Effect of insulin on uric acid excretion in humans

Galvan, Aq; Natali, Andrea; Baldi, Simona; Frascerra, Silvia; Sanna, Giovanna; Ciociaro, Demetrio; Ferrannini, Eleuterio

doi:10.1152/ajpendo.1995.268.1.e1

Cited by 274 publications

(216 citation statements)

References 24 publications

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“…5 Previous work in the NAS and by others has found that hyperinsulinemia and elements of the metabolic syndrome are associated with the SUA level. [23][24][25] Insulin is known to decrease the renal excretion of uric acid, 4 and hyperinsulinemia predicts the development of hypertension. 26 We do not have serum insulin levels available at the baseline examination; however, the work of Imazu et al 12 suggests that the relationship between uric acid and the development of hypertension is independent of the insulin level.…”

Section: Discussionmentioning

confidence: 99%

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Uric Acid and the Development of Hypertension

Perlstein

Gumieniak²,

Williams³

et al. 2006

Hypertension

259

105

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Abstract-Experimental evidence supports a causative role for uric acid in the pathogenesis of hypertension. Prospective studies have variably adjusted for relevant confounders and have been of relatively limited duration. We prospectively examined the relationship between uric acid level and the development of hypertension in the Normative Aging Study, a longitudinal cohort of healthy adult men. Key Words: uric acid Ⅲ hypertension Ⅲ renal function Ⅲ prospective studies Ⅲ aging T he association of hyperuricemia with hypertension has long been recognized. 1 It remains unresolved whether the association of hyperuricemia with hypertension is solely because of underlying renal and metabolic abnormalities. Decreased renal blood flow 2 and decreased tubular secretion of uric acid 3 have been associated with hyperuricemia in hypertension. Hyperinsulinemia secondary to insulin resistance may also contribute to the association of hyperuricemia with hypertension. 4,5 Recent observations in experimental hyperuricemia suggest that uric acid may in fact have a pathogenic role in hypertension. 6 Hyperuricemia induces hypertension in experimental animals that corrects with hypouricemic therapy. 7 Elevated serum uric acid level has been associated with increased risk for developing hypertension. 8 -18 The Normative Aging Study (NAS), a longitudinal study of aging begun in 1963 and with ongoing follow-up, presented a unique opportunity to examine the relationship between serum uric acid level and the development of hypertension. The duration of follow-up, Յ40 years, allowed us to assess the durability of the prospective association of uric acid level with hypertension. The comprehensive data collection allowed adjustment for key potential confounding covariates, such as central adiposity, alcohol intake, metabolic parameters, and, in a subset of study subjects, the serum creatinine level. Previous studies have variably accounted for these confounders. Specifically, some did not adjust for blood pressure, 8,9,17,18 Ն2 elements of the metabolic syndrome, 8 -11,13-15 or alcohol intake, 11,12 and only 1 adjusted for renal function. 13 We, therefore, examined the prospective association of serum uric acid level with the development of hypertension among subjects at risk for the development of hypertension within the NAS cohort, including an analysis of those at risk for the development of hypertension at the time of their first serum creatinine determination. We have included in our multivariable model(s) covariates of the metabolic syndrome, alcohol intake, and renal function. MethodsSubjects were participants in the NAS, a longitudinal study of aging established by the Veterans Administration in 1961. 19 The study cohort consists of 2280 community-dwelling men from the greater Boston area who were 21 to 80 years of age on enrollment. Volunteers were screened at entry according to specific health criteria and were free of known chronic medical conditions at the

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Section: Discussionmentioning

confidence: 99%

“…Hyperinsulinemia secondary to insulin resistance may also contribute to the association of hyperuricemia with hypertension. 4,5 Recent observations in experimental hyperuricemia suggest that uric acid may in fact have a pathogenic role in hypertension. 6 Hyperuricemia induces hypertension in experimental animals that corrects with hypouricemic therapy.…”

mentioning

confidence: 99%

Uric Acid and the Development of Hypertension

Perlstein

Gumieniak²,

Williams³

et al. 2006

Hypertension

259

105

View full text Add to dashboard Cite

show abstract

“…One potential explanation is that hyperinsulinemia may cause hyperuricemia. For example, insulin acts on the proximal tubule to stimulate urate reabsorption coupled with sodium [32]. Fasting insulin levels inversely correlate with urinary uric acid clearance and are positively associated with serum uric acid in healthy subjects [28].…”

Section: Metabolic Syndrome Renal Disease and Uric Acidmentioning

confidence: 99%

The conundrum of hyperuricemia, metabolic syndrome, and renal disease

et al. 2008

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The level of serum uric acid in human has been increasing over the last decades, and correlates with an increase prevalence of renal disease and metabolic syndrome. Understanding the role of uric acid in these conditions may provide clues for preventing the current epidemic of renal disease. Controversy still remains if hyperuricemia is simply a consequence or a cause of renal disease although epidemiological studies have attempted to resolve this issue. In this review, we discuss the clinical and experimental evidence for a causal role of hyperuricemia in renal diseases and potential relationships of hyperuricemia with metabolic syndrome.

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“…There are various hypotheses as to why obesity causes hyperuricemia: for instance, accelerated uric acid production coupled with the synthesis of triglyceride (10), underexcretion of uric acid into the urine caused by the effect of insulin on the urinary tubular tract (11)(12)(13).…”

Section: Many Previous Reports Have Shown the Relationship Between Obmentioning

confidence: 99%

“…4). (19) (12,13,21). It is known that uric acid and sodium have a co-transporter system in the kidney (22).…”

Section: F I G U R E 1 Re L a T I O N S H I P B E T We E N T H E S mentioning

confidence: 99%