LETTER

TO

THE

EDITOR

Association of Serum Uric Acid Concentration With Metabolic Risk Factors in Patients With Type 2 Diabetes To the Editor: We read the recent article by Marotta and colleagues1 with great interest. This study assessed the association of hyperuricemia with conventional cardiovascular risk factors in elderly patients and indicated that uric acid (UA) clusters in a sex-specific fashion with features of the metabolic syndrome.1 A recent meta-analysis of cohort studies showed that serum UA levels are positively associated with incidence of impaired fasting glucose and type 2 diabetes.2 However, the association of serum UA concentration with metabolic risk factors such as glycemic control and obesity in patients with type 2 diabetes remains unknown. We studied correlations of serum UA concentration with body mass index (BMI), waist circumference, fat areas measured by abdominal computed tomography, blood pressure, fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), and fasting serum lipid levels in 47 patients with type 2 diabetes. We could not find any significant correlations of serum UA concentration with metabolic risk factors in all patients. We divided patients into men (n=27) and women (n=20) and studied correlations of serum UA concentration with each parameter. The meanstandard deviation of age, height, weight, BMI, systolic and diastolic BPs, FPG, and HbA1c in patients were 63.712.0 years and 66.310.7 years, 163.77.7 cm and 153.06.3 cm, 65.112.3 kg and 65.116.9 kg, 24.23.7 kg/m2 and 27.55.5 kg/m2, 138.718.5mm Hg and 133.413.8 mm Hg, 78.610.7 mm Hg and 77.910.3 mm Hg, 149.041.7 mg/dL and 129.7 24.2 mg/dL, and 6.9%1.0% and 6.6%0.6% in men and women, respectively. Serum UA concentration was significantly and inversely correlated with BMI, waist circumference, total fat area, subcutaneous fat area, and HbA1c in men with type 2 diabetes (Table). However, any significant correlations of serum UA concentration with these metabolic parameters were not observed in women with type 2 diabetes. We observed no significant correlations of serum UA concentration with systolic and diastolic BPs, visceral fat area, FPG, and serum lipid levels in both men and women. The association between serum UA concentration and cardiovascular risk factors remains controversial, possibly and partially as a result of the differences between sexes. Marotta and colleagues1 reported that elderly women with higher UA levels (>5.5 mg/dL) had higher BMI, waist circumference, and serum glucose and triglyceride concentrations than women with lower UA levels, which was not observed in elderly men. Their study suggested that serum UA was unfavorably associated with cardiovascular risk factors in elderly

TABLE. Correlations of Serum Uric Acid Concentration With Cardiovascular Risk Factors in Men and Women With Type 2 Diabetes Men (n=27) r

P Value

Women (n=20) r

P Value

Body mass index Waist circumference

0.444 0.523

.020 .005

0.145 0.102

.541 .667

Systolic blood pressure Diastolic blood pressure

0.012 0.04

.954 .843

0.070 0.287

.769 .221

Total fat area Subcutaneous fat area

0.400 0.497

.039 .009

0.188 0.051

.427 .830

Visceral fat area Fasting plasma glucose

0.351 0.156

.071 .437

0.359 0.063

.120 .792

Glycated hemoglobin Triglycerides

0.608 0.295

.001 .136

0.006 0.225

.981 .341

LDL cholesterol

0.027

.895

0.142

.551

HDL cholesterol

0.311

.114

0.206

.383

Abbreviations: HDL, high-density lipoprotein; LDL, low-density lipoprotein. r indicates Spearman’s rank correlation coefficient. Total, subcutaneous, and visceral fat areas were measured by abdominal computed tomography.

women, which was not shown in men. Our study showed that serum UA was favorably associated with men with type 2 diabetes, which was not observed in women. Both studies demonstrated a significant difference between sexes in correlations of serum UA with cardiovascular risk factors. The limitation of our study was that the number of patients was small. To elucidate our hypothesis, further studies, preferably with larger numbers of patients, will be needed. Our study showed that serum UA was significantly and inversely correlated with BMI, waist circumference, fat area, and HbA1c in men with type 2 diabetes. This study also presented sex differences in correlations of serum UA with cardiovascular risk factors. 1

Hidekatsu Yanai, MD, PhD;1 Yuji Hirowatari, PhD2 From the Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan; 2Bioscience Division, Tosoh Corporation, Kanagawa, Japan

References 1. Marotta T, Liccardo M, Schettini F, et al. Association of hyperuricemia with conventional cardiovascular risk factors in elderly patients. J Clin Hypertens (Greenwich). 2015;17:27–32. 2. Jia Z, Zhang X, Kang S, Wu Y. Serum uric acid levels and incidence of impaired fasting glucose and type 2 diabetes mellitus: a meta-analysis of cohort studies. Diabetes Res Clin Pract. 2013;101:88–96.

doi: 10.1111/jch.12580 The Journal of Clinical Hypertension

Vol 17 | No 9 | September 2015

741

Association of Serum Uric Acid Concentration With Metabolic Risk Factors in Patients With Type 2 Diabetes.

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