Serum uric acid and insulin sensitivity in adolescents and adults with and without type 1 diabetes
Petter Bjornstad, Janet K Snell-Bergeon, Kimberly McFann, R Paul Wadwa, Marian Rewers, Christopher J Rivard, Diana Jalal, Michel B Chonchol, Richard J Johnson, David M Maahs, Petter Bjornstad, Janet K Snell-Bergeon, Kimberly McFann, R Paul Wadwa, Marian Rewers, Christopher J Rivard, Diana Jalal, Michel B Chonchol, Richard J Johnson, David M Maahs
Abstract
Hypothesis: Decreased insulin sensitivity (IS) exists in type 1 diabetes. Serum uric acid (SUA), whose concentration is related to renal clearance, predicts vascular complications in type 1 diabetes. SUA is also inversely associated with IS in non-diabetics, but has not been examined in type 1 diabetes. We hypothesized SUA would be associated with reduced IS in adolescents and adults with type 1 diabetes.
Methods: The cross-sectional and longitudinal associations of SUA with IS were investigated in 254 adolescents with type 1 diabetes and 70 without in the Determinants of Macrovascular Disease in Adolescents with Type 1 Diabetes Study, and in 471 adults with type 1 diabetes and 571 without in the Coronary Artery Calcification in Type 1 diabetes (CACTI) study.
Results: SUA was lower in subjects with type 1 diabetes (p<0.0001), but still remained inversely associated with IS after multivariable adjustments in adolescents (β±SE: -1.99±0.62, p=0.001, R2 =2%) and adults (β±SE: -0.91±0.33, p=0.006, R2 = 6%) with type 1 diabetes, though less strongly than in non-diabetic controls (adolescents: β±SE: -2.70±1.19, p=0.03, R2 = 15%, adults: β±SE: -5.99±0.75, p<0.0001, R2 =39%).
Conclusion: We demonstrated a significantly weaker relationship between SUA and reduced IS in subjects with type 1 diabetes than non-diabetic controls.
Keywords: Adolescents and adults; Insulin sensitivity; Serum uric acid; Type 1 diabetes.
Conflict of interest statement
Duality of interest
RJJ has patent applications related to the lowering of uric acid and or blocking fructose metabolism as a means for slowing diabetic nephropathy or improving insulin resistance, and has shares with XORT Therapeutics related to these patents. Drs. Bjornstad, Snell-Bergeon, McFann, Wadwa, Rewers, Rivard, Jalal, Chonchol and Maahs have no conflict of interest to disclose.
Copyright © 2014 Elsevier Inc. All rights reserved.
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Source: PubMed