Top

Journal of Endocrinological Investigation

Published in:

01-05-2014 | Original Article

Serum uric acid is associated with arterial stiffness in men with newly diagnosed type 2 diabetes mellitus

Authors: J. Zhang, G. Xiang, L. Xiang, H. Sun

Published in: Journal of Endocrinological Investigation | Issue 5/2014

Abstract

Background

Increased serum uric acid levels and vascular atherosclerosis are very common in diabetes. However, few studies focused on the relationship between serum uric acid and aortic or peripheral arterial stiffness in newly diagnosed diabetic patients. This study investigated the association between serum uric acid levels and carotid–femoral pulse wave velocity (cfPWV) or carotid–radial (cr) PWV in male patients with newly diagnosed type 2 diabetes mellitus (T2DM).

Methods

106 male patients with newly diagnosed T2DM were recruited. cfPWV and crPWV as well as anthropometric parameters, blood pressure, serum uric acid, blood glucose, fasting insulin, C-reactive protein and blood lipids were measured.

Results

The subjects were divided into low uric acid (UA) subgroup and high UA subgroup according to uric acid median. cfPWV and crPWV were significantly higher in high UA subgroup. Serum uric acid significantly correlated with cfPWV (r = 0.533, P < 0.001), crPWV (r = 0.334, P = 0.001), waist circumference (r = 0.350, P < 0.001), waist-to-hip ratio (r = 0.254, P = 0.009), fasting insulin (r = 0.432, P < 0.001), HOMA-IR (r = 0.173, P = 0.042), fasting blood glucose (r = −0.271, P = 0.005), haemoglobin A1c (r = −0.202, P = 0.038), and HDL-cholesterol (r = −0.267, P = 0.006) after correction for age. Stepwise multiple regressions showed that the independent determinants of cfPWV were serum uric acid, age, C-reactive protein, HDL-cholesterol, and smoking status. And the independent determinants of crPWV were serum uric acid, age, diastolic blood pressure, and HDL-cholesterol.

Conclusions

Serum uric acid is significantly associated with increased aortic and peripheral arterial stiffness in men with T2DM at the early stage.

Yu Y, Lyons TJ (2005) A lethal tetrad in diabetes: hyperglycemia, dyslipidemia, oxidative stress, and endothelial dysfunction. Am J Med Sci 330(5):227–232PubMedCrossRef

Laurent S, Cockcroft J, Van BL et al (2006) Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 27(21):2588–2605PubMedCrossRef

Tillina T, Chambersa J, Malika I et al (2007) Measurement of pulse wave velocity: site matters. J Hypertens 25(2):383–389CrossRef

Schram MT, Henry RM, van Dijk RA et al (2004) Increased central artery stiffness in impaired glucose metabolism and type 2 diabetes: the Hoorn Study. Hypertension 43(2):176–181PubMedCrossRef

Nakagawa T, Hu H, Zharikov S et al (2006) A causal role for uric acid in fructose-induced metabolic syndrome. Am J Physiol Renal Physiol 290(3):F625–F631PubMedCrossRef

Baldwin W, McRae S, Marek G et al (2011) Hyperuricemia as a mediator of the proinflammatory endocrine imbalance in the adipose tissue in a murine model of the metabolic syndrome. Diabetes 60(4):1258–1269PubMedCentralPubMedCrossRef

Hoieggen A, Alderman MH, Kjeldsen SE et al (2004) The impact of serum uric acid on cardiovascular outcomes in the LIFE study. Kidney Int 65(3):1041–1049PubMedCrossRef

Niskanen LK, Laaksonen DE, Nyyssönen K et al (2004) Uric acid level as a risk factor for cardiovascular and all-cause mortality in middle-aged men: a prospective cohort study. Arch Intern Med 164(14):1546–1551PubMedCrossRef

Li Q, Yang Z, Lu B et al (2011) Serum uric acid level and its association with metabolic syndrome and carotid atherosclerosis in patients with type 2 diabetes. Cardiovasc Diabetol 10:72–79PubMedCentralPubMedCrossRef

10.

Wakabayashi I, Masuda H (2006) Lipoprotein (a) as a determinant of arterial stiffness in elderly patients with type 2 diabetes mellitus. Clin Chim Acta 373(1–2):127–131PubMedCrossRef

11.

Fukui M, Tanaka M, Shiraishi E et al (2008) Serum uric acid is associated with microalbuminuria and subclinical atherosclerosis in men with type 2 diabetes mellitus. Metabolism 57(5):625–629PubMedCrossRef

12.

WHO (1999) WHO consultation report: definition and diagnosis and classification of diabetic mellitus and its complications. World Health Organization, Geneva

13.

Kürüm T, Yildiz M, Soy M, Ozbay G, Alimgil L, Tüzün B (2005) Arterial distensibility as determined by carotid–femoral pulse wave velocity in patients with Behcet’s disease. Clin Rheumatol 24(2):134–138PubMedCrossRef

14.

Corry DB, Eslami P, Yamamoto K, Nyby MD, Makino H, Tuck ML (2008) Uric acid stimulates vascular smooth muscle cell proliferation and oxidative stress via the vascular renin–angiotensin system. J Hypertens 26(2):269–275PubMedCrossRef

15.

Khosla UM, Zharikov S, Finch JL et al (2005) Hyperuricemia induces endothelial dysfunction. Kidney Int 67(5):1739–1742PubMedCrossRef

16.

Yu MA, Sánchez-Lozada LG, Johnson RJ, Kang DH (2010) 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 28(6):1234–1242PubMed

17.

Kanellis J, Watanabe S, Li JH et al (2003) Uric acid stimulates monocyte chemoattractant protein-1 production in vascular smooth muscle cells via mitogen-activated protein kinase and cyclooxygenase-2. Hypertension 41(6):1287–1293PubMedCrossRef

18.

Kang DH, Park SK, Lee IK, Johnson RJ (2005) Uric acid–induced C-reactive protein expression: implication on cell proliferation and nitric oxide production of human vascular cells. J Am Soc Nephrol 16(12):3553–3562PubMedCrossRef

19.

Tsioufis C, Kyvelou S, Dimitriadis K et al (2011) The diverse associations of uric acid with low-grade inflammation, adiponectin and arterial stiffness in never-treated hypertensives. J Hum Hypertens 5(9):554–559CrossRef

20.

Turak O, Ozcan F, Tok D et al (2013) Serum uric acid, inflammation, and nondipping circadian pattern in essential hypertension. J Clin Hypertens (Greenwich) 15(1):7–13CrossRef

21.

Yoo TW, Sung KC, Shin HS et al (2005) Relationship between serum uric acid concentration and insulin resistance and metabolic syndrome. Circ J 69:928–933PubMedCrossRef

22.

Conen D, Wietlisbach V, Bovet P (2004) Prevalence of hyperuricemia and relation of serum uric acid with cardiovascular risk factors in a developing country. BMC Public Health 4:9PubMedCentralPubMedCrossRef

23.

Nakanishi N, Okamoto M, Yoshida H, Matsuo Y, Suzuki K, Tatara K (2003) Serum uric acid and risk for development of hypertension and impaired fasting glucose or type II diabetes in Japanese male office workers. Eur J Epidemiol 18:523–530PubMedCrossRef

24.

Rahman S, Ismail AA, Ismail SB, Naing NN, Rahman AR (2008) Early manifestation of macrovasculopathy in newly diagnosed never treated type II diabetic patients with no traditional CVD risk factors. Diabetes Res Clin Pract 80(2):253–258PubMedCrossRef

25.

Webb DR, Khunti K, Silverman R et al (2010) Impact of metabolic indices on central artery stiffness: independent association of insulin resistance and glucose with aortic pulse wave velocity. Diabetologia 53(6):1190–1198PubMedCrossRef

26.

Li CH, Wu JS (2012) YangYC, Shih CC, Lu FH, Chang CJ. Increased arterial stiffness in subjects with impaired glucose tolerance and newly diagnosed diabetes but not isolated impaired fasting glucose. J Clin Endocrinol Metab 97(4):E658–E662PubMedCrossRef

27.

Maple-Brown LJ, Piers LS, O’Rourke MF, Celermajer DS, O’Dea K (2007) Increased arterial stiffness in remote Indigenous Australians with high risk of cardiovascular disease. J Hypertens 25(3):585–591PubMedCrossRef

28.

Hua Q, Tan J, Liu DX, Wen J, Xing XR (2005) The changes and impact factors of carotid–femoral and carotid–radial pulse wave velocity in patients with essential hypertension. Zhonghua Xin Xue Guan Bing Za Zhi 33(12):1088–1091PubMed

29.

Van der Heijden-Spek JJ, Staessen JA, Fagard RH et al (2000) Effect of age on brachial artery wall properties differs from the aorta and is gender dependent: a population study. Hypertension 35(2):637–642PubMedCrossRef

30.

Boutouyrie P, Laurent S, Benetos A, Girerd XJ, Hoeks AP, Safar ME (1992) Opposing effects of ageing on distal and proximal large arteries in hypertensives. J Hypertens Suppl 10(6):S87–S91PubMed

Title: Serum uric acid is associated with arterial stiffness in men with newly diagnosed type 2 diabetes mellitus
Authors: J. Zhang
G. Xiang
L. Xiang
H. Sun
Publication date: 01-05-2014
Publisher: Springer International Publishing
Published in: Journal of Endocrinological Investigation / Issue 5/2014
Electronic ISSN: 1720-8386
DOI: https://doi.org/10.1007/s40618-013-0034-9

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 5/2014

The association between serum 25OHD levels and hypothyroid Hashimoto’s thyroiditis

Management of hypovitaminosis D in patients with primary hyperparathyroidism

Relevance of genetic investigation in male infertility

Kallmann’s syndrome and normosmic isolated hypogonadotropic hypogonadism: two largely overlapping manifestations of one rare disorder

Achieving HbA1c targets in clinical trials and in the real world: a systematic review and meta-analysis

Pantoprazole may improve beta cell function and diabetes mellitus

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

At a glance: The STEP trials