ASSOCIATION OF SERUM URIC ACID WITH DIABETES MELLITUS TYPE-2: A NARRATIVE REVIEW
Keywords:
Uric acid, Glycated hemoglobin, Diabetes mellitus, T2DM, HbA1C, Biomarker, ComplicationsAbstract
Diabetes mellitus type 2 (T2DM) is a disease which imposes a great burden on the health resources of the emerging and developing world. It is a global pandemic which leads to chronic complications. Serum uric acid (SUA) is a biomarker that could be of value in detection of early complications and better prognosis in diabetic patients. SUA serves both as a causal factor and disease progression marker in DM, having a causal relationship with diabetic complications. This narrative review aims to determine the association between SUA and T2DM. Research articles from the year 2005 to 2023 were selected for this review. Literature search was conducted from PubMed and Google Scholar which resulted in short listing of 15 articles. It also reflects upon the diabetic complications associated with Hyperuricemia (HUA) and focuses on the health implications of HUA in T2DM patients. SUA and T2DM were negatively associated in 8 research studies and positively associated in 6 studies in which one revealed a partial association, one was prevalent in the female gender only, and one was negatively associated in uncontrolled DM. Another study was associated with both hypouricemia and HUA.
Pak J Physiol 2024;20(1):ePub ahead of publication
Downloads
References
Ijaz M, Ali I, Hussain A. Diabetes mellitus in Pakistan: the past, present, and future. Int J Diabetes Developing Countries. 2020;40:153–4.
Wilkinson I, Wilkinson IB, Raine T, Wiles K, Goodhart A, Hall C, et al. Oxford Handbook of Clinical Medicine: Oxford University Press; 2017.
Onchoke VB, Banturaki A, Onyanga N, Nganda P, Munyambalu DK, Lagoro CA, et al. Prevalence of hyperuricemia, associated factors and its effect on risk of coronary artery disease among out-patients with Diabetes Mellitus in Uganda. Preprint, 2023. https://doi.org/10.21203/rs.3.rs-2613282/v1
Ying X, Wang K, Jia Z, Xu T, Xu Q, Zhang C, et al. Zurampic protects pancreatic ?-cells from high uric acid induced-damage by inhibiting URAT1 and inactivating the ROS/AMPK/ERK pathways. Cell Physiol Biochem 2018;47(3):1074–83.
Raja S, Kumar A, Aahooja RD, Thakuria U, Ochani S, Shaukat F. Frequency of hyperuricemia and its risk factors in the adult population. Cureus 2019;11(3). Cureus 11(3):e4198. DOI 10.7759/cureus.4198.
Ali G, Kamran MA, Amir M, Mumtaz B, Khan I, Tariq M. Frequency of hyperuricemia in type-2 diabetes mellites and its relation with diabetic nephropathy. Pak Armed Forces Med J 2023;73(1):199–203.
Beniwal S. Assessment of hyperuricemia among type 2 diabetes mellitus patients. Int J Med Sci Educ 2021;8(4):7–10.
Jiang J, Zhang T, Liu Y, Chang Q, Zhao Y, Guo C, et al. Prevalence of diabetes in patients with hyperuricemia and gout: A systematic review and meta-analysis. Curr Diabetes Rep 2023;1–15.
Eckenstaler R, Benndorf RA. The role of ABCG2 in the pathogenesis of primary hyperuricemia and gout—An update. Int J Molec Sci 2021;22(13):6678.
Zhang C, Li L, Zhang Y, Zeng C. Recent advances in fructose intake and risk of hyperuricemia. Biomed Pharmacother 2020;131:110795.
Ghasemi A. Uric acid?induced pancreatic ?-cell dysfunction. BMC Endocrine Disorders 2021;21(1):1–5.
Ji P, Zhu J, Feng J, Li H, Yu Q, Qin H, et al. Serum uric acid levels and diabetic kidney disease in patients with type 2 diabetes mellitus: A dose-response meta-analysis. Primary Care Diabetes 2022;16(3):457–65.
Mende C. Management of chronic kidney disease: the relationship between serum uric acid and development of nephropathy. Adv Therapy 2015;32:1177–91.
Singh SK, Singh R, Singh SK, Iquebal MA, Jaiswal S, Rai PK. Uric acid and diabetes mellitus: an update. Postgrad Med J 2023;99(1178):1220–5.
Wang W, Li W, Duan H, Xu C, Tian X, Li S, et al. Mediation by DNA methylation on the association of BMI and serum uric acid in Chinese monozygotic twins. Gene 2023;850:146957.
Su H, Liu T, Li Y, Fan Y, Wang B, Liu M, et al. Serum uric acid and its change with the risk of type 2 diabetes: A prospective study in China. Primary Care Diabetes 2021;15(6):1002–6.
Yu W, Xie D, Yamamoto T, Koyama H, Cheng J. Mechanistic insights of soluble uric acid-induced insulin resistance: Insulin signaling and beyond. Rev Endocrine Metabol Dis 2023:1–17.
Yuan H, Hu Y, Zhu Y, Zhang Y, Luo C, Li Z, et al. Metformin ameliorates high uric acid-induced insulin resistance in skeletal muscle cells. Molec Cell Endocrinol 2017;443:138–45.
Fernández?Chirino L, Antonio?Villa NE, Fermín?Martínez CA, Márquez?Salinas A, Guerra EC, Vargas?Vázquez A, et al. Elevated serum uric acid is a facilitating mechanism for insulin resistance mediated accumulation of visceral adipose tissue. Clin Endocrinol 2022;96(5):707–18.
Liu N, Xu H, Sun Q, Yu X, Chen W, Wei H, et al. The role of oxidative stress in hyperuricemia and xanthine oxidoreductase (XOR) inhibitors. Oxidative Med Cell Longevity 2021;2021. https://doi.org/10.1155/2021/1470380.
Lytvyn Y, Perkins BA, Cherney DZ. Uric acid as a biomarker and a therapeutic target in diabetes. Canad J Diabetes 2015;39(3):239–46.
Saito Y, Tanaka A, Node K, Kobayashi Y. Uric acid and cardiovascular disease: a clinical review. J Cardiol 2021;78(1):51–7.
Xiong Q, Liu J, Xu Y. Effects of uric acid on diabetes mellitus and its chronic complications. Int J Endocrinol 2019;2019.
Copur S, Demiray A, Kanbay M. Uric acid in metabolic syndrome: Does uric acid have a definitive role? Eur J Int Med 2022.4–12.
Galán I, Goicoechea M, Quiroga B, Macías N, Santos A, de Vinuesa MSG, et al. Hyperuricemia is associated with progression of chronic kidney disease in patients with reduced functioning kidney mass. Nefrologia 2018;38(1):73–8.
Madonna R, Pieragostino D, Balistreri CR, Rossi C, Geng Y-J, Del Boccio P, et al. Diabetic macroangiopathy: Pathogenetic insights and novel therapeutic approaches with focus on high glucose-mediated vascular damage. Vasc Pharmacol 2018;107:27–34.
El Ridi R, Tallima H. Physiological functions and pathogenic potential of uric acid: A review. J Adv Res 2017;8(5):487–93.
Estiverne C, Mandal AK, Mount DB. Molecular pathophysiology of uric acid homeostasis. Seminars in Nephrology 2020;40(6):535–49. https://doi.org/10.1016/j.semnephrol.2020.12.006.
Hu Y, Li Q, Min R, Deng Y, Xu Y, Gao L. The association between serum uric acid and diabetic complications in patients with type 2 diabetes mellitus by gender: a cross-sectional study. PeerJ 2021;9:e10691.
Dório M, Benseñor IM, Lotufo P, Santos IS, Fuller R. Reference range of serum uric acid and prevalence of hyperuricemia: a cross-sectional study from baseline data of ELSA-Brasil cohort. Adv Rheumatol 2022;62.
Tai S, Li X, Zhu Z, Tang L, Yang H, Fu L, et al. Hyperuricemia is a risk factor for one-year overall survival in elderly female patients with acute coronary syndrome. Cardiovascular Therapeutics 2020;2020.
Kafi F, Yousefi P, Bakhshaei S, Pouramini A, Bakhshaei B, Reddy S, et al. Role of hyperuricemia in cardiovascular disease and its treatment options: A review article. J Parathyroid Disease 2023;11:e11174.
Hisatome I, Li P, Miake J, Taufiq F, Mahati E, Maharani N, et al. Uric acid as a risk factor for chronic kidney disease and cardiovascular disease –Japanese guideline on the management of asymptomatic hyperuricemia. Circ J 2021;85(2):130–8.
Han Y, Wang S, Zhao H, Cao Y, Han X, Di H, et al. Lower serum uric acid levels may lower the incidence of diabetic chronic complications in US adults aged 40 and over. J Clin Med 2023;12(2):725.
Gliozzi M, Malara N, Muscoli S, Mollace V. The treatment of hyperuricemia. Int J Cardiol 2016;213:23–7.
Lee SJ, Oh BK, Sung K-C. Uric acid and cardiometabolic diseases. Clin Hyperten 2020;26:1–7.
Yuan H-J, Yang X-G, Shi X-Y, Rui T, Zhao Z-G. Association of serum uric acid with different levels of glucose and related factors. Chinese Med J 2011;124(10):1443–8.
Hidayat MF, Syafril S, Lindarto D. Elevated uric acid level decreases glycated hemoglobin in type 2 diabetes mellitus. Universa Medicina 2014;33(3):199–204.
Xue B, Tan JB, Ning F, Sun JP, Zhang KY, Liu L, et al. Association between serum uric acid and prevalence of type 2 diabetes diagnosed using HbA1c criteria among Chinese adults in Qingdao, China. Biomed Environ Sci: BES 2015;28(12):884–93.
Wei F, Chang B, Yang X, Wang Y, Chen L, Li W-D. Serum uric acid levels were dynamically coupled with hemoglobin A1c in the development of type 2 diabetes. Sci Rep 2016;6(1):28549.
Neupane S, Dubey RK, Gautam N, Agrawal KK, Jayan A, Shrestha S, et al. Association between serum uric acid, urinary albumin excretion, and glycated hemoglobin in Type 2 diabetic patient. Niger Med J: J Niger Med Association 2016;57(2):119.
Cui Y, Bu H, Ma X, Zhao S, Li X, Lu S. The relation between serum uric acid and HbA1c is dependent upon hyperinsulinemia in patients with newly diagnosed type 2 diabetes mellitus. J Diabetes Res 2016;2016. https://doi.org/10.1155/2016/7184123.
Hussain A, Latiwesh OB, Ali F, Younis MYG, Alammari JA. Effects of body mass index, glycemic control, and hypoglycemic drugs on serum uric acid levels in type 2 diabetic patients. Cureus 2018;10(8):e3158.
Kawamoto R, Ninomiya D, Kasai Y, Senzaki K, Kusunoki T, Ohtsuka N, et al. Interaction between gender and uric acid on hemoglobin A1c in community-dwelling persons. J Endocrinol Invest 2018;41:421–9.
Donkeng M, Kuaté D, Koudjou PN, Noubiap JJ, Kuiate JR. Association between hyperuricemia and glycated hemoglobin in type 2 diabetes at the District Hospital of Dschang. Pan African Med J 2021;40.
Samin KA, Ullah K, Shah MI, Ansari A, Khalil S. A study on serum uric acid level in type II diabetes mellitus. Pak J Med Health Sci 2021;15(7):2317.
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 Metabol Synd 2022;14(1):1–11.
Dhungana A, Pandeya A, Pant S, Pokharel BR. Evaluation of serum uric acid, glucose and other glycemic parameter in type II diabetic individuals. J Chitwan Med Coll 2022;12(2):68–73.
Singh SK, Singh R, Singh SK. Prevalence of hypouricemia and hyperuricemia and looking beyond serum uric acid in patients with newly onset type 2 diabetes mellitus in eastern part of Uttar Pradesh: A cross-sectional study. J Association Physicians Ind 2023;71(5):11–2.
Choi HK, McCormick N, Lu N, Rai SK, Yokose C, Zhang Y. Population impact attributable to modifiable risk factors for hyperuricemia. Arth Rheumatol 2020;72(1):157–65.
Keenan RT, (Ed). The Biology of Urate. In: Seminars in Arthritis and Rheumatism; 2020: Elsevier.
Naseem R, Zafar SMA-F, Jawed S, Mukhtar S, Ijaz F, Aftab RK. Influence of serum estradiol on serum uric acid level in pre and postmenopausal women. Professional Med J 2019;26(9):1587–91.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Pakistan Journal of Physiology
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Pakistan Journal of Physiology, Pak J Physiol, PJP is FREE for research and academic purposes. It can be freely downloaded and stored, printed, presented, cited and quoted with full reference of, and acknowledgement to the PJP.
