Serum uric acid in type 2 diabetics

Aims: To compare the level of serum uric acid (UA) in type 2 diabetics with a control group and to demonstrate its relation with other risk factors as age , BMI, duration of diabetes, blood glucose and total cholesterol level. Methods: The study was conducted in Al-Wafa Diabetic Clinic in Mosul during the period from February to May 2007 as a case-control study. A 39 patients of both sexes with type 2 diabetes with a mean ± SD age of 51.5± 11.1 years , and 20 healthy subjects of both sexes with a mean ± SD age of 46.5±15.5 years as a control group. The concentrations of fasting serum glucose, total cholesterol and UA was determined; BMI was calculated. Results: BMI, fasting serum glucose, UA and total cholesterol concentrations are significantly higher (P < 0.001, 0.01 , 0.01 respectively) in type 2 diabetics compared to the control group with a positive correlation ( r = 0.605 , P < 0.005 ) between serum UA and the duration of diabetes. Conclusions: Because serum UA concentration is significantly higher in type 2 diabetics independent on other factors and as it predicts the occurrence of ischemic heart diseases, stroke and even renal disease in these patients; therefore, its measurement is recommended. Since it positively correlated with the duration of diabetes, therefore, the longer the history of diabetes was, the more frequent measurement should be done. لا صلاخ ة ثحبلا فادهأ : عمَ يناثلا طمنلا نم يرك ُّ سلا ءادب نيباصملل مدلا لصمل يِلوبلا ضماحلا ىوتسم ةنَرَاقَمُل ةعومجم طباض ة رِطخلا تارشؤمب هتقلاع راهظإو زوآولجلا ىوَتَسمُ ،يِركّسلا ضرم ةدّم ، مسجلا ةِلتآ ليلد ،رمعُلاآ ىرخلأا ِّ مدلا يف ِّ يلكلا ِلورتيسلِوكُلاو . قرطلا : رياربف نْمِ ةِرتفلل لصوملا يف يِركّسلا ءادل ءافولا ةدايع يف ةساردلا تيرجأ / ويام ةياغلو طِابش / سيام ٢٠٠٧ مجملأ عم هيضرملأ تلااحلا ةنراقم ةقيرطب ةطباضلا هعو . نوآراشملا : ةساردلا تلمش ٣٩ غلبي ثيح نيسنجلا لاآ نم يناثلا طمنلا نم يِركّسلا ءادب نيباصملا ىضرملا ْنمِ مهرامعلأ يرايعملا فارحنلااو لدعملا ٥١.٥ . ± ١١.١ و ةِنس ٢٠ عومجمآ نيسنجلا لاآ نم ءاحصلأا نم ة طباض ة مهرامعلأ يرايعملا فارحنلااو لدعملا غلبي ثيح ٤٦.٥ ± ١٥.٥ ةِنس . يّلكلا لوريتسيلوكلا، ِزوآولجلا ىوتسم سايق مت مسجلا ةِلتآ ليلد باسح عم نيتعومجملا اتلكل موصلا هلاح يف مدلا لصمل يلوبلا ضماحلاو . جئِاتنَلا : ، ِ زوآولجلا تايوتسمو مسجلا ةِلتآ ليلد ميقل ايونعم اعافترا ثحبلا جئاتن ترهظأ يّلكلا لوريتسيلوكلا لاو مدلا لِصمل يلوبلا ضماح P < 0.001, 0.01 , 0.01) يلاوتلا ىلع ( يناثلا طمنلا نم يرك ُّ سلا ءادب نيباصملل يونعم يباجيإ طابترا دوجول هفاضلااب ةطباضلا ةعومجملاب هنراقم ( r = 0.605 , P < 0.005 ) ضماحلا زيآرت نيب يِركّسلا ضرم ةدّمو مدلا لِصمل يلوبلا . تاجاتنتسلاا : بسب هروصب يناثلا طمنلا نم يركسلا ءادب نيباصملا يف ىلعأ مدلا لصمل يلوبلا ضماحلا زيآرت نأ ب م هنوكلو ىرخلأا لِماوعلا نع ةلقتس ثودح عُقّوتيَ ةيبلقلا يووذ ضارمأ ، طلجلأ ة يغامدلأ ة ةيولكلا ضارملأا ىتحو ا ةدم عم يباجيإ طابترا دوجول ارظنو هسايقب ىصويُ اذل ىضرملا ءلاؤهل ةدايز عم رثآأ هسايق راركت يعدتسي اذل ضرمل ضرملا خيرات . Annals of the College of Medicine Vol. 34 No. 1, 2008 © 2008 Mosul College of Medicine 70 umans convert adenosine and guanosine into UA. In mammals other than higher primates, uricase converts UA to the water-soluble allantoin. However, since humans lack uricase, the end product of purine catabolism is UA . Different studies have indicated that hyperuricemia predicts the development of ischemic heart disease in non-diabetic subjects , this applies also to the patients with type 2 diabetes . Even “asymptomatic hyperuricemia” have also demonstrated a remarkable association with hypertension, obesity, metabolic syndrome, kidney disease, and cardiovascular disease . And lowering UA in patients with renal disease and asymptomatic hyperuricemia resulted in less progression of their renal problem (14, . Recent studies in humans found that elevated serum UA predicts the development of hyperinsulinemia , obesity (17, , type 2 diabetes (16, , in addition to the development of stroke in middle-aged patients with type 2 diabetes independently of other cardiovascular risk factors . The aim of this study is to compare the UA concentration in patients with type 2 diabetes with a control group in Mosul city and its relation with other risk factors as age, Body Mass Index (BMI), duration of diabetes, blood glucose and total cholesterol level in those diabetic patients. Patients and methods This study was conducted during the period from February to May 2007, the subjects enrolled in this study were divided into two groups (group I and II). Group I composed of 20 apparently healthy subjects (11males and 9 females), their ages ranged from (29-77) years with a mean ± SD of 46.5±15.5 years. Group II composed of 39 patients (17 males and 22 females) with type 2 diabetes was diagnosed by clinical history and laboratory investigations who were attending Al-Wafa Diabetic Clinic in Mosul. Their ages ranged from (26-73) years with a mean ± SD of 51.5 ± 11.1 years. They have no any evidence of renal, cardiovascular or stroke attacks. None of the control and patients had a history of any cause that may affect their serum UA concentration. A complete record of history was obtained, including name, age, sex, duration of diabetes, diet and drugs; measurement of height (Ht) and weight (Wt) was done for all subjects enrolled in the study. Fasting blood samples were obtained from the patients and controls then blood samples were centrifuged at 3000 rpm for 15 minutes. Estimation of serum glucose, total cholesterol and UA was done within one hour of sample collection in the clinical chemistry laboratory of the Department of Biochemistry, Nineveh College of Medicine, by the enzymatic colorimetric methods using glucose oxidase peroxidase, cholesterol oxidase and uricase methods (23) respectively. The results were evaluated by statistical methods including the mean ( X ), standard deviation (SD), range (minimumH Annals of the College of Medicine Vol. 34 No. 1, 2008 © 2008 Mosul College of Medicine 71 maximum), Linear regression analysis (Pearson correlation coefficient r) , paired and unpaired student’s t-test (24, 25, 26) to evaluate the relation between different parameters in group I and II. Differences between observations were considered not significant at p > 0.05. BMI was calculated by dividing Wt/Ht,. Results There is no significant difference (P>0.05) in the age between group I and II (Table 1). Fasting serum glucose, UA and total cholesterol concentrations are significantly higher in group II than group I (P < 0.001, 0.01 , 0.01 respectively , table 1). BMI in group II was significantly higher than group I (P< 0.001, table 1) . There is positive correlation (r = 0.605 , p < 0.005) between serum UA concentration and the duration of diabetes in group II (Fig:1) while there is no significant correlations with age , BMI , fasting serum glucose and serum total cholesterol level. Table 1 : Comparison between different parameters of both groups. (Values are presented as mean ± SD)