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Li H, Sun M, Huang C, Wang J, Huang Y. Association between Glycosylated Hemoglobin and Serum Uric Acid: A US NHANES 2011-2020. Int J Endocrinol 2024; 2024:5341646. [PMID: 38515506 PMCID: PMC10957249 DOI: 10.1155/2024/5341646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 02/08/2024] [Accepted: 03/01/2024] [Indexed: 03/23/2024] Open
Abstract
Background Serum uric acid (SUA) and glycosylated hemoglobin (HbA1c) were closely related to the body's metabolism. This study aimed to investigate the relationship between HbA1c and SUA in adults. Methods This study selected 7293 participants aged ≥20 from 2011 to 2020 in the National Health and Nutrition Examination Survey (NHANES). The multivariate linear regression model was used to test the association between HbA1c and SUA. Subgroup analysis was performed according to age, gender, race, and body mass index (BMI). This study solved the relationship between HbA1c and SUA by fitting a smooth curve. Finally, the inflection point in the nonlinear relationship was calculated by the recursive algorithm, and the relationship between HbA1c and SUA on both sides of the inflection point was analyzed by the two-segment piecewise linear regression model. Results All 7293 participants found a negative correlation between HbA1c and SUA by completely adjusting the model (β = -7.93 and 95% CI: -9.49--6.37). In addition, when this study was stratified by gender, age, race, and BMI status, this negative correlation was still statistically significant. In the subgroup analysis, we found that the relationship between the two had different results due to gender differences. In men, HbA1c had a significant negative correlation with SUA. However, in women, the HbA1c value was positively correlated with SUA before 6.8%, and the HbA1c value was negatively correlated with SUA after 6.8%, which indicates that the relationship between HbA1c and SUA in women has changed in prediabetes and diabetes. Conclusion This study shows that HbA1c is positively correlated with SUA in American adults before 7%. There is a negative correlation after the HbA1c value of 7%.
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Affiliation(s)
- Huan Li
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan 250014, China
| | - Mingliang Sun
- Department of Endocrinology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, China
| | - Chengcheng Huang
- Department of Endocrinology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, China
| | - Jingwu Wang
- Department of Endocrinology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, China
| | - Yanqin Huang
- Department of Endocrinology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, China
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Wang C, Wang J, Wan R, Yuan T, Yang L, Zhang D, Li X, Wang M, Liu H, Lei Y, Wei H, Li J, Liu M, Hua Y, Sun L, Zhang L. Relationship between baseline and changed serum uric acid and the incidence of type 2 diabetes mellitus: a national cohort study. Front Public Health 2023; 11:1170792. [PMID: 37483942 PMCID: PMC10357007 DOI: 10.3389/fpubh.2023.1170792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/13/2023] [Indexed: 07/25/2023] Open
Abstract
Objective To explore the correlation between baseline serum uric acid (SUA) and SUA changes with the incidence of type 2 diabetes mellitus (T2DM) among middle-aged and older individuals. Method Binary logistic regression was used to calculate the odds ratio (ORs) and 95% confidence intervals (CIs) of the effects of baseline and changes in SUA on the incidence of T2DM. Stratified analysis was conducted based on sex, and the SUA levels were classified into four quartiles to assess the effect of baseline and relative changes in SUA on the incidence of T2DM. Furthermore, interaction analysis was performed between body mass index (BMI) and SUA, age and SUA, and sex and SUA. Results In the cohort study, the highest quartiles of SUA were significantly correlated with an increased incidence of T2DM among females in model 1 [OR = 2.231 (1.631, 3.050)], model 2 [OR = 2.090 (1.523, 2.867)], model 3 [OR = 2.075 (1.511, 2.849)], and model 4 [OR = 1.707 (1.234, 2.362)]. The highest quartiles of SUA had a statistically significant effect on the incidence of T2DM among all participants in model 1 [OR = 1.601 (1.277, 2.008)], model 2 [OR = 1.519 (1.204, 1.915)], model 3 [OR = 1.597 (1.257, 2.027)], and model 4 [OR = 1.380 (1.083, 1.760)]. Regarding the relative change of SUA, the highest quantiles of SUA were significantly correlated with an increased incidence of T2DM among females in model 1 [OR = 1.409 (1.050, 1.890)], model 2 [OR = 1.433 (1.067, 1.926)], and model 3 [OR = 1.420 (1.056, 1.910)], and there was a statistically significant correlation with incident T2DM among all participants in model 4 [OR = 1.346 (1.079, 1.680)] after adjusting for all covariates. However, there was no significant correlation between baseline, relative, and absolute changes in SUA and the incidence of T2DM among males. The interaction analysis demonstrated that sex, BMI, and the relative changes in SUA had a combined effect on the incidence of T2DM, while age and the changes in SUA had a joint effect on the incidence of T2DM only in females. Conclusion There was a positive association between SUA and the incidence of T2DM for all participants. However, significant sex differences in incidence were observed only in women, not men.
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Affiliation(s)
- Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Higher Education Park, Wuhu, China
| | - Jiazhi Wang
- Sports Institute, Chi Zhou College, Education Park, Chi Zhou, China
| | - Rui Wan
- Business School, Yunnan University of Finance and Economics, Kunming, China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Higher Education Park, Wuhu, China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Higher Education Park, Wuhu, China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, Higher Education Park, Wuhu, China
| | - Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Higher Education Park, Wuhu, China
| | - Min Wang
- Department of Pharmacy, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Haiyang Liu
- Student Health Center, Wannan Medical College, Higher Education Park, Wuhu, China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Higher Education Park, Wuhu, China
| | - Huanhuan Wei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Higher Education Park, Wuhu, China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Higher Education Park, Wuhu, China
| | - Mingming Liu
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Higher Education Park, Wuhu, China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wannan Medical College, Higher Education Park, Wuhu, China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Higher Education Park, Wuhu, China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Higher Education Park, Wuhu, China
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Wei Y, Wu Z, Wang Y, Wang G, Liu J. Interaction of sex and diabetes on the association between hemoglobin glycation index, hemoglobin A1c and serum uric acid. Diabetol Metab Syndr 2022; 14:185. [PMID: 36464722 PMCID: PMC9719659 DOI: 10.1186/s13098-022-00955-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Hemoglobin glycation index (HGI), which is calculated by blood glucose and hemoglobin A1c(HbA1c), reflects the individual discrepancy in HbA1c. This study aimed to investigate the association between HGI/HbA1c and serum uric acid(SUA) stratified by sex and diabetes. METHODS The study recruited 33772 participants who underwent physical examinations between April 2016 and August 2021 in Beijing Chao-Yang Hospital. A random subsample of 3000 subjects was utilized to calculate the formula of HGI and data of the remaining 30772 participants were used for analysis. HGI and HbA1c were categorized according to quartiles (Q1, Q2, Q3, Q4), using Q1 as the reference. We used multiple linear regression and restricted cubic splines for data analysis. RESULTS 30772 participants with a mean age of 44.4 years old were included in the analysis, 48.6% (N = 14944) of which were female and 7.7% (N = 2363) with diabetes. Associations of HGI, HbA1c and SUA were modified by sex and diabetes. The relationship between SUA levels and HGI was positive in women without diabetes, with one unit increase in HGI associating with an 11.3 μmol/L increase in SUA (P < 0.001) after adjusting for other confounders. On average, each one-unit increase in HbA1c was associated with a 14.3 μmol/L decrease in SUA in women with diabetes, a 14.9 μmol/L decrease in SUA in men with diabetes, and a 16.5 μmol/L increase in SUA in women without diabetes (all P < 0.001). The SUA levels in men without diabetes showed a bell-shaped relation with HbA1c, increasing as the HbA1c rose to around 5.7% and then falling with a further increase of HbA1c (P < 0.001). CONCLUSIONS SUA levels were inversely correlated with HbA1c in diabetic patients, also in men with prediabetes (HbA1c ≥ 5.7%), but positively correlated with HbA1c and HGI in women without diabetes. Glycemic control may help to reduce the risk of hyperuricemia in non-diabetes women.
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Affiliation(s)
- Ying Wei
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing, China
| | - Zhenyu Wu
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing, China
| | - Ying Wang
- Health Management Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Guang Wang
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing, China
| | - Jia Liu
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing, China
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Yang Y, Ma Y, Cheng Y, Xu Y, Fang Y, Ke J, Zhao D. The perirenal fat thickness was independently associated with serum uric acid level in patients with type 2 diabetes mellitus. BMC Endocr Disord 2022; 22:210. [PMID: 35987648 PMCID: PMC9392942 DOI: 10.1186/s12902-022-01081-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 06/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Obesity is an important risk factor for hyperuricemia. We aimed to explore the relationship between perirenal fat thickness (PrFT) and paranephric fat thickness (PnFT) and serum uric acid (SUA) in patients with type 2 diabetes mellitus (T2DM). METHODS This was a cross-sectional study involving 257 patients with T2DM recruited from Beijing Luhe Hospital from September 2019 to May 2020. The basic and clinical information such as age, gender, duration of diabetes was collected through the medical records. All patients underwent a physical examination including height, weight, waist circumference, hip circumference, systolic blood pressures and diastolic blood pressure. The venous blood and urine samples were collected to measure SUA, fasting blood glucose, total cholesterol, triglyceride, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, serum creatinine, blood urea nitrogen and glycosylated hemoglobin. PrFT and PnFT were measured via ultrasonography. Pearson correlation test and linear regression analysis were used to analyze the association between PrFT and PnFT and SUA. RESULTS We found that PrFT and PnFT increased according to the tertiles of SUA level (P = 0.001 and P = 0.009, respectively). In addition, the PrFT and PnFT were positively associated with SUA level (r = 0.25, P < 0.001, r = 0.23, P < 0.001, respectively). Moreover, this association was stronger in males, non-obesity patients and patients with normal renal function. In the multivariate analysis, the PrFT was independently associated with SUA level after adjusting confounding factors. CONCLUSIONS The PrFT was independently associated with SUA level in patients with T2DM.
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Affiliation(s)
- Yuxian Yang
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Yan Ma
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Yanan Cheng
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Yuechao Xu
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Yuan Fang
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Jing Ke
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, China.
| | - Dong Zhao
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, China.
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Martínez-Sánchez FD, Vargas-Abonce VP, Guerrero-Castillo AP, Santos-Villavicencio MDL, Eseiza-Acevedo J, Meza-Arana CE, Gulias-Herrero A, Gómez-Sámano MÁ. Serum Uric Acid concentration is associated with insulin resistance and impaired insulin secretion in adults at risk for Type 2 Diabetes. Prim Care Diabetes 2021; 15:293-299. [PMID: 33218916 DOI: 10.1016/j.pcd.2020.10.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 09/21/2020] [Accepted: 10/13/2020] [Indexed: 02/07/2023]
Abstract
AIMS Insulin resistance (IR) predisposes to type 2 diabetes mellitus (T2DM). Although previous studies have associated serum uric acid concentration with IR in T2DM, its association with impaired insulin secretion and beta-cell dysfunction in subjects at risk for developing T2DM remains uncertain. Thus, we aimed to analyze the association of serum uric acid concentration with IR using surrogate insulin resistance/secretion and beta-cell function indices in subjects at risk for developing T2DM. METHODS This is a cross-sectional study that included 354 subjects who underwent an oral glucose tolerance test who had at least two risk factors for T2DM without any chronic disease. RESULTS Participants were 51±8 years old, 72.2% were women, had a mean body mass index of 29.9±6.5kg/m2 and mean serum uric acid concentration of 5.7±1.3mg/dL. HOMA-IR, first-phase insulin secretion (S1PhOGTT), second-phase insulin secretion (S2PhOGTT), Matsuda and disposition indices were significantly correlated with serum uric acid concentrations (r=0.239, r=0.225, r=0.201, r=-0.287, r=-0.208; respectively). After multiple linear regression analysis, serum uric acid concentration was independently associated with HOMA-IR (β=0.283), HOMA-B (β=0.185), S1PhOGTT (β=0.203), S2PhOGTT (β=0.186), and Matsuda Index (β=-0.322). A serum uric acid concentration of 5.5mg/dL had the best sensitivity/sensibility to identify subjects with IR (HOMA-IR ≥2.5). CONCLUSIONS Serum uric acid concentration is significantly associated with IR and impaired insulin secretion, but not with beta-cell dysfunction, in subjects at risk for developing T2DM.
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Affiliation(s)
- Froylan D Martínez-Sánchez
- Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga # 15, Belisario Domínguez Sección XVI, Tlalpan, 14080 Mexico City, Mexico; Facultad de Ciencias de la Salud, Universidad Anáhuac México Norte, Av. Universidad Anáhuac #46. Lomas Anáhuac, 52786 Huixquilucan, Estado de Mexico, Mexico.
| | - Valerie Paola Vargas-Abonce
- Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga # 15, Belisario Domínguez Sección XVI, Tlalpan, 14080 Mexico City, Mexico.
| | - Anna Paula Guerrero-Castillo
- Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga # 15, Belisario Domínguez Sección XVI, Tlalpan, 14080 Mexico City, Mexico.
| | | | - Jocelyn Eseiza-Acevedo
- Escuela Nacional de Medicina y Homeopatía, Instituto Politécnico Nacional, 239, Mexico City, Mexico City, Mexico.
| | - Clara Elena Meza-Arana
- Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga # 15, Belisario Domínguez Sección XVI, Tlalpan, 14080 Mexico City, Mexico.
| | - Alfonso Gulias-Herrero
- Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga # 15, Belisario Domínguez Sección XVI, Tlalpan, 14080 Mexico City, Mexico.
| | - Miguel Ángel Gómez-Sámano
- Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga # 15, Belisario Domínguez Sección XVI, Tlalpan, 14080 Mexico City, Mexico.
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Eljaaly Z, Mujammami M, Nawaz SS, Rafiullah M, Siddiqui K. Risk Predictors of High Uric Acid Levels Among Patients with Type-2 Diabetes. Diabetes Metab Syndr Obes 2021; 14:4911-4920. [PMID: 34992399 PMCID: PMC8713713 DOI: 10.2147/dmso.s344894] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/07/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Patients with diabetes are at higher risk of the negative consequences of hyperuricemia. The objective of this study was to investigate gender and age-specific differences in the uric acid levels and to evaluate the associated risk factors among patients with diabetes. METHODS A retrospective cross-sectional study was conducted at Strategic Center for Diabetes Research from September 2019 to January 2020, among adult type-2 diabetic patients. Serum uric acid (SUA) and several other metabolic and clinical parameters were examined. Multiple regression analysis was done to identify risk factors independently associated with hyperuricemia. RESULTS A total of 433 patients were included in the analysis. SUA level was higher in males than females (5.82±1.65 mg/dL versus 5.29±1.54 mg/dL, p < 0.001). The prevalence of hyperuricemia was higher in females than males (28.8% versus 20.5%, p = 0.049). There was no significant difference in uric acid levels or the prevalence of hyperuricemia by age groups in the total sample or gender-stratified samples. In multivariate analysis, hyperuricemia was associated with bigger hip circumference (odds ratios [OR] were 1.03, 95% CI = 1.01-1.05), higher triglycerides (OR = 1.005, 95% CI = 1.002-1.008), and higher serum creatinine (OR = 1.34, 95% CI = 1.21-1.49). Hip circumference, total cholesterol, high-density lipoprotein, and serum creatinine were independent risk factors in males, while triglycerides and higher serum creatinine were independent risk factors among females. CONCLUSION The present study demonstrates gender-specific differences in the uric acid levels and hyperuricemia prevalence. In males and females, hyperuricemia was associated with hip circumference, total cholesterol, high-density lipoprotein, triglycerides, and serum creatinine. Future large studies are needed to confirm our findings, especially in elderly females.
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Affiliation(s)
- Zobeida Eljaaly
- University Diabetes Center, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
- Division of Endocrinology, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Muhammad Mujammami
- University Diabetes Center, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
- Division of Endocrinology, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Shaik Sarfaraz Nawaz
- Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohamed Rafiullah
- Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khalid Siddiqui
- Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Correspondence: Khalid Siddiqui Strategic Center for Diabetes Research, College of Medicine, King Saud University, P.O. Box 245, Riyadh, 11411, Saudi Arabia Email
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Tian T, Wang Y, Xie W, Zhang J, Zhu Q, Peng X, Zhou Y, Dai Y. Associations of Serum Uric Acid with Clustering of Cardiovascular Risk Factors and a 10-Year Atherosclerotic Cardiovascular Disease Risk Score in Jiangsu Adults, China. Diabetes Metab Syndr Obes 2021; 14:3447-3460. [PMID: 34349538 PMCID: PMC8326528 DOI: 10.2147/dmso.s323917] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 07/14/2021] [Indexed: 12/16/2022] Open
Abstract
PURPOSE The relationship between serum uric acid (SUA) and Chinese characteristic 10-year atherosclerotic cardiovascular disease (ASCVD) risk score has not been well evaluated in Chinese populations. Aims of this cross-sectional study were to describe the correlation between SUA level and clustering of prevalent cardiovascular risk factors (CRFs) including overweight, central obesity, hypertension, diabetes and dyslipidemia, as well as the Chinese 10-year ASCVD risk score in adults from Jiangsu Province located in Eastern China. PATIENTS AND METHODS A total of 7700 adults from 12 cities in Jiangsu Province were selected through multi-stage stratified cluster random sampling method in 2015. Face-to-face interviews, physical examinations and laboratory examinations were carried out to collect the information of the participants. Multivariate logistic analysis was used to analyze the relationship between SUA quartiles and various CVD risk factors. The nonlinear analysis was conducted to evaluate the relationship between SUA levels and the China-PAR 10-year ASCVD risk scores. RESULTS The prevalence of hyperuricemia was 13.3% in all of the participants. By adjusting potential confounders, significant correlations were found between the SUA level and the overweight, central obesity, hypertension and dyslipidemia in both males and females. The clustering of CRFs was different across SUA quantiles (χ 2=607.685, P<0.001). After Gamma trend test (P < 0.001) and ordered logistic regression analysis, it was found out that with the increase of SUA quantiles, prevalent CRFs gradually gathered in both males and females. Furthermore, sex-specific difference was identified between SUA and 10-year ASCVD risk scores. CONCLUSION The accumulation of CRFs increased with elevated SUA levels, whereas it was different between genders in the relationship between SUA and 10-year ASCVD risk scores. Tailored strategies should be taken when it came to males and females in managing SUA.
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Affiliation(s)
- Ting Tian
- Institute of Food Safety and Assessment, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, People’s Republic of China
| | - Yuanyuan Wang
- Institute of Food Safety and Assessment, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, People’s Republic of China
- Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, 210009, People’s Republic of China
| | - Wei Xie
- Institute of Food Safety and Assessment, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, People’s Republic of China
| | - Jingxian Zhang
- Institute of Food Safety and Assessment, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, People’s Republic of China
| | - Qianrang Zhu
- Institute of Food Safety and Assessment, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, People’s Republic of China
| | - Xianzhen Peng
- Department of Public Health and Preventive Medicine, Kangda College of Nanjing Medical University, Lianyungang, Jiangsu, 222000, People’s Republic of China
| | - Yonglin Zhou
- Institute of Food Safety and Assessment, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, People’s Republic of China
- Correspondence: Yonglin Zhou; Yue Dai Email ;
| | - Yue Dai
- Institute of Food Safety and Assessment, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, People’s Republic of China
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Lee SY, Park W, Suh YJ, Lim MJ, Kwon SR, Lee JH, Joo YB, Oh YK, Jung KH. Association of Serum Uric Acid with Cardiovascular Disease Risk Scores in Koreans. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234632. [PMID: 31766442 PMCID: PMC6926564 DOI: 10.3390/ijerph16234632] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 11/16/2019] [Accepted: 11/18/2019] [Indexed: 01/13/2023]
Abstract
As the prevalence of gout and hyperuricemia increases, the comorbidities of gout and hyperuricemia have become a public health burden. In particular, risks of cardiovascular disease (CVD)-related complications are increasing. However, a few guidelines exist for the management of hyperuricemia. This cross-sectional study aimed to investigate the association of serum uric acid with CVD risk in the general population of Korean adults. We examined cross-sectional data from the first and second years of the seventh Korea National Health and Nutrition Examination Survey 2016–2017. Among 16,277 participants, 8781 were analyzed. We estimated the CVD risk using a 10-year CVD risk score prediction formula. There was a significant association of serum uric acid with 10-year CVD risk scores after adjusting for physical activity, body mass index, serum creatinine, and alcohol consumption in both sexes (p < 0.001). In the fitted fractional polynomial model, an approximate U-shaped association between serum uric acid levels and 10-year CVD risk scores was found in men. At the serum uric acid level of 6.9 mg/dL, the CVD risk was lowest. An approximate J-shaped association between serum uric acid levels and 10-year CVD risk scores was found in women. Our study showed that hyperuricemia was associated with an increased CVD risk. Hypouricemia was also associated with an increased CVD risk in men. We, therefore, recommend proper management of uric acid levels in the general population to reduce CVD risks.
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Affiliation(s)
- Seung Yun Lee
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, Inha University, Incheon 22332, Korea; (S.Y.L.); (W.P.); (M.J.L.); (S.-R.K.)
| | - Won Park
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, Inha University, Incheon 22332, Korea; (S.Y.L.); (W.P.); (M.J.L.); (S.-R.K.)
| | - Young Ju Suh
- Department of Biomedical Sciences, College of Medicine, Inha University, Incheon 22332, Korea; (Y.J.S.); (Y.-K.O.)
| | - Mie Jin Lim
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, Inha University, Incheon 22332, Korea; (S.Y.L.); (W.P.); (M.J.L.); (S.-R.K.)
| | - Seong-Ryul Kwon
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, Inha University, Incheon 22332, Korea; (S.Y.L.); (W.P.); (M.J.L.); (S.-R.K.)
| | - Joo-Hyun Lee
- Department of Rheumatology, Inje University Ilsan Paik Hospital, Goyang 10380, Korea;
| | - Young Bin Joo
- Division of Rheumatology, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon 16247, Korea;
| | - Youn-Kyung Oh
- Department of Biomedical Sciences, College of Medicine, Inha University, Incheon 22332, Korea; (Y.J.S.); (Y.-K.O.)
| | - Kyong-Hee Jung
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, Inha University, Incheon 22332, Korea; (S.Y.L.); (W.P.); (M.J.L.); (S.-R.K.)
- Correspondence: ; Tel.: +82-32-890-3496
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Zhong X, Zhang D, Yang L, Du Y, Pan T. 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. PeerJ 2019; 7:e6666. [PMID: 30941277 PMCID: PMC6440459 DOI: 10.7717/peerj.6666] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 02/22/2019] [Indexed: 12/14/2022] Open
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.
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Affiliation(s)
- Xing Zhong
- Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University, He Fei, Anhui Province, China
| | - Deyuan Zhang
- Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University, He Fei, Anhui Province, China
| | - Lina Yang
- Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University, He Fei, Anhui Province, China
| | - Yijun Du
- Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University, He Fei, Anhui Province, China
| | - Tianrong Pan
- Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University, He Fei, Anhui Province, China
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Gaita L, Timar R, Lupascu N, Roman D, Albai A, Potre O, Timar B. The Impact Of Hyperuricemia On Cardiometabolic Risk Factors In Patients With Diabetes Mellitus: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2019; 12:2003-2010. [PMID: 31632111 PMCID: PMC6781154 DOI: 10.2147/dmso.s222570] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 09/03/2019] [Indexed: 12/22/2022] Open
Abstract
PURPOSE Hyperuricemia (HUA) is linked to a variety of non-communicable diseases such as atherosclerotic cardiovascular disease (ASCVD), chronic kidney disease (CKD) and hypertension, with evidence showing its role in the development of diabetes mellitus (DM). Our study's main aim was to explore the associations of HUA with other traditional risk factors in Romanian patients with DM and to assess the impact of the increase of serum UA on DM complications and HbA1c. PATIENTS AND METHODS In this cross-sectional, non-interventional study, we enrolled, according to a population-based, consecutive-case principle, 133 patients previously diagnosed with DM. HbA1c, uric acid, lipid profile, urinary albumin/creatinine ratio, glomerular filtration rate, TSH and FT4 measurements were performed, while the diagnosis of retinopathy and of diabetic neuropathy was established using standardized methods. RESULTS An increased uric acid level was associated with a significant increase in the risk for development of stroke (OR=1.526; p=0.004). A weak, positive and statistically significant correlation can also be observed between the BMI and the presence of hyperuricemia (r=0.131; p=0.034), and between the triglyceride levels and hyperuricemia (r= 0.173; p=0.004). Glomerular filtration rate was correlated to hyperuricemia in a strong and negative manner, having an important statistical significance (r=-0.818; p=0.003). In our study, UA levels and HbA1c were negatively correlated, without reaching statistical significance. CONCLUSION Serum UA is strongly correlated with the BMI, triglyceride level and GFR in Romanian patients with DM and HUA is significantly associated with a higher risk of stroke in these individuals.
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Affiliation(s)
- Laura Gaita
- Second Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Romulus Timar
- Second Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Department of Diabetes and Metabolic Diseases, “Pius Brinzeu” Emergency Hospital, Timisoara, Romania
- Correspondence: Romulus Timar Second Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu, Timisoara300041, RomaniaTel +4 0748 331 294 Email
| | - Nicoleta Lupascu
- Second Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Deiana Roman
- Second Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Alin Albai
- Second Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Department of Diabetes and Metabolic Diseases, “Pius Brinzeu” Emergency Hospital, Timisoara, Romania
| | - Ovidiu Potre
- First Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Department of Hematology, Municipal Emergency Hospital, Timisoara, Romania
| | - Bogdan Timar
- Department of Diabetes and Metabolic Diseases, “Pius Brinzeu” Emergency Hospital, Timisoara, Romania
- Department of Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
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11
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Tseng WC, Chen YT, Ou SM, Shih CJ, Tarng DC. U-Shaped Association Between Serum Uric Acid Levels With Cardiovascular and All-Cause Mortality in the Elderly: The Role of Malnourishment. J Am Heart Assoc 2018; 7:e007523. [PMID: 29440009 PMCID: PMC5850189 DOI: 10.1161/jaha.117.007523] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 01/18/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND The link between elevated serum uric acid (SUA) levels and cardiovascular disease (CVD)-related mortality in the elderly population remains inconclusive. Nutritional status influences both SUA and CVD outcomes. Therefore, we investigated whether SUA-predicted mortality and the effect-modifying roles of malnourishment in older people. METHODS AND RESULTS A longitudinal Taiwanese cohort including 127 771 adults 65 years and older participating in the Taipei City Elderly Health Examination Program from 2001 to 2010 were stratified by 1-mg/dL increment of SUA. Low SUA (<4 mg/dL) strata was categorized by malnourishment status defined as Geriatric Nutritional Risk Index <98, serum albumin <38 g/L, or body mass index <22 kg/m2. Study outcomes were all-cause and CVD-related mortality. Cox models were used to estimate hazard ratios (HRs) of mortality, after adjusting for 20 demographic and comorbid covariates. Over a median follow-up of 5.8 years, there were 16 439 all-cause and 3877 CVD-related deaths. Compared with the reference SUA strata of 4 to <5 mg/dL, all-cause mortality was significantly higher at SUA <4 mg/dL (HR, 1.16; 95% confidence interval, 1.07-1.25) and ≥8 mg/dL (HR, 1.13; confidence interval, 1.06-1.21), with progressively elevated risks at both extremes. Similarly, increasingly higher CVD-related mortality was found at the SUA level <4 mg/dL (HR, 1.19; confidence interval, 1.00-1.40) and ≥7 mg/dL (HR, 1.17; confidence interval, 1.04-1.32). Remarkably, among the low SUA (<4 mg/dL) strata, only malnourished participants had greater all-cause and CVD-related mortality. This modifying effect of malnourishment remained consistent across subgroups. CONCLUSIONS SUA ≥8 or <4 mg/dL independently predicts higher all-cause and CVD-related mortality in the elderly, particularly in those with malnourishment.
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Affiliation(s)
- Wei-Cheng Tseng
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yung-Tai Chen
- Division of Nephrology, Department of Medicine, Taipei City Hospital Heping-Fuyou Branch, Taipei, Taiwan
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shuo-Ming Ou
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chia-Jen Shih
- Department of Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yilan, Taiwan
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Der-Cherng Tarng
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department and Institute of Physiology, National Yang-Ming University, Taipei, Taiwan
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
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