HYPERURICEMIA IN DIABETIC PATIENTS : AN ADDITIONAL RISK FACTOR FOR MICROVASCULAR COMPLICATIONS – A CROSS SECTIONAL OBSERVATIONAL STUDY
DOI:
https://doi.org/10.51168/sjhrafrica.v5i12.1475Keywords:
Serum uric acid, Microvascular complications, Diabetic retinopathy, Diabetic nephropathyAbstract
Introduction
This study aims to evaluate hyperuricemia as an additional risk factor for the development of microvascular complications in diabetic patients.
Methods
This study involved a total of 200 diabetic patients, divided into two groups: 100 patients with microvascular complications and 100 without these complications, based on their clinical history and examinations. Serum uric acid (SU) levels were measured in both groups and compared.
Results
Among the 100 patients with microvascular complications, 48 had hyperuricemia, while 52 showed serum uric acid levels within the normal range. In contrast, of the 100 patients without microvascular complications, only 26 presented with hyperuricemia, yielding a P value of 0.0013, indicating a highly significant result. Among the 38 patients with retinopathy, 20 had hyperuricemia and 18 had serum uric acid levels within the normal range, with a P value of 0.0019. Within the group of 32 patients with neuropathy,10 had hyperuricemia and 22 had serum uric acid levels in the normal range, leading to a P value of 0.181. Finally, among the 48 patients with nephropathy, 32 had hyperuricemia and 16 had serum uric acid levels within the normal range, with a P value of 0.000013.
Conclusion
Serum Uric acid is elevated in microvascular complication as a whole group when compared to those without microvascular complication group and further hyperuricemia is strongly associated with nephropathy and retinopathy but not neuropathy.
Recommendation
Correcting hyperuricemia in diabetic patients is vital to overcoming microvascular complications and fostering a path toward improved health and vitality.
References
J. Maiuolo, F. Oppedisano, S. Gratteri, C. Muscoli, V. Mollace. Regulation of uric acid metabolism and excretion. Int J Cardiol, 213 (2015), pp. 8-14. Doi:10.1016/j.ijcard.2015.08.109.
Xin Li, Bo Huang, Yue Liu, Meng Wang, Jing-Qiu Cui. Uric acid in diabetic microvascular complications: Mechanisms and therapy, Journal of Diabetes and its Complications, Volume 39, Issue 2, 2025,108929,ISSN 1056-8727. https://doi.org/10.1016/j.jdiacomp.2024.108929.
R. El Ridi, H. Tallima. Physiological functions and pathogenic potential of uric acid: a review. J Adv Res, 8 (2017), pp. 487-493. https://doi.org/10.1016/j.jare.2017.03.003
“About diabetes”. World Health Organization. 2024. https://www.who.int/news-room/fact-sheets/detail/diabetes#:~:text=Diabetes%20is%20a%20chronic%20disease,of%20cardiovascular%20deaths%20(1).
Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2021. Results. Institute for Health Metrics and Evaluation. 2024 https://vizhub.healthdata.org/gbd-results/
Results from the International Diabetes Federation Diabetes Atlas, 9 (th) edition. Diabetes Res Clin Pract. 2019;157:107843. 10.1016/j.diabres.2019.107843. Doi: 10.1016/j.diabres.2019.107843. Epub 2019 Sep 10. PMID: 31518657.
Michael Brownlee, Lloyd Paul Aiello, Jennifer K. Sun, Paolo Sandico Silva, Peter Rossing, Eva L. Feldman, Naveed Sattar and Andrew JM Boulton. Williams Textbook of Endocrinology, 38, page 1466-1575.e29
“Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications” Harrisons Principal Of Internal Medicine 20th edition Page no 2850-2882.
Xu Y, Zhu J, Gao L, Liu Y, Shen J, Shen C, et al. (2013) Hyperuricemia as an Independent Predictor of Vascular Complications and Mortality in Type 2 Diabetes Patients: A Meta-Analysis. PLoS ONE 8(10): e78206. Doi:10.1371/journal.pone.0078206
Agrawal P, Sethi S, Reddy VS, Lamba S. Serum uric acid and lipid profile in diabetic retinopathy in rural Haryana, India. Int J Adv Med 2016;3:309-12. DOI: http://dx.doi.org/10.18203/2349-3933.ijam20161081
Navin S, Krishnamurthy N, Ashakiran S, Dayanand CD. The association of hypomagnesaemia, high normal uricaemia and dyslipidaemia in the patients with diabetic retinopathy. J Clin Diagn Res. 2013;7(9):1852-4.
Liang CC, Lin PC, Lee MY, Chen SC, Shin SJ, Hsiao PJ, Lin KD, Hsu WH. Association of Serum Uric Acid Concentration with Diabetic Retinopathy and Albuminuria in Taiwanese Patients with Type 2 Diabetes Mellitus. Int J Mol Sci. 2016 Aug 2;17(8):1248. Doi: 10.3390/ijms17081248. PMID: 27490538; PMCID: PMC5000646.
Kiani J, Habibi Z, Tajziehchi A, Moghimbeigi A, Dehghan A, Azizkhani H. Association between serum uric acid level and diabetic peripheral neuropathy (A case control study). Caspian J Intern Med. 2014 Winter;5(1):17-21. PMID: 24490008; PMCID: PMC3894465.
Fayazi, H.S., Yaseri, M., Mortazavi, S.S. et al. The relation between serum uric acid levels and diabetic peripheral neuropathy in type 2 diabetes in Guilan, north of Iran. BMC Endocr Disord 22, 39 (2022). https://doi.org/10.1186/s12902-022-00952-5
Zhuang, Y., Huang, H., Hu, X. et al. Serum uric acid and diabetic peripheral neuropathy: a double-edged sword. Acta Neurol Belg 123, 857–863 (2023). https://doi.org/10.1007/s13760-022-01978-1
Nazir Shah, Amanullah, Sheraz Jamal and Mumtaz Ali Marwat. Association Of Hyperuricemia With Diabetic Nephropathy Intype 2 Diabetes Mellitus. Khyber Journal of Medical Sciences.
Behradmanesh S, Horestani MK, Baradaran A, Nasri H. Association of serum uric acid with proteinuria in type 2 diabetic patients. J Res Med Sci. 2013 Jan;18(1):44-6. PMID: 23900353; PMCID: PMC3719225.
Su-Mi Kim; Young-Wook Choi; Hwa-Young Seok; Kyung-Hwan Jeong; Sang-Ho Lee; Tae-Won Lee; Chun-Gyoo Ihm; Sung Jig Lim; Ju-Young Moon. Nephron Experimental Nephrology (2012) 121 (3-4): e109–e121. https://doi.org/10.1159/000343567
Wu, H., Li, X., Zhang, W. et al. Causality between serum uric acid and diabetic microvascular complications – a mendelian randomization study. Diabetol Metab Syndr 16, 134 (2024). https://doi.org/10.1186/s13098-024-01377-x
Mauer M, Doria A. Uric Acid and Diabetic Nephropathy Risk. Contrib Nephrol. 2018;192:103-109. doi:10.1159/000484284
Qing Xiong, Jie Liu, Yancheng Xu, “Effects of Uric Acid on Diabetes Mellitus and Its Chronic Complications”, International Journal of Endocrinology, vol. 2019, Article ID 9691345, 8 pages, 2019
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Copyright (c) 2024 Binay Kumar Mahto , Aditya Prakash , Sanjay Kumar , Rashmi Kumari , Sujit Kumar , Shreya , Hotam Singh Kushwah , Ashish Kumar , Akshay Shamrao Tumram , Shashank Shekhar
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