Relationship Between Uric Acid Level and Blood Pressure in T2DM Patient Attending in BIRDEM General Hospital

Abstract

IntroductionHyperuricemia is becoming an increasing problem all over the world with a steady increase in prevalence 4 . Many factors contribute to hyperuricemia eg: genetics, insulin resistance, hypertension, renal insufficiency, obesity, diet, use of diuretics, and consumption of alcoholic beverages 3 . Some experimental and clinical studies suggest that uric acid has a contributory role in the pathogenesis of elevated blood pressure by several mechanisms such as inflammation, vascular smooth muscle cell proliferation in renal microcirculation, and activation of renin-angiotensin-aldosterone system 7 . Another study showed high arterial tension in gout due to higher level of uric acid in the blood increases tone of arterioles causing hypertension 8 . Several recent small clinical trials have demonstrated that serum uric acid lowering agents such as allopurinol and probenecid can reduce blood pressure (BP) in adolescents 9 . Some studies also showed that the subjects with higher levels of serum uric acid are more at risk of developing type 2 diabetes and it was also found that one-quarter of diabetic cases can be attributed to a high serum uric acid level 10 . Recent studies have introduced serum uric acid as a potential risk factor for hypertension, stroke and cardiovascular diseases [11][12][13] . A study showed the prevalence of hyperuricemia to be 33% of RELATIONSHIP BETWEEN URIC ACID LEVEL AND BLOOD PRESSURE IN T2DM PATIENTS ATTENDING THE BIRDEM GENERAL HOSPITAL ABSTRACTHyperuricemia is associated with higher mortality in patients suffering from hypertension, coronary heart disease, cerebrovascular events, metabolic syndrome, insulin resistance, gout and renal stone formation and it is more in individuals with diabetes. The prevalence of hyperuricemia is high in T2DM. The aim of the present study was to assess the relationship between hyperuricemia and blood pressure in T2DM subjects and thus to help the clinician for early diagnosis, treatment and to prevent further complications. Total 350 study subjects were enrolled for this study; among them 203 were T2DM with normal level of serum uric acid level and 147 were T2DM with high serum uric acid level. It was observed that systolic blood pressure was significantly higher (134.5±9.6 mm of Hg) in T2DM with hyperuricemia (p<0.001) than T2DM with normal serum uric acid level (123.3±10.9 mm of Hg). On the other hand diastolic blood pressure was significantly higher (87.1±5.9 mm of Hg) in T2DM with hyperuricemia (p<0.001) than T2DM with normal serum uric acid level (79.6±8.3 mm of Hg). Age (years) showed no significant difference between T2DM with serum uric acid<7 mg/dl and T2DM with serum uric acid>7 mg/dl (p<0.05). In our study it was revealed that males were in greater risk of developing hyperuricemia. BMI was significantly (p<0.001) greater in T2DM subjects who had normal serum uric acid level (27.9±3.8) than with those who had serum uric acid>7 mg/dl (24.4±3.83). No significant differences were found in FBS, blood sugar 2 hours after breakfast, HbA1C, seru...