Elevated Serum Uric Acid Is Associated With Greater Risk for Hypertension and Diabetic Kidney Diseases in Obese Adolescents With Type 2 Diabetes: An Observational Analysis From the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) Study

Different alterations of glomerular filtration rate and their association with uric acid in children and adolescents with type 1 diabetes or with overweight/obesity

BACKGROUND

Hyperfiltration (HF) occurs early in diabetes or obesity (OB)-associated renal disease. Alterations of glomerular filtration rate (GFR) in childhood OB remain unclear.

OBJECTIVES

To compare the prevalence of GFR alterations and its association with uric acid in children and adolescents with type 1 diabetes (T1D) vs overweight (OW)/OB.

METHODS

Cross-sectional study of 29 youths (aged: 13 ± 2 years) with T1D (disease duration: 7 ± 3 years) and 165 with OW/OB (aged: 11 ± 3 years). Patients with an albumin-creatinine ratio >3.39 mg/mmol were excluded. GFR was estimated with creatinine-cystatin C Zappitelli equation. HF and low GFR were defined by a GFR > 135 and <90 mL/min.1.73 m² , respectively.

RESULTS

HF was higher in children with T1D vs OW/OB (28% vs 10%, P < .005). Children with OW/OB also showed a 10% of low GFR. In patients with T1D, HbA1c (β = .8, P < .001), and systolic blood pressure (β = 11.4, P < .005) were independent predictors of GFR (R² = .65). In OW/OB, HF cases were almost limited to prepubertal children and low GFR to pubertal ones. GFR in OW/OB was associated with age (β = -2.2, P < .001), male sex (β = -11.6, P < .001), and uric acid (β = -.05, P < .001) in adjusted models (R² = .33).

CONCLUSIONS

GFR alterations were different between youths with T1D and with OW/OB. Higher uric acid, older age, and puberty were related to lower GFR values in OW/OB children. Longitudinal studies will determine if low GFR is consequence of a rapid GFR decline in pediatric patients with OW/OB.

A highly sensitive red-emitting probe for the detection of viscosity changes in living cells, zebrafish, and human blood samples

Intracellular viscosity can be measured to reflect the state of living cells. Fluorescent probes are powerful tools for viscosity detection in vivo.

Hyperuricemia and Hypertension: Links and Risks

Hyperuricemia has long been recognized to be associated with increased cardiovascular risk, including risk of developing hypertension. Epidemiological findings suggest that the link with hypertension is stronger in children and adolescents. Uric acid acts as a strong antioxidant compound in the extracellular environment but has pro-inflammatory effects within the intracellular setting. A chronic phase of microvascular injury is known to occur after prolonged periods of hyperuricemia. This is proposed to contribute to afferent arteriolopathy and elevation of blood pressure that may become unresponsive to uric acid-lowering therapies over time. Studies have struggled to infer direct causality of hyperuricemia due to a vast number of confounders including body mass index. The aim of this review is to present the available data and highlight the need for large scale prospective randomized controlled trials in this area. At present, there is limited evidence to support a role for uric acid-lowering therapies in helping mitigate the risk of hypertension.

Study of association of serum uric acid with albuminuria and carotid atherosclerosis in type 2 diabetes mellitus patients

Introduction:

Type 2 diabetes mellitus is a heterogeneous group of metabolic disorders of disturbance of carbohydrate, fat, and protein metabolism causing macrovascular (like coronary artery disease) and microvascular (kidney damage) complications. Microalbuminuria is the first manifestation of injury to glomerular filtration barrier and carotid intima-media thickness (IMT) of common carotid artery serves as an excellent marker for early lesion of atherosclerosis.

Method:

A cross-sectional observational study was carried out over a period of 1.5 years in PGIMER, DR. RML Hospital, New Delhi. Patients with type 2 diabetes mellitus, aged between 35 and 60 years, were investigated for uric acid (UA), urine albumin levels, and common carotid IMT during this period. Patients on drugs that affect serum UA level, patients with acute illness, patients with serum creatinine >1.5 mg/dL, or with coronary artery disease were excluded from study.

Result:

Prevalence of hyperuricemia was found to be high (46%) in type 2 diabetic patients. It was also higher in females (73.7%) than males (25.8%). There was positive correlation between serum UA concentrations with logarithm of urine albumin excretion (P < 0.023) and carotid intima-media thickness (IMT) (P < 0.027). Plaque index also showed a positive correlation with UA (P < 0.019). However, there was no positive correlation with UA and other variable such as age, duration of diabetes, systolic blood pressure, diastolic blood pressure, HbA1c, lipid profiles, urea, and creatinine.

Conclusion:

Serum UA concentration thus serves as an early marker of renal dysfunction and cardiovascular diseases in type 2 diabetic patients.

Ultra-performance liquid chromatography-mass spectrometry-based metabolomics reveals Huangqiliuyi decoction attenuates abnormal metabolism as a novel therapeutic opportunity for type 2 diabetes

Background: As a typical chronic metabolic disease, type 2 diabetes mellitus causes a heavy health-care burden to society. In this study, we applied the metabolomics strategy to explore the potential molecular mechanism of the Huangqiliuyi decoction (HQLYD) for type-2 diabetes (T2D). Ultra-performance liquid chromatography-mass spectrometry (UPLC-MS) combined with pattern recognition methods was utilized to select specific metabolites closely associated with HQLYD. Biomarker pathway analysis and biological network were utilized to uncover the therapeutic effect and action mechanism related to HQLYD. A total of twenty-five biomarkers were identified in the animal model, in which sixteen biomarkers are associated with HQLYD treatment for T2D. They attenuated the abnormalities of metabolic pathways such as phenylalanine, tyrosine and tryptophan biosynthesis, phenylalanine metabolism, and the citrate cycle. HQLYD also significantly elevated the serum FINS and SOD, GSP-x level in the liver and kidney, and reduced the serum TC, TG, HDL, LDL, urea, Scr, AST, ALT, FBG, IRS, MDA, and CAT level. We found that the therapeutic mechanism of HQLYD against T2D affected amino acid metabolism, glucose metabolism and lipid metabolism. Metabolomics revealed that the Huangqiliuyi decoction attenuates abnormal metabolism as a novel therapeutic opportunity for type 2 diabetes.

Sex-linked changes and high cardiovascular risk markers in the mature progeny of father, mother, or both father and mother consuming a high-fructose diet

OBJECTIVES

The aim of this study was to observe the developmental origins of health and disease affecting offspring owing to the consumption of a diet containing high fructose by the father or mother or both, considering that progeny only received a control diet during postnatal life.

METHODS

Male (future father) and female (future mother) C57 BL/6 mice were fed a high-fructose diet (HFru; 45% energy) or a control diet (C) for 8 wk before mating until lactation. The offspring was termed according to sex, maternal diet (first acrostic), and paternal diet (second acrostic); and received a balanced control diet until 3-mo of age when they were sacrificed. Body mass (BM), plasmatic leptin, adiponectin, uric acid, and systolic blood pressure (BP) were measured in mature offspring.

RESULTS

Fasting glycemia and insulin were elevated in HFru fathers and mothers. Although there was no change in BM, fasting glycemia, or insulin of the offspring, those of HFru fathers, HFru mothers, and HFru fathers and mothers presented higher genital fat pad, leptin, uric acid, and BP, and lower adiponectin. The values of leptin and BP were maximized when both parents consumed a HFru diet. Also, there was sexual dimorphism in most of the variables, with the male offspring being affected to a greater extent than the females.

CONCLUSIONS

Consumption of a fructose-rich diet by the father, the mother, or both negatively affected the adipokines, BP, and uric acid concentrations of mature offspring, with males being more affected than females. It is significant to consider that high BP and plasmatic uric acid correspond to markers of elevated cardiovascular risk in the progeny.