Relationship between Diabetes and Hyperuricemia in Zakho city – Kurdistan region of Iraq: A Retrospective Cross-Sectional Study

Authors

  • Brisik Gardi Department of Clinical Sciences, College of Medicine, University of Zakho, Kurdistan Region of Iraq, Iraq.

DOI:

https://doi.org/10.22317/jcms.v10i3.1568

Keywords:

Diabetes Mellites, Hyperuricemia, Uric acid level, Zakho, Iraq

Abstract

Objective: This retrospective cross-sectional study aimed to explore the prevalence of hyperuricemia among patients with type 2 diabetes mellitus and identify associated factors.

Methods: A total of 228 adult patients diagnosed with type 2 diabetes mellitus were included in this study. Data including demographic characteristics, clinical parameters, and serum uric acid levels were collected from medical records. Patients were categorized into two groups based on uric acid levels: hyperuricemia (≥7 mg/dL for males, ≥6 mg/dL for females) and non-hyperuricemic. Descriptive statistics and unpaired t-tests were utilized for analysis.

Results: A total of 228 patient were included (60.53% of them were female), according to standard guidelines hyperuricemia was defined as (≥ 7 mg/dl for male and ≤ 6 mg/dl for female) among them, 39.47% exhibited hyperuricemia. Mean uric acid level was 5.84±2.03. Significant associations were observed between uric acid levels and age (p = 0.0003), marital status (p = 0.0358), duration of diabetes (p = 0.0013), and HbA1c levels (p < 0.0001). However, other factors such as gender, smoking status, family history of diabetes, body mass index, and waist circumference did not show significant associations with uric acid levels.

Conclusion: This study highlights a notable prevalence of hyperuricemia among patients with type 2 diabetes mellitus. Factors such as older age, longer duration of diabetes, and poorer glycemic control were associated with higher uric acid levels. These findings underscore the importance of monitoring and managing uric acid levels in diabetic patients to mitigate potential metabolic complications. Further prospective studies are warranted to elucidate the underlying mechanisms and clinical implications of this relationship.

References

Care D. Care in diabetes—2022. Diabetes care. 2022;45:S17.

Ogurtsova K, da Rocha Fernandes J, Huang Y, Linnenkamp U, Guariguata L, Cho NH, et al. IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes research and clinical practice. 2017;128:40-50.

Ali N, Miah R, Hasan M, Barman Z, Mou AD, Hafsa JM, et al. Association between serum uric acid and metabolic syndrome: a cross-sectional study in Bangladeshi adults. Scientific reports. 2020;10(1):7841.

Banjar G, Abdulrahim H, Alomari J, Aldeijy R, Almalki A, Alrabghi S, et al. Relation between serum uric acid and diabetes type II. International Journal Of Community Medicine And Public Health. 2018;5(9):3720.

Cheng D, Hu C, Du R, Qi H, Lin L, Wu X, et al. Serum uric acid and risk of incident diabetes in middle-aged and elderly Chinese adults: prospective cohort study. Frontiers of Medicine. 2020;14:802-10.

Martínez-Sánchez FD, Vargas-Abonce VP, Guerrero-Castillo AP, De los Santos-Villavicencio M, Eseiza-Acevedo J, Meza-Arana CE, et al. Serum Uric Acid concentration is associated with insulin resistance and impaired insulin secretion in adults at risk for Type 2 Diabetes. Primary care diabetes. 2021;15(2):293-9.

Haque T, Rahman S, Islam S, Molla NH, Ali N. Assessment of the relationship between serum uric acid and glucose levels in healthy, prediabetic and diabetic individuals. Diabetology & metabolic syndrome. 2019;11(1):1-8.

Hu X, Rong S, Wang Q, Sun T, Bao W, Chen L, Liu L. Association between plasma uric acid and insulin resistance in type 2 diabetes: A Mendelian randomization analysis. Diabetes research and clinical practice. 2021;171:108542.

Wilson R. Economic development in the Middle East: Routledge; 2021.

Alqahtani SAM. The Effect of Gender and Altitude on Vitamin D Status Among Saudi Population: A Cross Sectional Study. Current Topics in Nutraceutical Research. 2022;20(1).

Alqahtani SAM. Prevalence and characteristics of thyroid abnormalities and its association with anemia in ASIR region of Saudi Arabia: a cross-sectional study. Clinics and practice. 2021;11(3):494-504.

Islam S, Hossen MA-A, Rahman MA, Lubaba MI, Akram A. Serum uric acid level among type-2 diabetes subjects attending in a tertiary hospital of Bangladesh. World Journal of Biology Pharmacy and Health Sciences. 2022;12(1):081-5.

Latief M, Shafi O, Hassan Z, Farooq S, Abbas F. Uric acid level and its correlation with glycemic control in diabetics with normal renal function. Medical Journal of Dr DY Patil University. 2022;15(4):507-10.

Li X, Meng X, Timofeeva M, Tzoulaki I, Tsilidis KK, Ioannidis JP, et al. Serum uric acid levels and multiple health outcomes: umbrella review of evidence from observational studies, randomised controlled trials, and Mendelian randomisation studies. Bmj. 2017;357.

Qiu L, Cheng X-q, Wu J, Liu J-t, Xu T, Ding H-t, et al. Prevalence of hyperuricemia and its related risk factors in healthy adults from Northern and Northeastern Chinese provinces. BMC Public health. 2013;13(1):1-9.

Duman TT, Kocak MZ, Atak BM, Erkus E. Serum Uric acid is correlated with HbA1c levels in type 2 diabetes mellitus. Experimental Biomedical Research. 2018;1(1):6-9.

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. Frontiers in Endocrinology. 2020;11:577.

Bhole V, Choi JW, Kim SW, de Vera M, Choi H. Serum uric acid levels and the risk of type 2 diabetes: a prospective study. Am J Med. 2010;123(10):957-61.

Johnson RJ, Nakagawa T, Jalal D, Sánchez-Lozada LG, Kang D-H, Ritz E. Uric acid and chronic kidney disease: which is chasing which? Nephrology Dialysis Transplantation. 2013;28(9):2221-8.

Shaheen SA, Barrouq D, Irshaidat T. An up-todate systematic review on real-world evidence for the management of asymptomatic hyperuricemia. The Journal of Medical Research. 2023;9(4):96-103.

Liu J, Pan H, Liu Y, Guan M, Li X, Chen S, et al. Distinct hyperuricemia trajectories are associated with different risks of incident diabetes: A prospective cohort study. Nutrition, Metabolism and Cardiovascular Diseases. 2023;33(5):967-77.

Bombelli M, Quarti-Trevano F, Tadic M, Facchetti R, Cuspidi C, Mancia G, Grassi G. Uric acid and risk of new-onset metabolic syndrome, impaired fasting glucose and diabetes mellitus in a general Italian population: data from the Pressioni Arteriose Monitorate E Loro Associazioni study. Journal of hypertension. 2018;36(7):1492-8.

Zhou C, Liu M, Zhang Z, Zhang Y, Nie J, Liang M, et al. Positive association of serum uric acid with new‐onset diabetes in Chinese women with hypertension in a retrospective analysis of the China Stroke Primary Prevention Trial. Diabetes, Obesity and Metabolism. 2020;22(9):1598-606.

Lu J, He Y, Cui L, Xing X, Liu Z, Li X, et al. Hyperuricemia predisposes to the onset of diabetes via promoting pancreatic β-cell death in uricase-deficient male mice. Diabetes. 2020;69(6):1149-63.

Krishnan E, Akhras KS, Sharma H, Marynchenko M, Wu EQ, Tawk R, et al. Relative and attributable diabetes risk associated with hyperuricemia in US veterans with gout. Qjm. 2013;106(8):721-9.

Liu R, Han C, Wu D, Xia X, Gu J, Guan H, et al. Prevalence of hyperuricemia and gout in mainland China from 2000 to 2014: a systematic review and meta-analysis. BioMed research international. 2015;2015.

Onchoke VB, Banturaki A, Onyanga N, Nganda P, Munyambalu DK, Lagoro CA, et al. Prevalence of hyperuricemia, associated factors and its effect on risk of coronary artery disease among out-patients with Diabetes Mellitus in Uganda. 2023.

Babikr WG, Elhussein AB, Abdelraheem A, Magzoub A, Mohamed H, Alasmary M. The correlation of uric acid levels with glycemic control in type II diabetic patients. Biomedical and Pharmacology Journal. 2016;9(3):1005-8.

Bandaru P, Shankar A. Association between serum uric acid levels and diabetes mellitus. International journal of endocrinology. 2011;2011.

Tuomilehto J, Zimmet P, Wolf E, Taylor R, Ram P, King H. Plasma uric acid level and its association with diabetes mellitus and some biologic parameters in a biracial population of Fiji. American journal of epidemiology. 1988;127(2):321-36.

Herman J, Medalie J, Goldbourt U. Diabetes, prediabetes and uricaemia. Diabetologia. 1976;12:47-52.

Singh SK, Singh R, Singh SK, Iquebal MA, Jaiswal S, Singh A. Prevalence of hyperuricemia and the relationship between serum uric acid and hypertension in new onset diabetic patients: a cross-sectional Indian Study. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2022:1809-17.

Rashad BH, Abdi BA, Naqid IA, Hussein NR, Ibrahim ZA, Rashad JA, et al. Risk factors associated with poor glycemic control in patients with type two diabetes mellitus in Zakho city. J Contemp Med Sci| Vol. 2021;7(3):167-70.

Wang Y, Zhang W, Qian T, Sun H, Xu Q, Hou X, et al. Reduced renal function may explain the higher prevalence of hyperuricemia in older people. Scientific reports. 2021;11(1):1302.

Pangalissani F. Uric Acid Levels in Elderly Gymnastics Participants at the Elderly Posyandu. Jaringan Laboratorium Medis. 2022;4(2):79-85.

Singh N, Aggarwal J, Batra J. The correlation of serum uric acid levels with type II diabetic patients: A hospital based pilot study. International journal of health sciences. 2022;6(S8):2624-31.

Kalyani DV, Ilamaran M, Kumar PS, Nagalingam S. Serum uric acid level in type 2 diabetes mellitus. International Journal of Advances in Medicine. 2019;6(4):1265.

Juraschek SP, McAdams-Demarco M, Miller ER, Gelber AC, Maynard JW, Pankow JS, et al. Temporal relationship between uric acid concentration and risk of diabetes in a community-based study population. American journal of epidemiology. 2014;179(6):684-91.

Chen H, Sheng L, Wan Z, Wang X, Lin Y, Wang Y, et al. The relationship between smoking and hyperuricemia in Chinese residents. Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine]. 2018;52(5):524-9.

He H, Zhang R, Shan G, Zhang M. Prevalence of hyperuricemia and the population attributable fraction of modifiable risk factors: Evidence from a general population cohort in China. Frontiers in Public Health. 2022;10:936717.

van der Sande MA, Walraven GE, Milligan PJ, Banya WA, Ceesay SM, Nyan OA, McAdam KP. Family history: an opportunity for early interventions and improved control of hypertension, obesity and diabetes. Bulletin of the World health organization. 2001;79(4):321-8.

Wang L, Yu Z, Xu C, Wang Y, Cao J, Sun L, et al. Higher body mass index is associated with higher hyperurcemia in patients with obesity and obstructive sleep apnea. 2023.

Noor A, Kanwal S, Malik SE, Ullah Z, Ghaffar T, Usman K. FREQUENCY OF HYPERURICEMIA IN TYPE 2 DIABETES MELLITUS PATIENTS WITH BMI> 23 KG/M2-STUDY AT A TERTIARY CARE HOSPITAL. Journal of Medical Sciences. 2023;31(02):111-5.

Yang L, He Za, Gu X, Cheng H, Li L. Dose–response relationship between BMI and Hyperuricemia. International journal of general medicine. 2021:8065-71.

Li Q, Li R, Zhang S, Zhang Y, Liu M, Song Y, et al. Relation of BMI and waist circumference with the risk of new-onset hyperuricemia in hypertensive patients. QJM: An International Journal of Medicine. 2022;115(5):271-8.

Biradar MI, Chiang K-M, Yang H-C, Huang Y-T, Pan W-H. The causal role of elevated uric acid and waist circumference on the risk of metabolic syndrome components. International journal of obesity. 2020;44(4):865-74.

He H, Wang S, Xu T, Liu W, Li Y, Lu G, Tu R. Sex-related differences in the hypertriglyceridemic-waist phenotype in association with hyperuricemia: a longitudinal cohort study. Lipids in Health and Disease. 2023;22(1):38.

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Published

2024-07-02

How to Cite

Gardi, B. (2024). Relationship between Diabetes and Hyperuricemia in Zakho city – Kurdistan region of Iraq: A Retrospective Cross-Sectional Study. Journal of Contemporary Medical Sciences, 10(3). https://doi.org/10.22317/jcms.v10i3.1568