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Endocrine, Metabolic & Immune Disorders - Drug Targets

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ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

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Research Article

Relation Between URIC Acid Levels and Subclinical Hypothyroidism in Diabetic Patients

Author(s): Hosameldeen S. Shabana, Mahmoud A. Allam*, Youssef A. Nassar, Amgad Awad, Magdy M. Naguib, Abdelaleem A. Elgendy and Essam Elmahdi

Volume 22, Issue 5, 2022

Published on: 27 January, 2022

Page: [532 - 538] Pages: 7

DOI: 10.2174/1871530321666211018120419

Price: $65

Abstract

Background and Aim: Subclinical hypothyroidism (SCH) is frequently seen in diabetic patients. Elevated levels of uric acid (UA) were also reported in diabetic patients. No study assessed the relation between SCH and UA levels in diabetic patients. We aimed to evaluate this relation and the association of both conditions with other clinical and laboratory parameters in diabetic patients.

Subjects and Methods: This cross-sectional study included 100 T2DM patients in addition to 50 age and sex matched healthy controls. Diabetic patients comprised 50 patients with SCH and 50 euthyroid patients. All participants were subjected to careful history taking, thorough clinical examination and standard laboratory work up. The performed investigations included fasting and postprandial blood sugar, fasting insulin levels, HbA1c levels, thyroid hormones (FT3, FT4 and TSH), renal profile and serum UA.

Results: Comparison between the studied groups regarding serum UA levels revealed significantly higher levels in the diabetic group (5.4 ± 1.9 versus 4.2 ± 1.0 mg/dl, p<0.001). SCH + DM patients had significantly higher UA levels in comparison to DM group (6.1 ± 1.8 versus 4.8 ± 1.7 mg/dl, p<0.001) and control group (6.1 ± 1.8 versus 4.2 ± 1.0 mg/dl, p<0.001). SCH + DM patients had significantly higher HbA1c levels (8.9 ± 1.1 versus 7.6 ± 1.3%, p<0.001), HOMA-IR (3.9 ± 0.8 versus 2.8 ± 1.0, p<0.001) and UA levels (6.1 ± 1.8 versus 4.8 ± 1.7, p<0.001). Correlation analysis identified a significant direct correlation between serum UA and HOMA-IR in DM + SCH patients (r=0.4,p=0.004). In univariate analysis, presence of SCH [OR (95% CI): 2.57 (1.07-6.15), p=0.034] and nephropathy [OR (95% CI): 4.57 (1.77-11.8), p=0.002] was significant predictors of higher (upper tertile) UA in the studied patients. However, in multivariate analysis, only nephropathy [OR (95% CI): 4.25 (1.62-11.17), p=0.003] continued to be significant while SCH showed a marginal trend [OR (95% CI): 0.43 (0.17-1.08), p=0.073].

Conclusion : The present study suggests an association between SCH and increased UA levels in diabetic patients.

Keywords: Insulin resistance, diabetic nephropathy, glycemic control, hypothyroidism, thyroid, diabetic complications.

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[1]
Weisman, A.; Fazli, G.S.; Johns, A.; Booth, G.L. Evolving trends in the epidemiology, risk factors, and prevention of type 2 diabetes: A review. Can. J. Cardiol., 2018, 34(5), 552-564.
[http://dx.doi.org/10.1016/j.cjca.2018.03.002] [PMID: 29731019]
[2]
Harding, J.L.; Pavkov, M.E.; Magliano, D.J.; Shaw, J.E.; Gregg, E.W. Global trends in diabetes complications: A review of current evidence. Diabetologia, 2019, 62(1), 3-16.
[http://dx.doi.org/10.1007/s00125-018-4711-2] [PMID: 30171279]
[3]
Kalra, S.; Aggarwal, S.; Khandelwal, D. Thyroid dysfunction and type 2 diabetes mellitus: Screening strategies and implications for management. Diabetes Ther., 2019, 10(6), 2035-2044.
[http://dx.doi.org/10.1007/s13300-019-00700-4] [PMID: 31583645]
[4]
Talwalkar, P.; Deshmukh, V.; Bhole, M. Prevalence of hypothyroidism in patients with type 2 diabetes mellitus and hypertension in India: A cross-sectional observational study. Diabetes Metab. Syndr. Obes., 2019, 12, 369-376.
[http://dx.doi.org/10.2147/DMSO.S181470] [PMID: 30936734]
[5]
Cho, J.H.; Kim, H.J.; Lee, J.H.; Park, I.R.; Moon, J.S.; Yoon, J.S.; Lee, I.K.; Won, K.C.; Lee, H.W. Poor glycemic control is associated with the risk of subclinical hypothyroidism in patients with type 2 diabetes mellitus. Korean J. Intern. Med. (Korean. Assoc. Intern. Med.), 2016, 31(4), 703-711.
[http://dx.doi.org/10.3904/kjim.2015.198] [PMID: 27271351]
[6]
Han, C.; He, X.; Xia, X.; Li, Y.; Shi, X.; Shan, Z.; Teng, W. Subclinical hypothyroidism and type 2 diabetes: A systematic review and meta-analysis. PLoS One, 2015, 10(8), e0135233.
[http://dx.doi.org/10.1371/journal.pone.0135233] [PMID: 26270348]
[7]
Desideri, G.; Bocale, R.; D’Amore, A.M.; Carnassale, G.; Necozione, S.; Barini, A.; Barini, A.; Lombardi, C.P. Thyroid hormones modulate uric acid metabolism in patients with recent onset subclinical hypothyroidism by improving insulin sensitivity. Intern. Emerg. Med., 2020, 15(1), 67-71.
[http://dx.doi.org/10.1007/s11739-019-02065-9] [PMID: 30868444]
[8]
Fouad, M.; Fathy, H.; Zidan, A. Serum uric acid and its association with hypertension, early nephropathy and chronic kidney disease in type 2 diabetic patients. J. Bras. Nefrol., 2016, 38(4), 403-410.
[http://dx.doi.org/10.5935/0101-2800.20160065] [PMID: 28001185]
[9]
Alberti, K.G.; Eckel, R.H.; Grundy, S.M.; Zimmet, P.Z.; Cleeman, J.I.; Donato, K.A.; Fruchart, J.C.; James, W.P.; Loria, C.M.; Smith, S.C., Jr. Harmonizing the metabolic syndrome: A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation, 2009, 120(16), 1640-1645.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192644] [PMID: 19805654]
[10]
Keerman, M.; Yang, F.; Hu, H.; Wang, J.; Wang, F.; Li, Z.; Yuan, J.; Yao, P.; Zhang, X.; Guo, H.; Yang, H.; He, M. Mendelian randomization study of serum uric acid levels and diabetes risk: Evidence from the Dongfeng-Tongji cohort. BMJ Open Diabetes Res. Care, 2020, 8(1), e000834.
[http://dx.doi.org/10.1136/bmjdrc-2019-000834] [PMID: 32111716]
[11]
Wu, M.; Huang, X.; Yan, D.; Pan, H.; Li, F.; Ren, M.; Zhang, J.; Xu, M. Interactions among endotoxin, uric acid, and lactate in relation to the risk of type 2 diabetes: A population-based study. J. Diabetes, 2020, 12(8), 605-615.
[http://dx.doi.org/10.1111/1753-0407.13039] [PMID: 32216058]
[12]
Lou, Y.; Qin, P.; Wang, C.; Ma, J.; Peng, X.; Xu, S.; Chen, H.; Zhao, D.; Wang, L.; Liu, D.; Li, Y.; Zhao, P.; Han, D.; Hu, D.; Hu, F. Sex-specific association of serum uric acid level and change in Hyperuricemia status with risk of type 2 diabetes mellitus: A large cohort study in China. J. Diabetes Res., 2020, 2020, 9637365.
[http://dx.doi.org/10.1155/2020/9637365] [PMID: 32775463]
[13]
Chen, N.; Muhammad, I.F.; Li, Z.; Nilsson, P.M.; Borné, Y. Sex-specific associations of circulating uric acid with risk of diabetes incidence: A population-based cohort study from Sweden. Diabetes Metab. Syndr. Obes., 2020, 13, 4323-4331.
[http://dx.doi.org/10.2147/DMSO.S273387] [PMID: 33209045]
[14]
Ghasemi, A. Uric acid-induced pancreatic β-cell dysfunction. BMC Endocr. Disord., 2021, 21(1), 24.
[http://dx.doi.org/10.1186/s12902-021-00698-6] [PMID: 33593356]
[15]
Khassawneh, A.H.; Al-Mistarehi, A.H.; Zein Alaabdin, A.M.; Khasawneh, L.; AlQuran, T.M.; Kheirallah, K.A.; Saadeh, N.A.; Beni Yonis, O.; Shawkat, M.; Obeidat, N. Prevalence and predictors of thyroid dysfunction among type 2 diabetic patients: A case-control study. Int. J. Gen. Med., 2020, 13, 803-816.
[http://dx.doi.org/10.2147/IJGM.S273900] [PMID: 33116772]
[16]
Sharma, P.; Sinha, R.; Prasad, A.; Mitra, J.K. Lack of association between poor glycemic control in T2DM and subclinical hypothyroidism. J. Thyroid Res., 2020, 2020, 8121395.
[http://dx.doi.org/10.1155/2020/8121395] [PMID: 32963752]
[17]
Chen, X.; Deng, S.; Sena, C.; Zhou, C.; Thaker, V.V. Relationship of TSH levels with cardiometabolic risk factors in US youth and reference percentiles for thyroid function. J. Clin. Endocrinol. Metab., 2020.
[PMID: 33274355]
[18]
Xu, C.; Zhou, L.; Wu, K.; Li, Y.; Xu, J.; Jiang, D.; Gao, L. Abnormal Glucose Metabolism and Insulin Resistance Are Induced via the IRE1α/XBP-1 Pathway in Subclinical Hypothyroidism. Front. Endocrinol. (Lausanne), 2019, 10, 303.
[http://dx.doi.org/10.3389/fendo.2019.00303] [PMID: 31156553]
[19]
Xia, Q.; Zhang, S.H.; Yang, S.M.; Zhu, X.L.; Su, S.; Hu, A.P.; Zhu, J.; Li, D.M. Serum uric acid is independently associated with diabetic nephropathy but not diabetic retinopathy in patients with type 2 diabetes mellitus. J. Chin. Med. Assoc., 2020, 83(4), 350-356.
[http://dx.doi.org/10.1097/JCMA.0000000000000285] [PMID: 32132382]
[20]
Hou, L.; Shi, Y.; Wang, S.; Chen, Q.; Li, Q.; Zhao, M.; Zhou, X. Associations of serum uric acid level with diabetic retinopathy and albuminuria in patients with type 2 diabetes mellitus. J. Int. Med. Res., 2020, 48(12), 300060520963980.
[http://dx.doi.org/10.1177/0300060520963980] [PMID: 33334216]
[21]
Hu, Y.; Li, Q.; Min, R.; Deng, Y.; Xu, Y.; Gao, L. The association between serum uric acid and diabetic complications in patients with type 2 diabetes mellitus by gender: A cross-sectional study. PeerJ, 2021, 9, e10691.
[http://dx.doi.org/10.7717/peerj.10691] [PMID: 33520463]
[22]
Oliveira, I.O.; Mintem, G.C.; Oliveira, P.D.; Freitas, D.F.; Brum, C.B.; Wehrmeister, F.C.; Gigante, D.P.; Horta, B.L.; Menezes, A.M.B. Uric acid is independent and inversely associated to glomerular filtration rate in young adult Brazilian individuals. Nutr. Metab. Cardiovasc. Dis., 2020, 30(8), 1289-1298.
[http://dx.doi.org/10.1016/j.numecd.2020.04.016] [PMID: 32576415]
[23]
Joo, H.J.; Kim, G.R.; Choi, D.W.; Joo, J.H.; Park, E.C. Uric acid level and kidney function: A cross-sectional study of the Korean national health and nutrition examination survey (2016-2017). Sci. Rep., 2020, 10(1), 21672.
[http://dx.doi.org/10.1038/s41598-020-77702-x] [PMID: 33303792]
[24]
Martínez-Sánchez, F.D.; Vargas-Abonce, V.P.; Guerrero-Castillo, A.P.; Santos-Villavicencio, M.L.; Eseiza-Acevedo, J.; Meza-Arana, C.E.; Gulias-Herrero, A.; Gómez-Sámano, M. Serum Uric Acid concentration is associated with insulin resistance and impaired insulin secretion in adults at risk for Type 2 Diabetes. Prim. Care Diabetes, 2020.
[http://dx.doi.org/10.1016/j.pcd.2020.10.006] [PMID: 33218916]
[25]
Li, L.; Shi, Z.; Ma, L.; Lu, Y. Analysis of the correlation between plasma coagulation factor VII, PAI-1, and uric acid with insulin resistance and macrovascular complications in elderly patients with type 2 diabetes. Ann. Palliat. Med., 2021, 10(1), 664-671.
[http://dx.doi.org/10.21037/apm-20-2609] [PMID: 33545795]
[26]
Chen, J.; Ge, J.; Zha, M.; Miao, J.J.; Sun, Z.L.; Yu, J.Y. Effects of uric acid-lowering treatment on glycemia: A systematic review and meta-analysis. Front. Endocrinol. (Lausanne), 2020, 11, 577.
[http://dx.doi.org/10.3389/fendo.2020.00577] [PMID: 33013687]

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