Top

Published in:

Open Access 01-12-2011 | Original investigation

Serum uric acid level and its association with metabolic syndrome and carotid atherosclerosis in patients with type 2 diabetes

Authors: Qin Li, Zhen Yang, Bin Lu, Jie Wen, Zi Ye, Lili Chen, Min He, Xiaoming Tao, Weiwei Zhang, Ying Huang, Zhaoyun Zhang, Shen Qu, Renming Hu

Published in: Cardiovascular Diabetology | Issue 1/2011

Abstract

Objective

We aimed to investigate whether elevated serum uric acid concentrations are associated with higher risk of metabolic syndrome (MetS) and carotid atherosclerosis in patients with type 2 diabetes.

Methods

We conducted a population-based cross-sectional survey in Shanghai, with a total of 395 men and 631 women age 41 to 92 years. The carotid artery intima-media thickness (IMT) and carotid atherosclerotic plaques (PLQ) were measured by B-mode ultrasound. MetS was defined according to the updated National Cholesterol Education Program Adult Treatment Panel III criteria for Asian Americans.

Results

Uric acid levels were negatively associated with duration of diabetes, fasting plasma glucose, glycohemoglobin, eGFR, HDL-cholesterol (all P < 0.001) and positively with BMI, CRP, waist circumference, triglycerides, systolic blood pressure, ACR, HOMA-IR and IMT (all P < 0.05). In the highest quartile of uric acid levels, the risks were substantially higher for MetS [odds ratio 3.97, (95% confidence interval 2.58-6.13)] (P < 0.001 for trend) and PLQ [odds ratio 2.71 (95% confidence interval 1.62-4.47)] (p = 0.013 for trend) compared with that in the lowest quartile of uric acid levels after multiple adjustment. These associations remained significant after further adjustment for potential confounders.

Conclusions

Serum uric acid level is associated with MetS and is an independent risk factor for carotid atherosclerosis in patients with type 2 diabetes.

Available only for authorised users

Yamaoka-Tojo M, Tojo T, Takahira N, Matsunaga A, Aoyama N, Masuda T, Izumi T: Elevated circulating levels of an incretin hormone, glucagon-like peptide-1, are associated with metabolic components in high-risk patients with cardiovascular disease. Cardiovascular Diabetology. 2010, 9 (17).

Gu DF, Reynolds K, Wu XG, Chen F, Duan XF, Reynolds RF, Whelton PK, He J, Inter ACG: Prevalence of the metabolic syndrome and overweight among adults in China. Lancet. 2005, 365 (9468): 1398-1405. 10.1016/S0140-6736(05)66375-1.CrossRefPubMed

Moriarity JT, Folsom AR, Iribarren C, Nieto FJ, Rosamond WD: Serum Uric Acid and Risk of Coronary Heart Disease: Atherosclerosis Risk in Communities (ARIC) Study. Annals of Epidemiology. 2000, 10 (3): 136-143. 10.1016/S1047-2797(99)00037-X.CrossRefPubMed

So A, Thorens B: Uric acid transport and disease. Journal of Clinical Investigation. 2010, 120 (6): 1791-1799. 10.1172/JCI42344.PubMedCentralCrossRefPubMed

Koenig W, Meisinger C: Uric acid, type 2 diabetes, and cardiovascular diseases: Fueling the common soil hypothesis?. Clinical Chemistry. 2008, 54 (2): 231-233. 10.1373/clinchem.2007.099705.CrossRefPubMed

Meisinger C, Koenig W, Baumert J, Doring A: Uric acid levels are associated with all-cause and cardiovascular disease mortality independent of systemic inflammation in men from the general population - The MONICA/KORA cohort study. Arteriosclerosis Thrombosis and Vascular Biology. 2008, 28 (6): 1186-1192. 10.1161/ATVBAHA.107.160184.CrossRef

Verdecchia P, Schillaci G, Reboldi G, Santeusanio F, Porcellati C, Brunetti P: Relation between serum uric acid and risk of cardiovascular disease in essential hypertension the PIUMA study. Hypertension. 2000, 36 (6): 1072-1078.CrossRefPubMed

Mankovsky B, Kurashvili R, Sadikot S: Is serum uric acid a risk factor for atherosclerotic cardiovascular disease?: A review of the clinical evidence. Part 1. Diabetes and Metabolic Syndrome: Clinical Research and Reviews. 2010, 4 (3): 176-184. 10.1016/j.dsx.2010.07.010.CrossRef

Mazzali M, Hughes J, Kim YG, Jefferson JA, Kang DH, Gordon KL, Lan HY, Kivlighn S, Johnson RJ: Elevated uric acid increases blood pressure in the rat by a novel crystal-independent mechanism. Hypertension. 2001, 38 (5): 1101-1106. 10.1161/hy1101.092839.CrossRefPubMed

10.

Ishizaka N, Ishizaka Y, Toda E-I, Nagai R, Yamakado M: Association Between Serum Uric Acid, Metabolic Syndrome, and Carotid Atherosclerosis in Japanese Individuals. Arterioscler Thromb Vasc Biol. 2005, 25 (5): 1038-1044. 10.1161/01.ATV.0000161274.87407.26.CrossRefPubMed

11.

Nakagawa T, Hu H, Zharikov S, Tuttle KR, Short RA, Glushakova O, Ouyang X, Feig DI, Block ER, Herrera-Acosta J, Patel JM, Johnson RJ: A causal role for uric acid in fructose-induced metabolic syndrome. American Journal of Physiology - Renal Physiology. 2006, 290 (3): F625-F631.CrossRefPubMed

12.

Lu B, Wen J, Song XY, Dong XH, Yang YH, Zhang ZY, Zhao NQ, Ye HY, Mou B, Chen FL, Liu Y, Shen Y, Wang XC, Zhou LN, Li YM, Zhu XX, Hu RM: High prevalence of albuminuria in population-based patients diagnosed with type 2 diabetes in the Shanghai downtown. Diabetes Research and Clinical Practice. 2007, 75 (2): 184-192. 10.1016/j.diabres.2006.06.024.CrossRefPubMed

13.

Yang Z, Zhang ZY, Wen J, Wang XC, Lu B, Yang ZH, Zhang WW, Wang M, Feng XC, Ling C, Wu SH, Hu RM: Elevated Serum Chemokine CXC Ligand 5 Levels Are Associated with Hypercholesterolemia But Not a Worsening of Insulin Resistance in Chinese People. Journal of Clinical Endocrinology & Metabolism. 2010, 95 (8): 3926-3932. 10.1210/jc.2009-2194.CrossRef

14.

Matthews D, Hosker J, Rudenski A, Naylor B, Treacher D, Turner R: Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985, 28 (7): 412-419. 10.1007/BF00280883.CrossRefPubMed

15.

Epidemiology of Diabetes Interventions and Complications (EDIC) Research Group: Effect of intensive diabetes treatment on carotid artery wall thickness in the epidemiology of diabetes interventions and complications. Diabetes. 1999, 48 (2): 383-390.CrossRef

16.

Dagostino RB, Burke G, Oleary D, Rewers M, Selby J, Savage PJ, Saad MF, Bergman RN, Howard G, Wagenknecht L, Haffner SM: Ethnic differences in carotid wall thickness - The Insulin Resistance Atherosclerosis Study. Stroke. 1996, 27 (10): 1744-1749. 10.1161/01.STR.27.10.1744.CrossRef

17.

Wei M, Gonzalez C, Haffner SM, Oleary DH, Stern MP: Ultrasonographically assessed maximum carotid artery wall thickness in Mexico City residents and Mexican Americans living in San Antonio, Texas - Association with diabetes and cardiovascular risk factors. Arteriosclerosis Thrombosis and Vascular Biology. 1996, 16 (11): 1388-1392. 10.1161/01.ATV.16.11.1388.CrossRef

18.

Poli A, Tremoli E, Colombo A, Sirtori M, Pignoli P, Paoletti R: Ultrasonographic measurement of the common carotid artery wall thickness in hypercholesterolemic patients. A new model for the quantitation and follow-up of preclinical atherosclerosis in living human subjects. Atherosclerosis. 1988, 70 (3): 253-261. 10.1016/0021-9150(88)90176-1.CrossRefPubMed

19.

Lu B, Yang Y, Song X, Dong X, Zhang Z, Zhou L, Li Y, Zhao N, Zhu X, Hu R: An evaluation of the International Diabetes Federation definition of metabolic syndrome in Chinese patients older than 30 years and diagnosed with type 2 diabetes mellitus. Metabolism. 2006, 55 (8): 1088-1096. 10.1016/j.metabol.2006.04.003.CrossRefPubMed

20.

Liu J, Grundy SM, Wang W, Smith SC, Vega GL, Wu Z, Zeng Z, Wang W, Zhao D: Ethnic-Specific Criteria for the Metabolic Syndrome. Diabetes Care. 2006, 29 (6): 1414-1416. 10.2337/dc06-0481.CrossRefPubMed

21.

Kim ES, Kwon HS, Ahn CW, Lim DJ, Shin JA, Lee SH, Cho JH, Yoon KH, Kang MI, Cha BY, Son HY: Serum uric acid level is associated with metabolic syndrome and microalbuminuria in Korean patients with type 2 diabetes mellitus. Journal of Diabetes and its Complications. 2010

22.

Kanellis J, Watanabe S, Li JH, Kang DH, Li P, Nakagawa T, Wamsley A, Sheikh-Hamad D, Lan HY, Feng L, Johnson RJ: Uric Acid Stimulates Monocyte Chemoattractant Protein-1 Production in Vascular Smooth Muscle Cells Via Mitogen-Activated Protein Kinase and Cyclooxygenase-2. Hypertension. 2003, 41 (6): 1287-1293. 10.1161/01.HYP.0000072820.07472.3B.CrossRefPubMed

23.

Baldwin W MS, Marek G, Wymer D, Pannu V, Baylis C, Johnson RJ, Sautin YY: Hyperuricemia as a Mediator of the Proinflammatory Endocrine Imbalance in the Adipose Tissue in a Murine Model of the Metabolic Syndrome. Diabetes. 2011, 60 (4): 1258-1269. 10.2337/db10-0916.PubMedCentralCrossRefPubMed

24.

Kanellis J, Kang DH: Uric acid as a mediator of endothelial dysfunction, inflammation, and vascular disease. Seminars in Nephrology. 2005, 25 (1): 39-42. 10.1016/j.semnephrol.2004.09.007.CrossRefPubMed

25.

Tsai WC, Huang YY, Lin CC, Li WT, Lee CH, Chen JY, Chen JH: Uric acid is an independent predictor of arterial stiffness in hypertensive patients. Heart and Vessels. 2009, 24 (5): 371-375. 10.1007/s00380-008-1127-9.CrossRefPubMed

26.

Kawamoto R, Tabara Y, Kohara K, Miki T, Kusunoki T, Takayama S, Abe M, Katoh T, Ohtsuka N: High-sensitivity c-reactive protein and gamma-glutamyl transferase levels are synergistically associated with metabolic syndrome in community-dwelling persons. Cardiovascular Diabetology. 2010, 9.

27.

Pu LJ, Xu XW, Zhang RY, Zhang Q, Zhang JS, Hu J, Yang ZK, Ding FH, Chen QJ, Lou S, Shen J, Fang DH, Shen WF: Value of serum glycated albumin and high-sensitivity C-reactive protein levels in the prediction of presence of coronary artery disease in patients with type 2 diabetes. Cardiovascular Diabetology. 2006, 9.

28.

Fukui M, Tanak M, Shiraishi E, Harusato I, Hosoda H, Asano M, Kadono M, Hasegawa G, Yoshikawa T, Nakamura N: Serum uric acid is associated with micro albuminuria and subclinical atherosclerosis in men with type 2 diabetes mellitus. Metabolism-Clinical and Experimental. 2008, 57 (5): 625-629.CrossRefPubMed

29.

Kawamoto R, Tomita H, Oka Y, Ohtsuka N: Relationship between serum uric acid concentration, metabolic syndrome and carotid atherosclerosis. Internal Medicine. 2006, 45 (9): 605-614. 10.2169/internalmedicine.45.1661.CrossRefPubMed

30.

Butler R, Morris AD, Belch JJF, Hill A, Struthers AD: Allopurinol normalizes endothelial dysfunction in type 2 diabetics with mild hypertension. Hypertension. 2000, 35 (3): 746-751.CrossRefPubMed

31.

Farquharson CA, Butler R, Hill A, Belch JJF, Struthers AD: Allopurinol improves endothelial dysfunction in chronic heart failure. Circulation. 2002, 106 (2): 221-226. 10.1161/01.CIR.0000022140.61460.1D.CrossRefPubMed

32.

Doehner W, Schoene N, Rauchhaus M, Leyva-Leon F, Pavitt DV, Reaveley DA, Schuler G, Coats AJS, Anker SD, Hambrecht R: Effects of xanthine oxidase inhibition with allopurinol on endothelial function and peripheral blood flow in hyperuricemic patients with chronic heart failure - Results from 2 placebo-controlled studies. Circulation. 2002, 105 (22): 2619-2624. 10.1161/01.CIR.0000017502.58595.ED.CrossRefPubMed

33.

Facchini F, Chen Y-DI, Hollenbeck CB, Reaven GM: Relationship Between Resistance to Insulin-Mediated Glucose Uptake, Urinary Uric Acid Clearance, and Plasma Uric Acid Concentration. JAMA: The Journal of the American Medical Association. 1991, 266 (21): 3008-3011. 10.1001/jama.266.21.3008.CrossRefPubMed

Title: Serum uric acid level and its association with metabolic syndrome and carotid atherosclerosis in patients with type 2 diabetes
Authors: Qin Li
Zhen Yang
Bin Lu
Jie Wen
Zi Ye
Lili Chen
Min He
Xiaoming Tao
Weiwei Zhang
Ying Huang
Zhaoyun Zhang
Shen Qu
Renming Hu
Publication date: 01-12-2011
Publisher: BioMed Central
Published in: Cardiovascular Diabetology / Issue 1/2011
Electronic ISSN: 1475-2840
DOI: https://doi.org/10.1186/1475-2840-10-72

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Serum uric acid level and its association with metabolic syndrome and carotid atherosclerosis in patients with type 2 diabetes

Abstract

Objective

Methods

Results

Conclusions

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2011

Dietary saturated fat/cholesterol, but not unsaturated fat or starch, induces C-reactive protein associated early atherosclerosis and ectopic fat deposition in diabetic pigs

Effect of silibinin on endothelial dysfunction and ADMA levels in obese diabetic mice

Azelnidipine prevents cardiac dysfunction in streptozotocin-diabetic rats by reducing intracellular calcium accumulation, oxidative stress and apoptosis

Short-term effects of liraglutide on visceral fat adiposity, appetite, and food preference: a pilot study of obese Japanese patients with type 2 diabetes

Renal denervation in an animal model of diabetes and hypertension: Impact on the autonomic nervous system and nephropathy

NT-proBNP levels, atherosclerosis and vascular function in asymptomatic type 2 diabetic patients with microalbuminuria: peripheral reactive hyperaemia index but not NT-proBNP is an independent predictor of coronary atherosclerosis

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page