Serum uric acid and its association with hypertension, early nephropathy and chronic kidney disease in type 2 diabetic patients

Abstract

Ácido úrico sérico e sua associação com hipertensão, nefropatia precoce e doença renal crônica em pacientes diabéticos tipo 2 Introdução: A detecção precoce da nefropatia diabética (ND) é importante. O áci-do úrico sérico (AUS) tem um papel ainda desconhecido no desenvolvimento de ND. Objetivo: Estudar a relação entre AUS e hipertensão, nefropatia precoce e progressão da doença renal crônica (DRC) no diabetes mellitus tipo 2 (DM2). Métodos: O estudo contou com 986 participantes, de acordo com a presença e a duração do diabetes, os pacientes foram classificados em três grupos. O Grupo I incluiu 250 participantes saudá-veis. O Grupo II incluiu 352 pacientes com início de diabetes < 5 anos. O Grupo III incluiu 384 pacientes com o aparecimento de diabetes > 5 anos. Todos os participantes foram submetidos a exame clínico completo, medidas antropométricas, exames laboratoriais -incluindo hemoglobina glicosilada (HbA1C), bem como a razão entre triglicé-rides e lipoproteína de alta densidade (TG/ HDL-C), AUS, razão creatinina/albumina (RCA) urinária, e taxa estimada de filtração glomerular (eTFG). Resultados: A razão AUS, PA, HbA1c, TG/HDL-C e RCA foi significativamente maior no grupo III do que no grupo I, II e em II do que I. A eTFG foi significativamente menor no grupo III do que nos grupos I, II e no II do que no I (p < 0,001). Idade, IMC, PA, HbA1c, razão TG/ HDL-C, RCA, foram positivamente correlacionados com AUS, enquanto que a TFG esteve negativamente correlacionada. O AUS a níveis > 6,1 mg/dl, > 6,2 mg/dl e > 6,5 mg/dl apresentou maior sensibilidade e especificidade para identificar hipertensão, nefropatia precoce e declínio da eTFG, respectivamente. Conclusão: Mesmo elevados níveis de AUS, foi associado ao risco de hipertensão, nefropatia precoce e declínio da eTFG. Além disso, o nível de AUS pode identificar o iní-cio da hipertensão, nefropatia precoce e progressão da DRC em DM2. ResumoPalavras-chave: ácido úrico; diabetes mellitus tipo 2; hipertensão; nefropatias diabéticas. Introduction:Early detection diabetic nephropathy (DN) is important. Whether serum uric acid (SUA) has a role in the development of DN is not known. Objective: To study the relationship between SUA and hypertension, early nephropathy and progression of chronic kidney disease (CKD) in type 2 diabetes mellitus (T2DM). Methods: The total number of the study was 986 participants, according to presence and duration of diabetes were classified into three groups. Group I; including 250 healthy participants. Group II; including 352 with onset of diabetes < 5 years. Group III; including 384, with the onset of diabetes > 5 years. All participants were submitted to complete clinical examination, anthropometric measurements, laboratory investigations, including glycosylated hemoglobin (HbA1C), as well triglycerides to high-density lipoprotein ratios (TG/HDL-C), SUA, urinary albumin/creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR). Results: SUA, BP, HbA1c, TG/HDL-C ratio, and ACR levels were significantly higher in group III tha...

Hyperuricemia in Systemic Hypertension and its correlation with systolic and diastolic blood pressure.

“…Frequency of hyperuricemia of 57% of present study is supported by previous studies. 5,6 Mean± SD serum uric acid showed significant difference between control and cases. SUA in controls was 2.91±0.75 compared to 5.70±1.76 mg/ dl (P=0.0001).…”

“…Previous studies [2][3][4][5][6] reported rising prevalence of hyperuricemia in low and middle-income countries populations. Many of previous studies [3][4][5][6][7] had reported correlation of hyperuricemia, systemic hypertension and obesity. Since research is lacking regarding the association of serum uric acid and systemic hypertension in Pakistan, this motivated the researcher to conduct the present study.…”

“…2 Hyperuricemia has been reported as a risk factor for the systemic hypertension. [2][3][4][5] Previous studies 5,6 reported 25-50% of systemic hypertension cases show hyperuricemia. Hyperuricemia is now an established risk factor for the insulin resistance, weight gain and obesity, hyperlipidemia and dyslipidemia, kidney and systemic hypertension.…”

Hyperuricemia as a potential risk factor for type 2 diabetes and diabetic nephropathy

“…In the study by Fouad et al 8 the serum uric acid was higher in subjects with type 2 diabetes, with the highest levels of serum uric acid observed in those with poor glycemic control. One potential explanation provided by the authors was that their subjects already had kidney disease with falling eGFR, for which reason hyperfiltration that is commonly seen early in the course of diabetic kidney disease was not observed.…”

“…In this issue of the Brazilian Journal of Nephrology, Fouad et al 8 performed a case-control study in Egyptian adults with and without type 2 diabetes that were matched for age, sex and body mass index (BMI). The study included 986 participants; 250 non-diabetic controls, 352 with type 2 diabetes for less than 5-years and 384 with type 2 diabetes for more than 5-years.…”