#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Hyperuricemia and diabetes mellitus


Authors: Peter Jackuliak;  Juraj Payer
Authors‘ workplace: V. interná klinika LF UK a UNB, Nemocnica Ružinov, Bratislava
Published in: Forum Diab 2019; 8(1): 15-20
Category: Review Article

Overview

Hyperuricemia, an abnormally high level of uric acid, often occurs in patients with type 2 diabetes mellitus (T2DM). Based on various studies, there is an evidence of association between elevated uric acid levels and an increased risk of T2DM development, even in younger patients. Hyperuricemia also occurs often in patients with metabolic syndrome. Examination of uric acid levels is particularly important in terms of assessing the cardiovascular risk of diabetic patients. It has been shown, that higher levels of uric acid are associated with increased cardiovascular mortality, worsening prognosis of diabetic complications. Generally serum level of uric acid > 8 mg/dl (> 480 μmol/l) is considered to be a value for initiating risk assessment in patients with asymptomatic hyperuricemia, including diet, change of lifestyle, and/or pharmacotherapy. Xanthine oxidase inhibitors are used in pharmacotherapy of hyperuricemia. From antidiabetic drugs, the newest group – SGLT-2 inhibitors – have proven effect for lowering of uric acid levels.

Keywords:

acid uric – insulin resistance


Sources
  1. Karns R, Succop P, Zhang G et al. Modeling metabolic syndrome through structural equations of metabolic traits, comorbid diseases, and GWAS variants. Obesity (Silver Spring) 2013; 21(12): E745–754. Dostupné z DOI: <http://dx.doi.org/10.1002/oby.20445>.
  2. Niskanen L, Laaksonen DE, Lindström J et al. Serum Uric Acid as a Harbinger of Metabolic Outcome in Subjects With Impaired Glucose Tolerance: the Finnish Diabetes Prevention Study. Diabetes Care 2006; 29(3): 709–711.
  3. Kramer CK, von Muhlen D, Jassal SK et al. Serum uric acid levels improve prediction of incident type 2 diabetes in individuals with impaired fasting glucose: the Rancho Bernardo Study. Diabetes Care 2009; 32(7): 1272–1273. Dostupné z DOI: <http://dx.doi.org/10.2337/dc09–0275>.
  4. Dehghan A, van Hoek M, Sijbrands EJ et al. High serum uric acid as a novel risk factor for type 2 diabetes. Diabetes Care 2008; 31(2): 361–362. Dostupné z DOI: <http://dx.doi.org/10.2337/dc07–1276>.
  5. Bhole V, Choi JW, Kim SW et al. Serum uric acid levels and the risk of type 2 diabetes: a prospective study. Am J Med 2010; 123(10): 957–961. Dostupné z DOI: <http://dx.doi.org/10.1016/j.amjmed.2010.03.027>.
  6. Krishnan E, Akhras KS, Sharma H, Marynchenko M, Wu EQ, Tawk R, et al. Relative and attributable diabetes risk associated with hyperuricemia in US veterans with gout. QJM 2013; 106(8): 721–729. Dostupné z DOI: <http://dx.doi.org/10.1093/qjmed/hct093>.
  7. Choi HK, Ford ES. Prevalence of the metabolic syndrome in individuals with hyperuricemia. Am J Med 2007; 120(5): 442–447. Dostupné z DOI: <http://dx.doi.org/10.1016/j.amjmed.2006.06.040>.
  8. Grundy SM, Cleeman JI, Daniels SR et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112(17): 2735–2752. Dostupné z DOI: <http://dx.doi.org/10.1161/CIRCULATIONAHA.105.169404>. Erratum in Circulation 2005; 112(17): e298. Circulation 2005; 112(17): e297
  9. Alberti KG, Zimmet P, Shaw J. The metabolic syndrome – a new worldwide definition. Lancet 2005; 366(9491): 1059–1062. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(05)67402–8>.
  10. Alberti KG, Eckel RH, Grundy SM et al. Harmonizing the Metabolic Syndrome. A Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009; 120(16): 1640–1645. Dostupné z DOI: <http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192644>.
  11. Cohen E, Krause I, Fraser A et al. Hyperuricemia and metabolic syndrome: lessons from a large cohort from Israel. Isr Med Assoc J 2012; 14(11): 676–680.
  12. Bray GA, Nielsen SJ, Popkin BM. Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity. Am J Clin Nutr 2004; 79(4): 537–43. Dostupné z DOI: <http://dx.doi.org/10.1093/ajcn/79.4.537>. Erratum in Am J Clin Nutr 2004; 80(4): 1090.
  13. Nakagawa T, Tuttle KR, Short RA et al. Hypothesis: fructose-induced hyperuricemia as a causal mechanism for the epidemic of the metabolic syndrome. Nat Clin Pract Nephrol 2005; 1(2): 80–86. Dostupné z DOI: <http://dx.doi.org/10.1038/ncpneph0019>.
  14. Emmerson BT. The management of gout. N Engl J Med 1996; 334(7): 445–451. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJM199602153340707>.
  15. Johnson RJ, Andrews P, Benner SA et al. Theodore E. Woodward award. The evolution of obesity: insights from the mid-Miocene. Trans Am Clin Climatol Assoc 2010; 121: 295–305; discussion 305–308. Erratum in Trans Am Clin Climatol Assoc 2013; 124: 294.
  16. Messerli FH, Frohlich ED, Dreslinski GR et al. Serum uric acid in essential hypertension: an indicator of renal vascular involvement. Ann Intern Med 1980; 93(6): 817–821.
  17. Quinones Galvan A, Natali A, Baldi S et al. Effect of insulin on uric acid excretion in humans. American J Physiol 1995; 268(1 Pt 1) :E1–5. Dostupné z DOI: <http://dx.doi.org/10.1152/ajpendo.1995.268.1.E1>.
  18. Johnson RJ, Perez-Pozo SE, Sautin YY, Manitius J, Sanchez-Lozada LG, Feig DI, et al. Hypothesis: could excessive fructose intake and uric acid cause type 2 diabetes? Endocr Rev 2009; 30(1): 96–116.
  19. Lenfant C, Chobanian AV, Jones DW et al. Seventh report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7): resetting the hypertension sails. Hypertension 2003; 41(6): 1178–1179. Dostupné z DOI: <http://dx.doi.org/10.1161/01.HYP.0000075790.33892.AE>.
  20. Ames BN, Cathcart R, Schwiers E et al. Uric acid provides an antioxidant defense in humans against oxidant- and radical-caused aging and cancer: a hypothesis. Proc Natl Acad Sci USA 1981; 78(11) :6858–68662.
  21. Facchini F, Chen YD, Hollenbeck CB et al. Relationship between resistance to insulin-mediated glucose uptake, urinary uric acid clearance, and plasma uric acid concentration. Jama 1991; 266(21): 3008–3011.
  22. Sautin YY, Johnson RJ. Uric acid: the oxidant-antioxidant paradox. Nucleosides Nucleotides Nucleic Acids 2008; 27(6): 608–619. Dostupné z DOI: <http://dx.doi.org/10.1080/15257770802138558>.
  23. Furukawa S, Fujita T, Shimabukuro M et al. Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Invest 2004; 114(12): 1752–1761.
  24. Berg AH, Scherer PE. Adipose tissue, inflammation, and cardiovascular disease. Circ Res 2005; 96(9): 939–949.
  25. Gil-Campos M, Aguilera CM, Canete R et al. Uric acid is associated with features of insulin resistance syndrome in obese children at prepubertal stage. Nutr Hosp 2009; 24(5): 607–613.
  26. Hallfrisch J. Metabolic effects of dietary fructose. FASEB J 1990; 4(9): 2652–2660.
  27. Smith CM, Rovamo LM, Raivio KO. Fructose-induced adenine nucleotide catabolism in isolated rat hepatocytes. Can J Biochem 1977; 55(12): 1237–1240.
  28. Khanna D, Fitzgerald JD, Khanna PP et al. 2012 American College of Rheumatology guidelines for management of gout. Part 1: Systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia. Arthritis Care Res (Hoboken) 2012; 64(10): 1431–1446.
  29. Neogi T. Clinical practice. Gout. N Engl J Med 2011; 364(5): 443–452. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMcp1001124>.
  30. Richette P, Doherty M, Pascual E et al. 2016 updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis 2017; 76(1): 29–42. Dostupné z DOI: <http://dx.doi.org/10.1136/annrheumdis-2016–209707>.
  31. Tuomilehto J, Zimmet P, Wolf E, Taylor R, Ram P, King H. Plasma uric acid level and its association with diabetes mellitus and some biologic parameters in a biracial population of Fiji. Am J Epidemiol 1988; 127(2): 321–336.
  32. Zoppini G, Targher G, Negri C, Stoico V, Perrone F, Muggeo M, et al. Elevated serum uric acid concentrations independently predict cardiovascular mortality in type 2 diabetic patients. Diabetes Care 2009; 32(9): 1716–1720. Dostupné z DOI: <http://dx.doi.org/10.2337/dc09–0625>.
  33. Wang P, Li X, He C et al. Hyperuricemia and prognosis of acute ischemic stroke in diabetic patients. Neurol Res 2018: 1–7. Dostupné z DOI: <http://dx.doi.org/10.1080/01616412.2018.1553347/.
  34. Choi HK, Atkinson K, Karlson EW et al. Alcohol intake and risk of incident gout in men: a prospective study. Lancet 2004; 363(9417): 1277–1281. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(04)16000–5>.
  35. Rees F, Jenkins W, Doherty M. Patients with gout adhere to curative treatment if informed appropriately: proof-of-concept observational study. Ann Rheum Dis 2013; 72(6): 826–830. Dostupné z DOI: <http://dx.doi.org/10.1136/annrheumdis-2012–201676>.
  36. Zhang L, Zhang M, Zhang Y, Tong N. Efficacy and safety of dulaglutide in patients with type 2 diabetes: a meta-analysis and systematic review. Sci Rep 2016; 6: 18904. Dostupné z DOI: <http://dx.doi.org/10.1038/srep18904>.
  37. Wei L, Mackenzie IS, Chen Y et al. Impact of allopurinol use on urate concentration and cardiovascular outcome. Br J Clin Pharmacol 2011; 71(4): 600–607. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1365–2125.2010.03887.x>.
  38. Singh JA, Ramachandaran R, Yu S et al. Allopurinol use and the risk of acute cardiovascular events in patients with gout and diabetes. BMC Cardiovasc Disord 2017 Mar; 17(1): 76. Dostupné z DOI: <http://dx.doi.org/10.1186/s12872–017–0513–6>.
  39. Becker MA, MacDonald PA, Hunt BJ et al. Diabetes and gout: efficacy and safety of febuxostat and allopurinol. Diabetes Obes Metab 2013; 15(11): 1049–1055. Dostupné z DOI: <http://dx.doi.org/10.1111/dom.12135>.
  40. Whelton A, MacDonald PA, Chefo S et al. Preservation of renal function during gout treatment with febuxostat: a quantitative study. Postgrad Med 2013; 125(1): 106–114. Dostupné z DOI: <http://dx.doi.org/10.3810/pgm.2013.01.2626>.
  41. Becker MA, Schumacher HR, MacDonald PA et al. Clinical efficacy and safety of successful longterm urate lowering with febuxostat or allopurinol in subjects with gout. J Rheumatol 2009; 36(6): 1273–82. Dostupné z DOI: <http://dx.doi.org/10.3899/jrheum.080814>.
  42. Schumacher HR Jr, Becker MA, Wortmann RL et al. Effects of febuxostat versus allopurinol and placebo in reducing serum urate in subjects with hyperuricemia and gout: a 28-week, phase III, randomized, double-blind, parallel-group trial. Arthritis Rheum 2008; 59(11): 1540–1548. Dostupné z DOI: <http://dx.doi.org/10.1002/art.24209>.
  43. Becker MA, Schumacher HR, Wortmann RL et al. Febuxostat Compared with Allopurinol in Patients with Hyperuricemia and Gout. N Engl J Med 2005; 353(23): 2450–2461. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa050373>.
  44. Hala A, Sami A. Effects of Sodium Glucose Cotransporter-2 Inhibitors on Serum Uric Acid in Type 2 Diabetes Mellitus. Diabetes Technol Ther 2017; 19(9): 507–512. Dostupné z DOI: <http://dx.doi.org/10.1089/dia.2017.0070>.
  45. Chino Y, Samukawa Y, Sakai S et al. SGLT2 inhibitor lowers serum uric acid through alteration of uric acid transport activity in renal tubule by increased glycosuria. Biopharm Drug Dispos 2014; 35(7): 391–404. Dostupné z DOI: <http://dx.doi.org/10.1002/bdd.1909>.
  46. Zhao Y, Xu L, Tian D et al. Effects of sodium-glucose co-transporter 2 (SGLT2) inhibitors on serum uric acid level: A meta-analysis of randomized controlled trials. Diabetes Obes Metab 2018; 20(2): 458–462. Dostupné z DOI: <http://dx.doi.org/10.1111/dom.13101>.
  47. Davies MJ, Trujillo A, Vijapurkar U et al. Effect of canagliflozin on serum uric acid in patients with type 2 diabetes mellitus. Diabetes Obes Metab 2015; 17(4): 426–429. Dostupné z DOI: <http://dx.doi.org/10.1111/dom.12439>. Erratum in Erratum. [Diabetes Obes Metab. 2015].
  48. Hao Z, Huang X, Shao H et al. Effects of dapagliflozin on serum uric acid levels in hospitalized type 2 diabetic patients with inadequate glycemic control: a randomized controlled trial. Ther Clin Risk Manag 2018; 14: 2407–2413. Dostupné z DOI: <http://dx.doi.org/10.2147/TCRM.S186347>.
  49. Shubrook JH, Bokaie BB, Adkins SE. Empagliflozin in the treatment of type 2 diabetes: evidence to date. Drug Des Devel Ther 2015; 9: 5793–5803. Dostupné z DOI: <http://dx.doi.org/10.2147/DDDT.S69926>.
  50. Katsiki N, Papanas N, Fonseca VA et al. Uric acid and diabetes: Is there a link? Curr Pharm Des 2013; 19(27): 4930–4937.
Labels
Diabetology Endocrinology Internal medicine
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#