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Published in: Current Hypertension Reports 9/2017

01-09-2017 | Hypertension and the Kidney (RM Carey, Section Editor)

Hyperuricemia, Type 2 Diabetes Mellitus, and Hypertension: an Emerging Association

Author: Ibrahim Mortada

Published in: Current Hypertension Reports | Issue 9/2017

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Abstract

Uric acid is the final oxidation product of purine metabolism in circulation and has been associated with the occurrence of gout and kidney stones. Type 2 diabetes mellitus and hypertension are two important public health challenges, and both are linked to increased risk of cardiovascular events. Hyperuricemia has recently emerged as an independent risk factor in the development of type 2 diabetes mellitus and hypertension through several proposed mechanisms. Few clinical trials investigated the use of uric acid lowering agents in the management of these two disease entities; however, their results provided encouraging evidence to a potential role for these agents in fighting disease burden. Larger randomized controlled trials are therefore warranted to establish the role of uric acid as a promising target for novel therapeutic interventions in the management of type 2 diabetes mellitus and hypertension.
Literature
1.
go back to reference Rock KL, Kataoka H, Lai J-J. Uric acid as a danger signal in gout and its comorbidities. Nat Rev Rheumatol. 2013;9(1):13–23.CrossRefPubMed Rock KL, Kataoka H, Lai J-J. Uric acid as a danger signal in gout and its comorbidities. Nat Rev Rheumatol. 2013;9(1):13–23.CrossRefPubMed
3.
go back to reference Aung T, Myung G, FitzGerald JD. Treatment approaches and adherence to urate-lowering therapy for patients with gout. Patient Prefer Adherence. 2017;11:795–800.CrossRefPubMedPubMedCentral Aung T, Myung G, FitzGerald JD. Treatment approaches and adherence to urate-lowering therapy for patients with gout. Patient Prefer Adherence. 2017;11:795–800.CrossRefPubMedPubMedCentral
6.
go back to reference Pradeepa R, Mohan V. Prevalence of type 2 diabetes and its complications in India and economic costs to the nation. Eur J Clin Nutr. 2017;71(7):816–24.CrossRefPubMed Pradeepa R, Mohan V. Prevalence of type 2 diabetes and its complications in India and economic costs to the nation. Eur J Clin Nutr. 2017;71(7):816–24.CrossRefPubMed
7.
go back to reference Wang C, et al. Quercetin and allopurinol ameliorate kidney injury in STZ-treated rats with regulation of renal NLRP3 inflammasome activation and lipid accumulation. PLoS One. 2012;7(6):e38285.CrossRefPubMedPubMedCentral Wang C, et al. Quercetin and allopurinol ameliorate kidney injury in STZ-treated rats with regulation of renal NLRP3 inflammasome activation and lipid accumulation. PLoS One. 2012;7(6):e38285.CrossRefPubMedPubMedCentral
8.
go back to reference Rock KL, Kataoka H, Lai JJ. Uric acid as a danger signal in gout and its comorbidities. Nat Rev Rheumatol. 2013;9(1):13–23.CrossRefPubMed Rock KL, Kataoka H, Lai JJ. Uric acid as a danger signal in gout and its comorbidities. Nat Rev Rheumatol. 2013;9(1):13–23.CrossRefPubMed
9.
go back to reference • Jalal DI, et al. Uric acid as a target of therapy in CKD. American journal of kidney diseases : the official journal of the National Kidney Foundation. 2013;61(1):134–46. A review focusing on uric acid as a potential therapeutic target to prevent kidney disease onset and progression. CrossRef • Jalal DI, et al. Uric acid as a target of therapy in CKD. American journal of kidney diseases : the official journal of the National Kidney Foundation. 2013;61(1):134–46. A review focusing on uric acid as a potential therapeutic target to prevent kidney disease onset and progression. CrossRef
10.
go back to reference Maiuolo J, et al. Regulation of uric acid metabolism and excretion. Int J Cardiol. 2016;213:8–14.CrossRefPubMed Maiuolo J, et al. Regulation of uric acid metabolism and excretion. Int J Cardiol. 2016;213:8–14.CrossRefPubMed
15.
16.
go back to reference Terkeltaub R. Update on gout: new therapeutic strategies and options. Nat Rev Rheumatol. 2010;6(1):30–8.CrossRefPubMed Terkeltaub R. Update on gout: new therapeutic strategies and options. Nat Rev Rheumatol. 2010;6(1):30–8.CrossRefPubMed
17.
go back to reference •• Li L, et al. Is hyperuricemia an independent risk factor for new-onset chronic kidney disease?: a systematic review and meta-analysis based on observational cohort studies. BMC Nephrol. 2014;15:122. This systematic review and meta-analysis shows that elevated serum uric acid levels showed an increased risk for the development of chronic renal dysfunction. CrossRefPubMedPubMedCentral •• Li L, et al. Is hyperuricemia an independent risk factor for new-onset chronic kidney disease?: a systematic review and meta-analysis based on observational cohort studies. BMC Nephrol. 2014;15:122. This systematic review and meta-analysis shows that elevated serum uric acid levels showed an increased risk for the development of chronic renal dysfunction. CrossRefPubMedPubMedCentral
18.
go back to reference Lapi F, et al. Concurrent use of diuretics, angiotensin converting enzyme inhibitors, and angiotensin receptor blockers with non-steroidal anti-inflammatory drugs and risk of acute kidney injury: nested case-control study. BMJ : British Medical Journal. 2013;346:e8525.CrossRefPubMedPubMedCentral Lapi F, et al. Concurrent use of diuretics, angiotensin converting enzyme inhibitors, and angiotensin receptor blockers with non-steroidal anti-inflammatory drugs and risk of acute kidney injury: nested case-control study. BMJ : British Medical Journal. 2013;346:e8525.CrossRefPubMedPubMedCentral
19.
go back to reference Zhu J-N, et al. Dietary factors associated with hyperuricemia and glycolipid metabolism disorder in middle-aged and elderly people. Sichuan da xue xue bao Yi xue ban = Journal of Sichuan University Medical science edition. 2016;47(1):68–72.PubMed Zhu J-N, et al. Dietary factors associated with hyperuricemia and glycolipid metabolism disorder in middle-aged and elderly people. Sichuan da xue xue bao Yi xue ban = Journal of Sichuan University Medical science edition. 2016;47(1):68–72.PubMed
20.
go back to reference Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007–2008. Arthritis Rheum. 2011;63(10):3136–41.CrossRefPubMed Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007–2008. Arthritis Rheum. 2011;63(10):3136–41.CrossRefPubMed
21.
go back to reference Anton FM, et al. Sex differences in uric acid metabolism in adults: evidence for a lack of influence of estradiol-17 beta (E2) on the renal handling of urate. Metabolism. 1986;35(4):343–8.CrossRefPubMed Anton FM, et al. Sex differences in uric acid metabolism in adults: evidence for a lack of influence of estradiol-17 beta (E2) on the renal handling of urate. Metabolism. 1986;35(4):343–8.CrossRefPubMed
22.
go back to reference Hak AE, Choi HK. Menopause, postmenopausal hormone use and serum uric acid levels in US women—the Third National Health and Nutrition Examination Survey. Arthritis Res Ther. 2008;10(5):R116.CrossRefPubMedPubMedCentral Hak AE, Choi HK. Menopause, postmenopausal hormone use and serum uric acid levels in US women—the Third National Health and Nutrition Examination Survey. Arthritis Res Ther. 2008;10(5):R116.CrossRefPubMedPubMedCentral
23.
go back to reference •• Lv Q, et al. High serum uric acid and increased risk of type 2 diabetes: a systemic review and meta-analysis of prospective cohort studies. PLoS One. 2013;8(2):e56864. This meta-analysis of prospective cohort studies provides strong evidence that high level of serum uric acid is independent of other established risk factors, for developing type 2 diabetes in middle-aged and older people. CrossRefPubMedPubMedCentral •• Lv Q, et al. High serum uric acid and increased risk of type 2 diabetes: a systemic review and meta-analysis of prospective cohort studies. PLoS One. 2013;8(2):e56864. This meta-analysis of prospective cohort studies provides strong evidence that high level of serum uric acid is independent of other established risk factors, for developing type 2 diabetes in middle-aged and older people. CrossRefPubMedPubMedCentral
24.
go back to reference Jia Z, et al. Serum uric acid levels and incidence of impaired fasting glucose and type 2 diabetes mellitus: a meta-analysis of cohort studies. Diabetes Res Clin Pract. 2013;101(1):88–96.CrossRefPubMed Jia Z, et al. Serum uric acid levels and incidence of impaired fasting glucose and type 2 diabetes mellitus: a meta-analysis of cohort studies. Diabetes Res Clin Pract. 2013;101(1):88–96.CrossRefPubMed
25.
go back to reference Kim SC, Liu J, Solomon DH. Risk of incident diabetes in patients with gout: a cohort study. Arthritis & rheumatology (Hoboken, NJ). 2015;67(1):273–80.CrossRef Kim SC, Liu J, Solomon DH. Risk of incident diabetes in patients with gout: a cohort study. Arthritis & rheumatology (Hoboken, NJ). 2015;67(1):273–80.CrossRef
26.
go back to reference Liu Y, et al. Serum uric acid levels and the risk of impaired fasting glucose: a prospective study in adults of north China. PLoS One. 2013;8(12):e84712.CrossRefPubMedPubMedCentral Liu Y, et al. Serum uric acid levels and the risk of impaired fasting glucose: a prospective study in adults of north China. PLoS One. 2013;8(12):e84712.CrossRefPubMedPubMedCentral
27.
go back to reference Lee S-H, Kim K-M, Kim K-N. Combined effect of serum gamma-glutamyltransferase and uric acid on incidence of diabetes mellitus: a longitudinal study. Medicine. 2017;96(19):e6901.CrossRefPubMedPubMedCentral Lee S-H, Kim K-M, Kim K-N. Combined effect of serum gamma-glutamyltransferase and uric acid on incidence of diabetes mellitus: a longitudinal study. Medicine. 2017;96(19):e6901.CrossRefPubMedPubMedCentral
28.
go back to reference Krishnan E, et al. Relative and attributable diabetes risk associated with hyperuricemia in US veterans with gout. QJM: An International Journal of Medicine. 2013;106(8):721–9.CrossRef Krishnan E, et al. Relative and attributable diabetes risk associated with hyperuricemia in US veterans with gout. QJM: An International Journal of Medicine. 2013;106(8):721–9.CrossRef
29.
go back to reference Maahs DM, et al. Uric acid lowering to prevent kidney function loss in diabetes: the preventing early renal function loss (PERL) allopurinol study. Curr Diab Rep. 2013;13(4):550–9.CrossRefPubMedPubMedCentral Maahs DM, et al. Uric acid lowering to prevent kidney function loss in diabetes: the preventing early renal function loss (PERL) allopurinol study. Curr Diab Rep. 2013;13(4):550–9.CrossRefPubMedPubMedCentral
31.
go back to reference Matsuoka T, et al. Glycation-dependent, reactive oxygen species-mediated suppression of the insulin gene promoter activity in HIT cells. J Clin Investig. 1997;99(1):144–50.CrossRefPubMedPubMedCentral Matsuoka T, et al. Glycation-dependent, reactive oxygen species-mediated suppression of the insulin gene promoter activity in HIT cells. J Clin Investig. 1997;99(1):144–50.CrossRefPubMedPubMedCentral
32.
go back to reference Liu P, et al. The effects of allopurinol on the carotid intima-media thickness in patients with type 2 diabetes and asymptomatic hyperuricemia: a three-year randomized parallel-controlled study. Intern Med. 2015;54(17):2129–37.CrossRefPubMed Liu P, et al. The effects of allopurinol on the carotid intima-media thickness in patients with type 2 diabetes and asymptomatic hyperuricemia: a three-year randomized parallel-controlled study. Intern Med. 2015;54(17):2129–37.CrossRefPubMed
33.
go back to reference Takir M, et al. Lowering uric acid with allopurinol improves insulin resistance and systemic inflammation in asymptomatic hyperuricemia. J Investig Med. 2015;63(8):924–9.CrossRefPubMed Takir M, et al. Lowering uric acid with allopurinol improves insulin resistance and systemic inflammation in asymptomatic hyperuricemia. J Investig Med. 2015;63(8):924–9.CrossRefPubMed
34.
go back to reference El-Bassossy HM, et al. Ameliorative effect of allopurinol on vascular complications of insulin resistance. Journal of Diabetes Research. 2015;2015:10.CrossRef El-Bassossy HM, et al. Ameliorative effect of allopurinol on vascular complications of insulin resistance. Journal of Diabetes Research. 2015;2015:10.CrossRef
35.
go back to reference •• Grayson PC, et al. Hyperuricemia and incident hypertension: a systematic review and meta-analysis. Arthritis Care Res (Hoboken). 2011;63(1):102–10. This systematic review and meta-analysis show that hyperuricemia is associated with an increased risk for incident hypertension, independent of traditional hypertension risk factors. CrossRef •• Grayson PC, et al. Hyperuricemia and incident hypertension: a systematic review and meta-analysis. Arthritis Care Res (Hoboken). 2011;63(1):102–10. This systematic review and meta-analysis show that hyperuricemia is associated with an increased risk for incident hypertension, independent of traditional hypertension risk factors. CrossRef
36.
go back to reference Komendarek-Kowalska M. The assessment of renal function in patients with newly diagnosed hypertension—the role of hyperuricemia as a risk factor for chronic kidney disease—preliminary study. Pol Merkur Lekarski. 2017;42(251):193–6.PubMed Komendarek-Kowalska M. The assessment of renal function in patients with newly diagnosed hypertension—the role of hyperuricemia as a risk factor for chronic kidney disease—preliminary study. Pol Merkur Lekarski. 2017;42(251):193–6.PubMed
37.
go back to reference Perlstein TS, et al. Uric acid and the development of hypertension: the normative aging study. Hypertension. 2006;48(6):1031–6.CrossRefPubMed Perlstein TS, et al. Uric acid and the development of hypertension: the normative aging study. Hypertension. 2006;48(6):1031–6.CrossRefPubMed
38.
go back to reference Cicero AF, et al. Association between serum uric acid, hypertension, vascular stiffness and subclinical atherosclerosis: data from the Brisighella Heart Study. J Hypertens. 2014;32(1):57–64.CrossRefPubMed Cicero AF, et al. Association between serum uric acid, hypertension, vascular stiffness and subclinical atherosclerosis: data from the Brisighella Heart Study. J Hypertens. 2014;32(1):57–64.CrossRefPubMed
39.
go back to reference • Mazzali M, et al. Elevated uric acid increases blood pressure in the rat by a novel crystal-independent mechanism. Hypertension. 2001;38(5):1101–6. The study reveals that elevated uric acid increases blood pressure in the rat by a novel crystal-independent mechanism. CrossRefPubMed • Mazzali M, et al. Elevated uric acid increases blood pressure in the rat by a novel crystal-independent mechanism. Hypertension. 2001;38(5):1101–6. The study reveals that elevated uric acid increases blood pressure in the rat by a novel crystal-independent mechanism. CrossRefPubMed
40.
go back to reference Yu MA, et al. Oxidative stress with an activation of the renin-angiotensin system in human vascular endothelial cells as a novel mechanism of uric acid-induced endothelial dysfunction. J Hypertens. 2010;28(6):1234–42.PubMed Yu MA, et al. Oxidative stress with an activation of the renin-angiotensin system in human vascular endothelial cells as a novel mechanism of uric acid-induced endothelial dysfunction. J Hypertens. 2010;28(6):1234–42.PubMed
41.
go back to reference •• Feig DI, Soletsky B, Johnson RJ. Effect of allopurinol on blood pressure of adolescents with newly diagnosed essential hypertension: a randomized trial. JAMA. 2008;300(8):924–32. This randomized trial shows that treatment with allopurinol reduces blood pressure in adolescents with newly diagnosed hypertension. CrossRefPubMedPubMedCentral •• Feig DI, Soletsky B, Johnson RJ. Effect of allopurinol on blood pressure of adolescents with newly diagnosed essential hypertension: a randomized trial. JAMA. 2008;300(8):924–32. This randomized trial shows that treatment with allopurinol reduces blood pressure in adolescents with newly diagnosed hypertension. CrossRefPubMedPubMedCentral
42.
go back to reference Soletsky B, Feig DI. Uric acid reduction rectifies prehypertension in obese adolescents. Hypertension. 2012;60(5):1148–56.CrossRefPubMed Soletsky B, Feig DI. Uric acid reduction rectifies prehypertension in obese adolescents. Hypertension. 2012;60(5):1148–56.CrossRefPubMed
43.
go back to reference •• Kanbay M, et al. Effect of treatment of hyperuricemia with allopurinol on blood pressure, creatinine clearence, and proteinuria in patients with normal renal functions. Int Urol Nephrol. 2007;39(4):1227–33. This study brings indirect evidence that management of hyperuricemia may prevent the progression of renal disease, even in patients with normal renal function. CrossRefPubMed •• Kanbay M, et al. Effect of treatment of hyperuricemia with allopurinol on blood pressure, creatinine clearence, and proteinuria in patients with normal renal functions. Int Urol Nephrol. 2007;39(4):1227–33. This study brings indirect evidence that management of hyperuricemia may prevent the progression of renal disease, even in patients with normal renal function. CrossRefPubMed
Metadata
Title
Hyperuricemia, Type 2 Diabetes Mellitus, and Hypertension: an Emerging Association
Author
Ibrahim Mortada
Publication date
01-09-2017
Publisher
Springer US
Published in
Current Hypertension Reports / Issue 9/2017
Print ISSN: 1522-6417
Electronic ISSN: 1534-3111
DOI
https://doi.org/10.1007/s11906-017-0770-x

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