Prevalence of Hyperuricemia and the Relationship Between Serum Uric Acid and Hypertension in New Onset Diabetic Patients: A Cross-Sectional Indian Study

Overview

Journal Diabetes Metab Syndr Obes

Publisher Dove Medical Press

Specialty Endocrinology

Date 2022 Jun 21

PMID 35726334

Authors

Shailendra Kumar Singh

Rina Singh

Santosh Kumar Singh

Mir Asif Iquebal

Sarika Jaiswal

Archana Singh

Affiliations

Soon will be listed here.

Abstract

Objective: Prevalence of hyperuricemia (HU) is increasing and it is associated with hypertension, metabolic syndrome, diabetes mellitus (DM), obesity, chronic kidney disease, gout and cardiovascular disease. Elevated level of serum uric acid (SUA) has been shown to be associated with hypertension and diabetes in many countries but there is lack of evidence from India. The aim of this study is to know the prevalence of HU and to know the relationship between SUA and hypertension in newly onset DM.

Methods: This is a cross-sectional study from a tertiary center. A total of 305 (males: 212; females: 93) newly diagnosed diabetic patients were enrolled. All patients were categorized as normotensive (<140/90) and hypertensive (≥140/90) based on ADA criteria. Based on SUA level participants were grouped into 3 tertile (T1: <4.52; T2: 4.52-5.64; T3: >5.64 mg/dl).

Results: The mean age, systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the patients were 46.76 ±0.61 years, 130.6±1.06 mmHg and 84.11±0.63 mmHg, respectively. The mean level of SUA was 5.14±0.073 mg/dl and level was significantly higher in males compared with females (P <0.000). Overall prevalence of HU and hypertension was 12.13% and 44.59%, respectively. There was an increase in the prevalence of hypertension across the SUA tertile. SBP and DBP significantly increased across the SUA tertile (P <0.014 and <0.001, respectively). A multiple logistic regression analysis revealed that SUA tertile was independently associated with presence of hypertension (P <0.01).

Conclusion: This first report on the population of the eastern part of India indicates a significant positive relationship between SUA and hypertension among the newly onset Indian diabetic patients. Therefore, routine measurement of SUA is recommended in newly onset hypertensive diabetic patients to prevent HU and its related complications.

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References

Sarki A, Nduka C, Stranges S, Kandala N, Uthman O . Prevalence of Hypertension in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis. Medicine (Baltimore). 2015; 94(50):e1959. PMC: 5058882. DOI: 10.1097/MD.0000000000001959. View

Chen L, Zhu W, Chen Z, Dai H, Ren J, Chen J . Relationship between hyperuricemia and metabolic syndrome. J Zhejiang Univ Sci B. 2007; 8(8):593-8. PMC: 1934956. DOI: 10.1631/jzus.2007.B0593. View

Feig D, Johnson R . Hyperuricemia in childhood primary hypertension. Hypertension. 2003; 42(3):247-52. PMC: 1800942. DOI: 10.1161/01.HYP.0000085858.66548.59. View

Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N . Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9 edition. Diabetes Res Clin Pract. 2019; 157:107843. DOI: 10.1016/j.diabres.2019.107843. View

Krishnan E, Kwoh C, Schumacher H, Kuller L . Hyperuricemia and incidence of hypertension among men without metabolic syndrome. Hypertension. 2006; 49(2):298-303. DOI: 10.1161/01.HYP.0000254480.64564.b6. View

Nakanishi N, Okamoto M, Yoshida H, Matsuo Y, Suzuki K, Tatara K . Serum uric acid and risk for development of hypertension and impaired fasting glucose or Type II diabetes in Japanese male office workers. Eur J Epidemiol. 2003; 18(6):523-30. DOI: 10.1023/a:1024600905574. View

Fields L, Burt V, Cutler J, Hughes J, Roccella E, Sorlie P . The burden of adult hypertension in the United States 1999 to 2000: a rising tide. Hypertension. 2004; 44(4):398-404. DOI: 10.1161/01.HYP.0000142248.54761.56. View

Feig D, Soletsky B, Johnson R . Effect of allopurinol on blood pressure of adolescents with newly diagnosed essential hypertension: a randomized trial. JAMA. 2008; 300(8):924-32. PMC: 2684336. DOI: 10.1001/jama.300.8.924. View

Soletsky B, Feig D . Uric acid reduction rectifies prehypertension in obese adolescents. Hypertension. 2012; 60(5):1148-56. DOI: 10.1161/HYPERTENSIONAHA.112.196980. View

10.

Perez-Pozo S, Schold J, Nakagawa T, Sanchez-Lozada L, Johnson R, Lillo J . Excessive fructose intake induces the features of metabolic syndrome in healthy adult men: role of uric acid in the hypertensive response. Int J Obes (Lond). 2009; 34(3):454-61. DOI: 10.1038/ijo.2009.259. View

11.

NEWCOMBE D . Ethanol metabolism and uric acid. Metabolism. 1972; 21(12):1193-203. DOI: 10.1016/0026-0495(72)90115-1. View

12.

Powers R, Bodnar L, Ness R, Cooper K, Gallaher M, Frank M . Uric acid concentrations in early pregnancy among preeclamptic women with gestational hyperuricemia at delivery. Am J Obstet Gynecol. 2006; 194(1):160. DOI: 10.1016/j.ajog.2005.06.066. View

13.

Wild S, Roglic G, Green A, Sicree R, King H . Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004; 27(5):1047-53. DOI: 10.2337/diacare.27.5.1047. View

14.

Wright A, Kontopantelis E, Emsley R, Buchan I, Sattar N, Rutter M . Life Expectancy and Cause-Specific Mortality in Type 2 Diabetes: A Population-Based Cohort Study Quantifying Relationships in Ethnic Subgroups. Diabetes Care. 2016; 40(3):338-345. DOI: 10.2337/dc16-1616. View

15.

Peng H, Li H, Li C, Chao X, Zhang Q, Zhang Y . Association between vitamin D insufficiency and elevated serum uric acid among middle-aged and elderly Chinese Han women. PLoS One. 2013; 8(4):e61159. PMC: 3621974. DOI: 10.1371/journal.pone.0061159. View

16.

Desai R, Franklin J, Spoendlin-Allen J, Solomon D, Danaei G, Kim S . An evaluation of longitudinal changes in serum uric acid levels and associated risk of cardio-metabolic events and renal function decline in gout. PLoS One. 2018; 13(2):e0193622. PMC: 5831471. DOI: 10.1371/journal.pone.0193622. View

17.

Zheng X, Wei Q, Long J, Gong L, Chen H, Luo R . Gender-specific association of serum uric acid levels and cardio-ankle vascular index in Chinese adults. Lipids Health Dis. 2018; 17(1):80. PMC: 5896098. DOI: 10.1186/s12944-018-0712-x. View

18.

Loeffler L, Navas-Acien A, Brady T, Miller 3rd E, Fadrowski J . Uric acid level and elevated blood pressure in US adolescents: National Health and Nutrition Examination Survey, 1999-2006. Hypertension. 2012; 59(4):811-7. PMC: 3700426. DOI: 10.1161/HYPERTENSIONAHA.111.183244. View

19.

Cannon P, Stason W, Demartini F, SOMMERS S, LARAGH J . Hyperuricemia in primary and renal hypertension. N Engl J Med. 1966; 275(9):457-64. DOI: 10.1056/NEJM196609012750902. View

20.

Liu L, Lou S, Xu K, Meng Z, Zhang Q, Song K . Relationship between lifestyle choices and hyperuricemia in Chinese men and women. Clin Rheumatol. 2012; 32(2):233-9. DOI: 10.1007/s10067-012-2108-z. View