Diabetes mellitus is strongly associated with hyperuricemia.
The role of uric acid as a independent risk factor for cardiovascular
disease is a matter of controversy. The present study was proposed to
assess the uric acid status in patients with diabetes mellitus and to find
out its association with age, gender, BMI, WHR, smoking and CAD.
With rigid criteria, patients were selected carefully and evaluated on
social, clinical and laboratory aspects after getting institutional, ethical
clearance and informed consent. 30 healthy age, sex matched
individuals were kept as control. There were 43 males and 27 females
in the study group and 18 males and 12 females in the control group.
There was no significant difference among cases and controls in
relation to age.
In study group, BMI below 25 was seen in 34 cases (48.57%),
BMI above 25 seen in 36 cases (51.42%) which was significantly
more than controls. BMI had significantly correlated with
hyperuricemia. Similarly WHR was greater among women than men
in diabetics, which also correlated with elevated serum uric acid
significantly.
Elevated serum uric acid level was noticed more among those
who had hypertension dyslipidemia, coronary artery disease and they
were significant. Patients with longer duration of diabetes also had
elevated uric acid level.
The factors contributing to hyperuricemia in diabetes are,
1. Hyperinsulinemia acutely reduces urinary uric acid and sodium
excretion.
2. Hyperinsulinemia imposes a chronic antinatriuretic and anti
uricosuric effect on the kidney.
3. Microvascular disease in diabetes mellitus causes local tissue
ischemia and decreased renal blood flow leading to ischemia
with associated lactate production that blocks urate secretion in
proximal tubules. Increased uric acid synthesis occurs due to
increased purine metabolism, ischemia induced increased
xanthine oxidase production, insulin resistance and diuretic use.
Routine annual estimation of uric acid among diabetics from the
identification of diabetes will help the clinician to find out the
changing trends of uric acid level which is likely to be influenced by
control of blood sugar and development of hypertension, such cases
should be carefully monitored for CAD as well as other vascular
episodes.
Since uric acid is a confounding factor and multiple factors are
involved for elevated uric acid. A meticulous control of blood sugar,
hypertension, dyslipidemia among diabetics will bring down elevated
uric acid level in diabetics.
Let us have a Moto of,
“Assess diabetics for risk factors;
Assist to control them and
Arrest the development of complications”
With the Pharmacological and non pharmacological means
