title: Serum uric acid and disorders of glucose metabolism: the role of glycosuria.
abstract: Hyperuricemia has been associated with hypertension, diabetes mellitus, and metabolic syndrome. We studied the association between hyperuricemia and glycemic status in a nonrandomized sample of primary care patients. This was a cross-sectional study of adults ≥ 20 years old who were members of a community-based health care program. Hyperuricemia was defined as a value >7.0 mg/dL for men and >6.0 mg/dL for women. The sample comprised 720 participants including controls (n=257) and patients who were hypertensive and euglycemic (n=118), prediabetic (n=222), or diabetic (n=123). The mean age was 42.4 ± 12.5 years, 45% were male, and 30% were white. The prevalence of hyperuricemia increased from controls (3.9%) to euglycemic hypertension (7.6%) and prediabetic state (14.0%), with values in prediabetic patients being statistically different from controls. Overall, diabetic patients had an 11.4% prevalence of hyperuricemia, which was also statistically different from controls. Of note, diabetic subjects with glycosuria, who represented 24% of the diabetic participants, had a null prevalence of hyperuricemia, and statistically higher values for fractional excretion of uric acid, Na excretion index, and prevalence of microalbuminuria than those without glycosuria. Participants who were prediabetic or diabetic but without glycosuria had a similarly elevated prevalence of hyperuricemia. In contrast, diabetic patients with glycosuria had a null prevalence of hyperuricemia and excreted more uric acid and Na than diabetic subjects without glycosuria. The findings can be explained by enhanced proximal tubule reabsorption early in the course of dysglycemia that decreases with the ensuing glycosuria at the late stage of the disorder.
authors.affiliation: Divisão de Nefrologia, Departamento de Medicina Clínica, Faculdade de Medicina, Universidade Federal Fluminense, Niterói, RJ, Brasil.
authors.forename: J A M
authors.initials: JA
authors.lastname: Andrade
authors.affiliation: Departamento de Patologia, Faculdade de Medicina, Universidade Federal Fluminense, Niterói, RJ, Brasil.
authors.forename: H C
authors.initials: HC
authors.lastname: Kang
authors.affiliation: Divisão de Nefrologia, Departamento de Medicina Clínica, Faculdade de Medicina, Universidade Federal Fluminense, Niterói, RJ, Brasil.
authors.forename: S
authors.initials: S
authors.lastname: Greffin
authors.affiliation: Departamento de Epidemiologia e Bioestatística, Universidade Federal Fluminense, Niterói, RJ, Brasil.
authors.forename: M L
authors.initials: ML
authors.lastname: Garcia Rosa
authors.affiliation: Divisão de Nefrologia, Departamento de Medicina Clínica, Faculdade de Medicina, Universidade Federal Fluminense, Niterói, RJ, Brasil.
authors.forename: J R
authors.initials: JR
authors.lastname: Lugon
mesh_terms: D000328:Adult; D000367:Age Factors; D001786:Blood Glucose / Q000032:analysis; D001938:Brazil / Q000453:epidemiology; D003153:Community Health Services / Q000706:statistics & numerical data; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D005260:Female; D044882:Glucose Metabolism Disorders / Q000453:epidemiology; D038321:Glycemic Index; D006029:Glycosuria / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D033461:Hyperuricemia / Q000453:epidemiology*; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D011236:Prediabetic State / Q000453:epidemiology; D015995:Prevalence; D012494:Sampling Studies; D014527:Uric Acid / Q000097:blood*
chemical_list: D001786:Blood Glucose; D014527:Uric Acid