ironjustice

Serum uric acid level and its association with metabolic syndrome and
carotid atherosclerosis in patients with type 2 diabetes;
Li Q, Yang Z, Lu B, Wen J, Ye Z, Chen L, He M, Tao X, Zhang W, Huang
Y, Zhang Z, Qu S, Hu R;
Cardiovascular Diabetology 10 (1), 72 (Aug 2011)

ABSTRACT:
OBJECTIVE:
We aimed to investigate whether elevated serum uric acid
concentrations are associated with higher risk of metabolic syndrome
(MetS) and carotid atherosclerosis in patients with type 2 diabetes.
METHODS:
We conducted a population-based cross-sectional survey in Shanghai,
with a total of 395 men and 631 women age 41 to 92 years.
The carotid artery intima-media thickness (IMT) and carotid
atherosclerotic plaques (PLQ) were measured by B-mode ultrasound. MetS
was defined according to the updated National Cholesterol Education
Program Adult Treatment Panel III criteria for Asian Americans.
RESULTS:
Uric acid levels were negatively associated with duration of diabetes,
fasting plasma glucose, glycohemoglobin, eGFR, HDL-cholesterol (all
P<0.001) and positively with BMI, CRP, waist cir***ference,
triglycerides, systolic blood pressure, ACR, HOMA-IR and IMT (all
P<0.05).
In the highest quartile of uric acid levels, the risks were
substantially higher for MetS [odds ratio 3.97, (95% confidence
interval 2.58-6.13)] (p<0.001 for trend) and PLQ [odds ratio 2.71 (95%
confidence interval 1.62-4.47)] (p=0.013 for trend) compared with that
in the lowest quartile of uric acid levels after multiple adjustment.
These associations remained significant after further adjustment for
potential confounders.
CONCLUSIONS:
Serum uric acid level is associated with MetS and is an independent
risk factor for carotid atherosclerosis in patients with type 2
diabetes.

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The NIH is presently recruiting for a clinical trial of iron depletion
for diabetes and diabetes TOO has a high uric acid level.


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Risk of Developing Diabetes Increases With Rising Serum Uric Acid
Levels


NEW YORK (Reuters Health) Feb 26 - Serum uric acid is a strong and
independent risk factor for diabetes, according to findings published
in the February issue of Diabetes Care.


"Serum uric acid is positively associated with serum glucose in
healthy subjects," Dr. Jacqueline C. M. Witteman and colleagues from
Erasmus Medical Center, Rotterdam, the Netherlands, write. "However,
this association is not consistent between healthy and diabetic
individuals, as a low serum level of uric acid is reported in the
hyperglycemic state," they note. "Since most individuals experience a
phase of impaired glucose tolerance before progression to diabetes,
it
is not clear whether raised serum uric acid predicts the risk of type
2 diabetes."


To investigate, the researchers used data from the Rotterdam Study, a
large population-based, prospective cohort study among subjects aged
55 years and older. Included in the study were 4536 subjects free
from
diabetes at baseline.


The mean serum uric acid level measured at baseline was 323.7
micromol/ L (range, 107 to 756 micromol/L).
Among the participants, 462 developed diabetes during a
mean follow-up of 10.1 years.


The age- and ***-adjusted hazard ratios for diabetes were 1.30, 1.63,
and 2.83 for the second, third, and fourth quartiles of serum uric
acid, in comparison with the first quartile. On multivariate
****ysis, the corresponding hazard ratios dropped to 1.08, 1.12,
and 1.68, the researchers report.


"Our findings, together with those from previous literature, indicate
that lowering uric acid may be a novel treatment target for
preventing diabetes and justify a prospective clinical trial on the
possible benefits of the measurement and lowering of serum uric
acid on multiple chronic disease end points," Dr. Witteman and
colleagues conclude.


Diabetes Care 2008;31:361-362.


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Diabetes has a 'secondary marker' of increased red blood cell
production which again coincidentally CAUSES high uric acid.


Original Investigations: Pathogenesis and Treatment of Kidney Disease
and Hypertension Hyperuricemia, hypertension, and proteinuria
associated with high-altitude polycythemia*1
J. Ashley Jefferson MD, Elizabeth Escudero MD, Maria-Elena Hurtado
MD, Jackeline Pando Kelly MD, Erik R. Swenson MD, PhD, Mark H.
Wener MD, Michel Burnier MD, Marc Maillard PhD, George F. Schreiner
MD, PhD,
Robert B. Schoene MD, Abdias Hurtado MD and Richard J. Johnson MD
From the Department of Medicine and Laboratory Medicine, University
of Washington Medical Center, Seattle, WA; The Carlos Monge
Cassinelli
Nephrology Center, Hospital Loayza, Division of Nephrology,
University Cayetano Heredia, Lima, Peru; Division of Hypertension and
Vascular
Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne,
Switzerland; Scios Inc, Sunnyvale, CA; and the Department of
Medicine, Baylor College of Medicine, Houston, TX.
Received 12 October 2001. Available online 11 June 2002.


Abstract
Chronic exposure to high altitude is associated with the development
of erythrocytosis, proteinuria, and, in some cases, hyperuricemia. We
examined the relationship between high-altitude polycythemia and
proteinuria and hyperuricemia in Cerro de Pasco, Peru (altitude,
4,300
m). We studied 25 adult men with hematocrits less than 65% and 27
subjects with excessive erythrocytosis (EE; hematocrit > 65%) living
in Cerro de Pasco, Peru and compared them with 28 control subjects
living in Lima, Peru (at sea level) and after 48 hours of exposure to
high altitude. Serum urate levels were significantly elevated in
patients with EE at altitude, and gout occurred in 4 of 27 of these
subjects. Urate level strongly correlated with hematocrit (r = 0.71;
P
< 0.0001). Urate production (24-hour urine urate excretion and urine
urate-creatinine ratio) was increased in this group compared with
those at sea level. Fractional urate excretion was not increased, and
fractional lithium excretion was reduced, in keeping with increased
proximal reabsorption of filtrate. Significantly higher blood
pressures and decreased renin levels in the EE group were in keeping
with increased proximal sodium reabsorption. Serum urate levels
correlated with mean blood pressure (r = 0.50; P < 0.0001).
Significant proteinuria was more prevalent in the EE group despite
normal renal function. Hyperuricemia is common in subjects living at
high altitude and associated with EE, hypertension, and proteinuria.
The increase in uric acid levels appears to be caused by increased
urate generation secondary to systemic hypoxia, although a relative
impairment in renal excretion also may contribute.


*1 Supported in part by an extramural grant from Baxter.


American Journal of Kidney Diseases
Volume 39, Issue 6, June 2002, Pages 1135-1142


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