Is Serum Uric Acid an Added Risk Factor for Micro-Vascular Complications of Diabetes Mellitus? – A Prospective Study

Abstract

Introduction: Diabetes is the leading cause of adult blindness due to retinopathy, end stage renal disease due to nephropathy and foot ulcers and lower limb amputation due to neuropathy. Serum uric acid levels independently predict the development of micro vascular complications. In this study, we analyse the association of serum uric acid with the micro vascular complications of diabetes. Material and methods: In this hospital based observational study, hundred diabetic patients were included; of which fifty had micro vascular complications, the remaining fifty had no complications. Blood investigations including fasting(FBS) and post prandial blood sugars(PPBS), glycosylated haemoglobin (HbA1C), and serum creatinine and serum uric acid were done in all patients. All the parameters were compared between the two groups. Results: Females presented with significantly higher complications as compared to males. The mean age of the patients presented with and without complications was 56.4 ± 9.3 and 59.9 ± 10.3 respectively. HbA1C had a positive correlation with the serum uric acid (SUA) (r=0.327, P = 0.001). Mean uric acid levels were higher among patients with complications (5.96 ± 2.16) compared to patients without complications (4.95 ± 2.04) which was statistically significant (P value =0.021). Patients with nephropathy and neuropathy had significant elevation in serum uric acid levels than those without; however this significance was not noted in those with retinopathy. Conclusion: Patients with micro vascular complications had higher levels of serum uric acid compared to those without complications. Also there was positive correlation between HbA1C and serum uric acid levels.

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“…Elevated uric acid concentrations favor the development of kidney problems and increase the chances of development of obesity, metabolic syndrome, diabetes, fatty liver, arterial hypertension and cardiovascular disease. It may also stimulate the production of CRP, known to be a predictive marker of progression of atherosclerotic cardiovascular disease (34,35) .…”