Serum uric acid concentration is significantly associated with insulin resistance and impaired insulin secretion in people at risk for developing type 2 diabetes (T2D), according to results of a study published in Primary Care Diabetes.

Studies have shown serum uric acid concentration to be associated with insulin resistance in individuals already diagnosed with T2D, but its association with impaired insulin secretion and beta-cell dysfunction in individuals at risk for developing T2D has not yet been determined.

To assess this, data from 354 individuals (72.2% women) with 2 or more risk factors for, but no diagnosis of, T2D were analyzed. The mean age of included individuals was 51 plus or minus 8 years of age and the mean body mass index (BMI) was 29.9 plus or minus 6.5 kg/m2. Individuals with an oral glucose tolerance test (OGTT) of 75 g were included. The mean serum uric acid concentration of included individuals was 5.7 plus or minus 1.3 mg/dL.


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Individuals who were categorized as obese (BMI ≥30 kg/m2) were significantly younger than individuals with a BMI of less than 30 kg/m2 (P =.001). Obese individuals also had significantly higher insulin resistance, impaired beta-cell function, and impaired insulin secretion (P <.001).

Serum uric acid concentration was found to be independently associated with increased insulin resistance (P =.001) and insulin secretion phases 1 (P =.02) and 2 (P =.03). Serum uric acid concentration was significantly associated with the homeostasis model assessment (HOMA) of beta-cell function (P =.025) but not with the disposition index.

A study limitation was that researchers did not account for participants’ socioeconomics, nutrition, or level of physical activity. Additionally, the participants were selected from a single tertiary medical center in Mexico City, which may introduce a possible bias based on ethnicity.

The results of this study indicate that serum uric acid concentration was associated with increased levels of insulin resistance and impaired insulin secretion. Because insulin resistance is the core pathological mechanism of T2D, the ability to detect individuals with a predisposition to insulin resistance is key to the early detection of diabetes.

A serum uric acid concentration value of 5.5 mg/dL accurately identifies individuals with insulin resistance at a threshold of 2.5 (P <.001). Serum uric acid concentration may be a useful tool for the early detection of T2D.

Reference

Martínez-Sánchez FD, Vargas-Abonce VP, Guerrero-Castillo AP, et al. Serum uric acid concentration is associated with insulin resistance and impaired insulin secretion in adults at risk for type 2 diabetes. Published online October 13, 2020. Prim Care Diabetes. doi: 10.1016/j/pcd.2020.10.006