Research Article
BibTex RIS Cite

Evaluation of Serum Uric Acid Level in Type 1 Diabetes Mellitus Patients and Investigation of the Relationship Between Uric Acid Level and Microvascular Complications

Year 2021, Volume: 47 Issue: 1, 85 - 89, 01.04.2021
https://doi.org/10.32708/uutfd.893970

Abstract

Type 1 diabetes mellitus (T1DM) is a chronic metabolic disease that develops due to damage to beta cells in the pancreas and is characterized by insulin deficiency. Nephropathy, retinopathy, and neuropathy are known microvascular complications of diabetes. There are few studies evaluating serum uric acid (SUA) levels in T1DM patients, and the relationship of SUA level with microvascular complications is controversial. In the current study, we aimed to evaluate the SUA level in T1DM patients and investigate the relationship between SUA and microvascular complications. The present study was conducted by retrospectively evaluating the files of 160 patients and 85 healthy controls who followed up with a diagnosis of T1DM over the age of 18. The SUA level was lower in T1DM patients than in the control group (p: 0.035), and a negative correlation was found between the SUA level and HbA1c (r:-0.172, p: 0.03). There was a positive correlation between SUA and creatinine level (r: 0.269, p: 0.001). The SUA level was found to be higher in patients with nephropathy regardless of the duration of diabetes (r2: 0.185, p: 0.027). Elevated SUA level was not found as an independent risk factor in patients with neuropathy and retinopathy. In conclusion, although there was a lower SUA level in T1DM patients than in the control group, SUA level was elevated in patients with diabetic nephropathy. Further prospective studies are required to determine whether elevated SUA level is a risk factor for the development of diabetic nephropathy.

References

  • 1. IDF Atlas 9th edition and other resources [Internet]. [a.yer 28 Kasım 2020]. Erişim adresi: https://www.diabetesatlas. org/en/resources/.
  • 2. Ali N, Perveen R, Rahman S, et al. Prevalence of hyperurice-mia and the relationship between serum uric acid and obesity: A study on Bangladeshi adults. PloS One 2018;13(11):e0206850.
  • 3. Remedios C, Shah M, Bhasker AG, Lakdawala M. Hyperuri-cemia: a reality in the Indian obese. Obes Surg 2012;22(6):945–8.
  • 4. Saito Y, Kitahara H, Nakayama T, Fujimoto Y, Kobayashi Y. Relation of Elevated Serum Uric Acid Level to Endothelial Dysfunction in Patients with Acute Coronary Syndrome. J At-heroscler Thromb 2019;26(4):362–7.
  • 5. Pizarro MH, Santos DC, Barros BSV, de Melo LGN, Gomes MB. Serum uric acid and renal function in patients with type 1 diabetes: a nationwide study in Brazil. Diabetol Metab Syndr 2018;10:22.
  • 6. Bhole V, Choi JWJ, Kim SW, de Vera M, Choi H. Serum uric acid levels and the risk of type 2 diabetes: a prospective study. Am J Med 2010;123(10):957–61.
  • 7. Dehghan A, van Hoek M, Sijbrands EJG, Hofman A, Witteman JCM. High Serum Uric Acid as a Novel Risk Factor for Type 2 Diabetes. Diabetes Care 2008;31(2):361–2.
  • 8. Pilemann-Lyberg S, Hansen TW, Tofte N, et al. Uric Acid Is an Independent Risk Factor for Decline in Kidney Function, Car-diovascular Events, and Mortality in Patients With Type 1 Dia-betes. Diabetes Care 2019;42(6):1088–94.
  • 9. Ahola AJ, Sandholm N, Forsblom C, Harjutsalo V, Dahlström E, Groop P-H. The serum uric acid concentration is not causally linked to diabetic nephropathy in type 1 diabetes. Kidney Int 2017;91(5):1178–85.
  • 10. Lytvyn Y, Mahmud FH, Daneman D, et al. Association Between Plasma Uric Acid Levels and Cardiorenal Function in Adolescents With Type 1 Diabetes. Diabetes Care 2016;39(4):611–6.
  • 11. Melo LGN, Morales PH, Drummond KRG, et al. Current epidemiology of diabetic retinopathy in patients with type 1 diabetes: a national multicenter study in Brazil. BMC Public He-alth 2018;18(1):989.
  • 12. American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2021. Di-abetes Care 2021;44(Supplement 1):S15–33.
  • 13. Pilemann-Lyberg S, Hansen TW, Persson F, et al. Uric acid is not associated with diabetic nephropathy and other complicati-ons in type 1 diabetes. Nephrol Dial Transplant 2019;34(4):659–66.
  • 14. Bjornstad P, Snell-Bergeon JK, McFann K, et al. Serum uric acid and insulin sensitivity in adolescents and adults with and without type 1 diabetes. J Diabetes Complications 2014;28(3):298–304.
  • 15. Nan H, Dong Y, Gao W, Tuomilehto J, Qiao Q. Diabetes associated with a low serum uric acid level in a general Chinese population. Diabetes Res Clin Pract 2007;76(1):68–74.
  • 16. Erdberg A, Boner G, van Dyk DJ, Carel R. Urine uric acid excretion in patients with insulin-dependent diabetes mellitus. Nephron 1992;60(2):134–7.
  • 17. Rodríguez G, Soriano LC, Choi HK. Impact of diabetes against the future risk of developing gout. Ann Rheum Dis 2010;69(12):2090–4.
  • 18. Bjornstad P, Maahs DM, Rivard CJ, et al. Serum uric acid predicts vascular complications in adults with type 1 diabetes: the coronary artery calcification in type 1 diabetes study. Acta Diabetol 2014;51(5):783–91.
  • 19. Yu S, Chen Y, Hou X, et al. Serum Uric Acid Levels and Diabetic Peripheral Neuropathy in Type 2 Diabetes: a Systema-tic Review and Meta-analysis. Mol Neurobiol 2016;53(2):1045–51.
  • 20. Jiang T-N, Li Y-F, Huo L-L, et al. Association between serum uric acid and large-nerve fiber dysfunction in type 2 diabetes: a cross-sectional study. Chin Med J (Engl) 2019;132(9):1015–22.
  • 21. 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.

Tip 1 Diabetes Mellitus Hastalarında Serum Ürik Asit Düzeyinin Değerlendirilmesi ve Ürik Asit Düzeyinin Mikrovasküler Komplikasyonlar ile İlişkisinin İncelenmesi

Year 2021, Volume: 47 Issue: 1, 85 - 89, 01.04.2021
https://doi.org/10.32708/uutfd.893970

Abstract

Tip 1 diabetes mellitus (T1DM) pankreasta bulunan beta hücrelerinin hasarı sonucu gelişen ve insülin eksikliği ile karakterize kronik metabolik bir hastalıktır. Nefropati, retinopati ve nöropati diyabetin bilinen mikrovasküler komplikasyonlarıdır. T1DM hastalarında serum ürik asit (SÜA) düzeyini değerlendiren az sayıda çalışma mevcuttur ve SÜA düzeyinin mikrovasküler komplikasyonlar ile ilişkisi tartışmalıdır. Bu çalışmada T1DM hastalarında SÜA düzeyini değerlendirmeyi ve SÜA düzeyinin mikrovasküler komplikasyonlar ile ilişkisini incelemeyi amaçladık. Bu çalışma 18 yaşından büyük T1DM tanısı ile takipli 160 hastanın ve 85 sağlıklı kontrolün dosyalarının retrospektif değerlendirilmesi ile yapıldı. T1DM hastalarında kontrol grubuna göre SÜA düzeyi düşük bulundu (p:0.035) ve SÜA düzeyi ile HbA1c arasında negatif kolerasyon saptandı (r:-0.172, p:0.03). SÜA ile kreatinin düzeyi arasında pozitif kolerasyon saptandı (r:0.269, p:0.001). Nefropati gelişen hastalarda SÜA düzeyi diyabet süresinden bağımsız olarak yüksek saptanırken (r2:0.185, p:0.027) nöropati ve retinopatisi mevcut olan hastalarda SÜA yüksekliği bağımsız bir risk faktörü olarak saptanmadı. Sonuç olarak T1DM hastalarında kontrol grubuna göre daha düşük SÜA düzeyi bulunmasına rağmen diyabetik nefropati gelişen hastalarda SÜA düzeyinin yüksek olduğu saptandı. Yüksek SÜA düzeyinin diyabetik nefropati gelişiminde risk faktörü olup olmadığını belirlemek için daha ileri prospektif çalışmalar gereklidir.

References

  • 1. IDF Atlas 9th edition and other resources [Internet]. [a.yer 28 Kasım 2020]. Erişim adresi: https://www.diabetesatlas. org/en/resources/.
  • 2. Ali N, Perveen R, Rahman S, et al. Prevalence of hyperurice-mia and the relationship between serum uric acid and obesity: A study on Bangladeshi adults. PloS One 2018;13(11):e0206850.
  • 3. Remedios C, Shah M, Bhasker AG, Lakdawala M. Hyperuri-cemia: a reality in the Indian obese. Obes Surg 2012;22(6):945–8.
  • 4. Saito Y, Kitahara H, Nakayama T, Fujimoto Y, Kobayashi Y. Relation of Elevated Serum Uric Acid Level to Endothelial Dysfunction in Patients with Acute Coronary Syndrome. J At-heroscler Thromb 2019;26(4):362–7.
  • 5. Pizarro MH, Santos DC, Barros BSV, de Melo LGN, Gomes MB. Serum uric acid and renal function in patients with type 1 diabetes: a nationwide study in Brazil. Diabetol Metab Syndr 2018;10:22.
  • 6. Bhole V, Choi JWJ, Kim SW, de Vera M, Choi H. Serum uric acid levels and the risk of type 2 diabetes: a prospective study. Am J Med 2010;123(10):957–61.
  • 7. Dehghan A, van Hoek M, Sijbrands EJG, Hofman A, Witteman JCM. High Serum Uric Acid as a Novel Risk Factor for Type 2 Diabetes. Diabetes Care 2008;31(2):361–2.
  • 8. Pilemann-Lyberg S, Hansen TW, Tofte N, et al. Uric Acid Is an Independent Risk Factor for Decline in Kidney Function, Car-diovascular Events, and Mortality in Patients With Type 1 Dia-betes. Diabetes Care 2019;42(6):1088–94.
  • 9. Ahola AJ, Sandholm N, Forsblom C, Harjutsalo V, Dahlström E, Groop P-H. The serum uric acid concentration is not causally linked to diabetic nephropathy in type 1 diabetes. Kidney Int 2017;91(5):1178–85.
  • 10. Lytvyn Y, Mahmud FH, Daneman D, et al. Association Between Plasma Uric Acid Levels and Cardiorenal Function in Adolescents With Type 1 Diabetes. Diabetes Care 2016;39(4):611–6.
  • 11. Melo LGN, Morales PH, Drummond KRG, et al. Current epidemiology of diabetic retinopathy in patients with type 1 diabetes: a national multicenter study in Brazil. BMC Public He-alth 2018;18(1):989.
  • 12. American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2021. Di-abetes Care 2021;44(Supplement 1):S15–33.
  • 13. Pilemann-Lyberg S, Hansen TW, Persson F, et al. Uric acid is not associated with diabetic nephropathy and other complicati-ons in type 1 diabetes. Nephrol Dial Transplant 2019;34(4):659–66.
  • 14. Bjornstad P, Snell-Bergeon JK, McFann K, et al. Serum uric acid and insulin sensitivity in adolescents and adults with and without type 1 diabetes. J Diabetes Complications 2014;28(3):298–304.
  • 15. Nan H, Dong Y, Gao W, Tuomilehto J, Qiao Q. Diabetes associated with a low serum uric acid level in a general Chinese population. Diabetes Res Clin Pract 2007;76(1):68–74.
  • 16. Erdberg A, Boner G, van Dyk DJ, Carel R. Urine uric acid excretion in patients with insulin-dependent diabetes mellitus. Nephron 1992;60(2):134–7.
  • 17. Rodríguez G, Soriano LC, Choi HK. Impact of diabetes against the future risk of developing gout. Ann Rheum Dis 2010;69(12):2090–4.
  • 18. Bjornstad P, Maahs DM, Rivard CJ, et al. Serum uric acid predicts vascular complications in adults with type 1 diabetes: the coronary artery calcification in type 1 diabetes study. Acta Diabetol 2014;51(5):783–91.
  • 19. Yu S, Chen Y, Hou X, et al. Serum Uric Acid Levels and Diabetic Peripheral Neuropathy in Type 2 Diabetes: a Systema-tic Review and Meta-analysis. Mol Neurobiol 2016;53(2):1045–51.
  • 20. Jiang T-N, Li Y-F, Huo L-L, et al. Association between serum uric acid and large-nerve fiber dysfunction in type 2 diabetes: a cross-sectional study. Chin Med J (Engl) 2019;132(9):1015–22.
  • 21. 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.
There are 21 citations in total.

Details

Primary Language Turkish
Subjects Endocrinology
Journal Section Research Article
Authors

Murat Çalapkulu 0000-0002-7445-2275

Muhammed Erkam Sencar 0000-0001-5581-4886

İlknur Öztürk Ünsal 0000-0003-3999-6426

Seyit Bayram This is me 0000-0003-1459-5765

Davut Sakız 0000-0003-1480-888X

Mustafa Özbek 0000-0003-1125-3823

Erman Çakal 0000-0003-4455-7276

Publication Date April 1, 2021
Acceptance Date April 9, 2021
Published in Issue Year 2021 Volume: 47 Issue: 1

Cite

APA Çalapkulu, M., Sencar, M. E., Öztürk Ünsal, İ., Bayram, S., et al. (2021). Tip 1 Diabetes Mellitus Hastalarında Serum Ürik Asit Düzeyinin Değerlendirilmesi ve Ürik Asit Düzeyinin Mikrovasküler Komplikasyonlar ile İlişkisinin İncelenmesi. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 47(1), 85-89. https://doi.org/10.32708/uutfd.893970
AMA Çalapkulu M, Sencar ME, Öztürk Ünsal İ, Bayram S, Sakız D, Özbek M, Çakal E. Tip 1 Diabetes Mellitus Hastalarında Serum Ürik Asit Düzeyinin Değerlendirilmesi ve Ürik Asit Düzeyinin Mikrovasküler Komplikasyonlar ile İlişkisinin İncelenmesi. Uludağ Tıp Derg. April 2021;47(1):85-89. doi:10.32708/uutfd.893970
Chicago Çalapkulu, Murat, Muhammed Erkam Sencar, İlknur Öztürk Ünsal, Seyit Bayram, Davut Sakız, Mustafa Özbek, and Erman Çakal. “Tip 1 Diabetes Mellitus Hastalarında Serum Ürik Asit Düzeyinin Değerlendirilmesi Ve Ürik Asit Düzeyinin Mikrovasküler Komplikasyonlar Ile İlişkisinin İncelenmesi”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 47, no. 1 (April 2021): 85-89. https://doi.org/10.32708/uutfd.893970.
EndNote Çalapkulu M, Sencar ME, Öztürk Ünsal İ, Bayram S, Sakız D, Özbek M, Çakal E (April 1, 2021) Tip 1 Diabetes Mellitus Hastalarında Serum Ürik Asit Düzeyinin Değerlendirilmesi ve Ürik Asit Düzeyinin Mikrovasküler Komplikasyonlar ile İlişkisinin İncelenmesi. Uludağ Üniversitesi Tıp Fakültesi Dergisi 47 1 85–89.
IEEE M. Çalapkulu, M. E. Sencar, İ. Öztürk Ünsal, S. Bayram, D. Sakız, M. Özbek, and E. Çakal, “Tip 1 Diabetes Mellitus Hastalarında Serum Ürik Asit Düzeyinin Değerlendirilmesi ve Ürik Asit Düzeyinin Mikrovasküler Komplikasyonlar ile İlişkisinin İncelenmesi”, Uludağ Tıp Derg, vol. 47, no. 1, pp. 85–89, 2021, doi: 10.32708/uutfd.893970.
ISNAD Çalapkulu, Murat et al. “Tip 1 Diabetes Mellitus Hastalarında Serum Ürik Asit Düzeyinin Değerlendirilmesi Ve Ürik Asit Düzeyinin Mikrovasküler Komplikasyonlar Ile İlişkisinin İncelenmesi”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 47/1 (April 2021), 85-89. https://doi.org/10.32708/uutfd.893970.
JAMA Çalapkulu M, Sencar ME, Öztürk Ünsal İ, Bayram S, Sakız D, Özbek M, Çakal E. Tip 1 Diabetes Mellitus Hastalarında Serum Ürik Asit Düzeyinin Değerlendirilmesi ve Ürik Asit Düzeyinin Mikrovasküler Komplikasyonlar ile İlişkisinin İncelenmesi. Uludağ Tıp Derg. 2021;47:85–89.
MLA Çalapkulu, Murat et al. “Tip 1 Diabetes Mellitus Hastalarında Serum Ürik Asit Düzeyinin Değerlendirilmesi Ve Ürik Asit Düzeyinin Mikrovasküler Komplikasyonlar Ile İlişkisinin İncelenmesi”. Uludağ Üniversitesi Tıp Fakültesi Dergisi, vol. 47, no. 1, 2021, pp. 85-89, doi:10.32708/uutfd.893970.
Vancouver Çalapkulu M, Sencar ME, Öztürk Ünsal İ, Bayram S, Sakız D, Özbek M, Çakal E. Tip 1 Diabetes Mellitus Hastalarında Serum Ürik Asit Düzeyinin Değerlendirilmesi ve Ürik Asit Düzeyinin Mikrovasküler Komplikasyonlar ile İlişkisinin İncelenmesi. Uludağ Tıp Derg. 2021;47(1):85-9.

ISSN: 1300-414X, e-ISSN: 2645-9027

Uludağ Üniversitesi Tıp Fakültesi Dergisi "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License" ile lisanslanmaktadır.


Creative Commons License
Journal of Uludag University Medical Faculty is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

2023