Hyperuricemia has been associated with hypertension, diabetes mellitus, and metabolic
syndrome. We studied the association between hyperuricemia and glycemic status in a
nonrandomized sample of primary care patients. This was a cross-sectional study of
adults ≥20 years old who were members of a community-based health care program.
Hyperuricemia was defined as a value >7.0 mg/dL for men and >6.0 mg/dL for
women. The sample comprised 720 participants including controls (n=257) and patients
who were hypertensive and euglycemic (n=118), prediabetic (n=222), or diabetic
(n=123). The mean age was 42.4±12.5 years, 45% were male, and 30% were white. The
prevalence of hyperuricemia increased from controls (3.9%) to euglycemic hypertension
(7.6%) and prediabetic state (14.0%), with values in prediabetic patients being
statistically different from controls. Overall, diabetic patients had an 11.4%
prevalence of hyperuricemia, which was also statistically different from controls. Of
note, diabetic subjects with glycosuria, who represented 24% of the diabetic
participants, had a null prevalence of hyperuricemia, and statistically higher values
for fractional excretion of uric acid, Na excretion index, and prevalence of
microalbuminuria than those without glycosuria. Participants who were prediabetic or
diabetic but without glycosuria had a similarly elevated prevalence of hyperuricemia.
In contrast, diabetic patients with glycosuria had a null prevalence of hyperuricemia
and excreted more uric acid and Na than diabetic subjects without glycosuria. The
findings can be explained by enhanced proximal tubule reabsorption early in the
course of dysglycemia that decreases with the ensuing glycosuria at the late stage of
the disorder.
Prehypertension in Brazil is associated with well-recognized cardiovascular risk factors even in a continuously monitored population such the one under study. Prehypertension can be a valuable clue to alert health professionals to treat underlying perturbations to prevent overt cardiovascular disease.
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