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Uric acid levels are associated with microvascular endothelial dysfunction in patients with Type 1 diabetes 1
Author(s) -
Matheus A. S. de M.,
Tibiriçá E.,
da Silva P. B.,
de Fátima Bevilácqua da Matta M.,
Gomes M. B.
Publication year - 2011
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2011.03349.x
Subject(s) - medicine , uric acid , endothelial dysfunction , endocrinology , diabetes mellitus , hyperaemia , type 2 diabetes , sodium nitroprusside , endothelium , nitric oxide , blood flow
Diabet. Med. 28, 1188–1193 (2011) Abstract Aims Recent data identified uric acid as an independent risk factor for cardiovascular disease. The aim of the present study was to assess the association between uric acid and endothelial dysfunction in 57 patients with Type 1 diabetes and 53 healthy control subjects. Methods Microvascular endothelial function was evaluated using laser Doppler perfusion monitoring coupled with pharmacological (iontophoretic administration of acetylcholine and sodium nitroprusside) and physiological (post‐occlusive reactive hyperaemia and thermal hyperaemia) stimuli. Results Uric acid was higher in subjects without diabetes than in those with diabetes ( P = 0.03). Microvascular vasodilator response to acetylcholine was significantly reduced in Type 1 diabetes ( P = 0.002) and was correlated to disease duration ( r = −0.3, P = 0.01), triglyceride ( r = −0.37, P = 0.005), insulin dose ( r = −0.28, P = 0.03), fasting plasma glucose levels ( r = −0.3, P = 0.02), HbA 1c ( r = −0.34, P = 0.001) and uric acid ( r = −0.3, P = 0.005). On stepwise multivariate analysis, age, HbA 1c and uric acid were the most important independent variables that were associated with the endothelium‐dependent response in Type 1 diabetes ( P = 0.02). Conclusions Glycaemic control and uric acid in the normal range were the most important contributing factors to the decreasing endothelium‐dependent responses associated with Type 1 diabetes. Consequently, uric acid could be a new potential marker of microvascular endothelial dysfunction in these patients. Further studies are required to explore the clinical relevance of the relationship between uric acid levels, oxidative stress and endothelial dysfunction in patients with Type 1 diabetes, as well as whether treatment with uric acid‐lowering drugs for slight elevations in uric acid would benefit these patients.