The relationship between serum uric acid within the normal range and β-cell function in Chinese patients with type 2 diabetes: differences by body mass index and gender

Abstract

Background Elevated serum uric acid (SUA) has a positive correlation with insulin secretion and insulin resistance indexes. However, whether weight- and gender-specific differences regarding the relationship between SUA within the normal range and β-cell function and insulin resistance exist is unknown in type 2 diabetes mellitus (T2DM) patients. Methods A total of 380 patients with type 2 diabetes were divided into two groups as overweight/obesity (n = 268) and normal weight (n = 112). Each group were again divided into low (LSUA) and high normal SUA (HSUA). The HbA1c, C-peptide, SUA, creatinine, and lipids profiles were measured. HOMA2IR and HOMA%2B were estimated using fasting glucose and C-peptide by homeostasis model assessment (HOMA). Pearson’s correlations and multiple linear regression analyses were conducted to assess the associations between SUA levels and islet function indexes. Results In overweight/obesity subgroup, the levels of body mass index, fasting C-peptide (FCP), P2hCP, fasting CPI (FCPI), postprandial CPI (PPCPI), ΔC-peptide, HOMA2%B, and HOMA2IR were higher in HSUA group than in LSUA group. In contrast, the HbA1c, FBS, and P2hBS were lower in HSUA than in LSUA. In normal weight subgroup, there were no differences between the HSUA than LSUA group in terms of clinical characteristics. Pearson’s correlations indicated that there were no significant correlations between SUA and insulin secretory capacity in normal weight group, but in overweight/obesity group, SUA had positive significant correlations with P2hCP, FCPI, PPCPI, ΔC-peptide, and HOMA2%B. In the female group, there were no significant correlations between SUA and insulin secretory capacity. However, in the male group, SUA had positive significant correlations with insulin secretory capacity include P2hCP, FCPI, PPCPI, ΔC-peptide, and HOMA2%B. Multiple linear regression showed that SUA was significantly associated with HOMA2%B, but not with HOMA2IR in overweight/obesity and male group. Conclusions Our study shows that SUA levels within normal range were associated with β-cell function in T2DM patients with overweight/obesity or male. This finding supports that the association between SUA within normal range and insulin secretion ability differs by weight and sex.

Urine Uric Acid Excretion Levels are Positively Associated with Obesity and Abdominal Obesity in Type 2 Diabetes Patients without Chronic Kidney Disease

“…31 More importantly, high SUA levels also predict the development and progression of obesity in the general population in a prospective study. 32 The articles we have published also showed that SUA levels are closely associated with obesity, BMI and WC in Chinese inpatients with T2D. 4,8 Although the association between SUA levels and obesity, including abdominal obesity, has been investigated and confirmed, the relationship between UUAE levels and obesity is scarcely reported in both healthy and diabetic populations.…”

The association between serum uric acid and diabetic complications in patients with type 2 diabetes mellitus by gender: a cross-sectional study

“…Elevated uric acid causes a series of pathophysiological changes through inflammation, oxidative stress and activation of the renin-aldosterone-angiotensin system (RAAS), which subsequently promotes the initiation and progression of multiple diseases including metabolic syndrome ( Xiong, Liu & Xu, 2019 ). Recently, serum uric acid (SUA) has been regarded as a risk factor for T2DM ( Kodama et al, 2009 ) since hyperuricemia stimulates insulin secretion and aggravates insulin resistance ( Hu et al, 2018 ; Zhong et al, 2019 ). A clinical study from 8,678 patients with gout reports that uric acid-lowering therapy improves insulin resistance and reduces the incidence of T2DM ( Niu et al, 2018 ).…”

The Association of Serum Uric Acid with Beta-Cell Function and Insulin Resistance in Nondiabetic Individuals: A Cross-Sectional Study

“…Currently, the relationship between SUA and insulin resistance and beta-cell function has been established in several studies in patients with diabetes. [15][16][17][18] However, a large-scale study investigating this relationship in nondiabetic population is still lacking. In the present study, we explored the association of SUA with glucose homeostasis in nondiabetic individuals as assessed by HOMA models, which may help to define the role of SUA in the early natural history of type 2 diabetes.…”