. Van Hoek, E. J. G. Sijbrands, A. Hofman, and J. C. M. Witteman, “High serum uric acid as a novel risk factor for type 2 diabetes,” Diabetes Care. 2008; 31: 361–2.
  8. L. Chien, M. F. Chen, H. C. Hsu et al., “Plasma uric acid and the risk of type 2 diabetes in a Chinese community,” Clinical Chemistry. 2008; 54: 310–6.
  9. Kodama, K. Saito, Y. Yachi et al., “Association between serum uric acid and development of type 2 diabetes,” Diabetes Care. 2009; 32: 1737–42.
  10. Modan, H. Halkin, A. Karasik, and A. Lusky, “Elevated serum uric acid—a facet of hyperinsulinaemia,” Diabetologia. 1987; 30: 713–8.
  11. Taniguchi, T. Hayashi, K. Tsumura, G. Endo, S. Fujii, and K. Okada, “Serum uric acid and the risk for hypertension and type 2 diabetes in Japanese men: the Osaka health survey,” Journal of Hypertension. 2001; 19: 1209–15.
  12. Oda, R. Kawai, V. Sukumaran, and K. Watanabe, “Uric acid is positively associated with metabolic syndrome but negatively associated with diabetes in Japanese men,” Internal Medicine. 2009; 48: 1785–91.
  13. Nan, Y. Dong, W. Gao, J. Tuomilehto, and Q. Qiao, “Diabetes associated with a low serum uric acid level in a general Chinese population,” Diabetes Research and Clinical Practice. 2007; 76: 68-74.
  14. Modan M, Halkin H, Almog S, Lusky A, Eshkol A, Shefi M, al. Hyperinsulinemia. a link between hypertension, obesity and glucose intolerance. J Clin Invest 1985; 75 : 809-17.
  15. Krishnan E, Pandya B J, Chung L, Hariri A and Dabbous O. Hyperuricemia in young adults and risk of insulin resistance, Pre-diabetes and diabetes: A 15 year follow up study. Am J Epidemiol.2012; 176: 108-16.
  16. Sudhindra RM, Sahayo BJ. A study of serum uric acid in diabetes mellitus and Pre-diabetes in a south Indian Tertiary care hospital. NUJHS. 2012; 2: 18-23.
  17. Feig DI, Mazzali M, Kang DH, Nakagawa T, Price K, Kannelis J, al. Serum uric acid: a risk factor and a target for treatment, J. Am. Soc. Nephrol. 2006; 17 : 69-73.
  18. Gotfredsen A, McNair P, Christiansen C, Transbol I. Renal hypouricaemia in insulin treated diabetes mellitus. Clin Chim Acta 1982; 20: 355-61.
  19. Koenig W, Meisinger C. Uric acid, type 2 diabetes, and cardiovascular diseases: fueling the common soil hypothesis? Clinical Medicine 2008; 54 : 231-3.
  20. Muscelli E, Natali A, Bianchi S, Bigazzi R, Galvan AQ, Sironi AM, al. Effects of insulin on renal sodium and uric acid handling in essential hypertesnio. Am J Hypertens. 1996; 9 : 746-52.
  21. Enomoto A, Kimura H, Chairoungdua A, Shigeta Y, Jutabha P, Ho Cha S, al. Molecular identification of a renal urate anion exchanger that regulates blood urate levels. Nature. 2002; 417: 447-52.
  22. Niskanen L, Laaksonen DE, Lindstrom J, Eriksson JG, Keinanen-Kiukaanniemi S, Ilanne-Parikka P, et al. Serum uric acid as a harbinger of metabolic outcome in subjects with impaired glucose tolerance: the Finnish Diabetes P ± revention Study. Diabetes Care. 2006; 29 : 709-11.

Corresponding Author

Dr M.L.Patel

Associate Professor, Department of Medicine, K.G.M.U., Lucknow, U.P., India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Ph: 917839317837