Serum uric acid and insulin sensitivity in adolescents and adults with and without type 1 diabetes.
OBJECTIVE
Decreased insulin sensitivity (IS) exists in type 1 diabetes. Serum uric acid (SUA), whose concentration is related to renal clearance, predicts vascular complications in type 1 diabetes. SUA is also inversely associated with IS in non-diabetics, but has not been examined in type 1 diabetes. We hypothesized SUA would be associated with reduced IS in adolescents and adults with type 1 diabetes.


METHODS
The cross-sectional and longitudinal associations of SUA with IS were investigated in 254 adolescents with type 1 diabetes and 70 without in the Determinants of Macrovascular Disease in Adolescents with Type 1 Diabetes Study, and in 471 adults with type 1 diabetes and 571 without in the Coronary Artery Calcification in Type 1 diabetes (CACTI) study.


RESULTS
SUA was lower in subjects with type 1 diabetes (p<0.0001), but still remained inversely associated with IS after multivariable adjustments in adolescents (β±SE: -1.99±0.62, p=0.001, R2 =2%) and adults (β±SE: -0.91±0.33, p=0.006, R2 = 6%) with type 1 diabetes, though less strongly than in non-diabetic controls (adolescents: β±SE: -2.70±1.19, p=0.03, R2 = 15%, adults: β±SE: -5.99±0.75, p<0.0001, R2 =39%).


CONCLUSIONS
We demonstrated a significantly weaker relationship between SUA and reduced IS in subjects with type 1 diabetes than non-diabetic controls.
Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO. Electronic address: Petter.Bjornstad@childrenscolorado.org.
Petter
P
Bjornstad
Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO; Barbara Davis Center for Diabetes, University of Colorado Denver, Aurora, CO.
Janet K
JK
Snell-Bergeon
University of Colorado School of Public Health, Colorado Biostatistics Consortium, Aurora, CO.
Kimberly
K
McFann
Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO; Barbara Davis Center for Diabetes, University of Colorado Denver, Aurora, CO.
R Paul
RP
Wadwa
Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO; Barbara Davis Center for Diabetes, University of Colorado Denver, Aurora, CO.
Marian
M
Rewers
Department of Nephrology, University of Colorado Denver, Aurora, CO.
Christopher J
CJ
Rivard
University of Colorado School of Public Health, Colorado Biostatistics Consortium, Aurora, CO.
Diana
D
Jalal
Department of Nephrology, University of Colorado Denver, Aurora, CO.
Michel B
MB
Chonchol
Department of Nephrology, University of Colorado Denver, Aurora, CO.
Richard J
RJ
Johnson
Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO; Barbara Davis Center for Diabetes, University of Colorado Denver, Aurora, CO; Department of Nephrology, University of Colorado Denver, Aurora, CO.
David M
DM
Maahs
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D015994:Incidence; D007333:Insulin Resistance / Q000502:physiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*; D014652:Vascular Diseases / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult
D014527:Uric Acid
Adolescents and adults; Insulin sensitivity; Serum uric acid; Type 1 diabetes