High urinary excretion rate of glucose attenuates serum uric acid level in type 2 diabetes with normal renal function

Abstract

Aims/introduction: The relationship between urinary excretion rate of glucose (UEGL) and uric acid (UA) metabolism in adults with type 2 diabetes (T2D) remains unclear to date. This study aimed to investigate the relationships of UEGL with serum UA (SUA), urinary excretion rate of uric acid (UEUA), and renal clearance of uric acid (CLUA) in adults with T2D. We hypothesised that high UEGL increases UA excretion, which in turn leads to lower SUA.

Materials and methods: This was a cross-sectional study of 635 inpatients with T2D recruited between 2018 and 2019. The relationships of UEGL with UEUA, CLUA, and hyperuricaemia were assessed using analysis of covariance and multivariate regression analysis.

Results: Patients in the higher quartile of UEGL tended to have lower SUA levels than those in the lower quartile. In contrast, patients in the higher quartile of UEGL tended to have higher CLUA (p for trend < 0.0001), and a similar trend was observed for UEUA. In adjusted multivariable linear regression model, UEGL was negatively correlated with SUA (β = - 0.023, 95% CI - 0.034 to - 0.013, p < 0.0001). However, positive correlations of UEGL with UEUA (β = 0.046, 95% CI 0.018-0.074, p = 0.001) and CLUA (β = 0.063, 95% CI 0.042-0.085, p < 0.0001) were found. Furthermore, consistent significant inverse associations were observed between quartiles of UEGL and hyperuricaemia in the adjusted multivariate logistic regression model.

Conclusions: A high UEGL level was positively correlated with UEUA and CLUA. Moreover, it was inversely associated with SUA level, and a consistently increased UEGL level reduced the risk of hyperuricaemia in patients with T2D.

Keywords: Diabetes; Hyperuricaemia; Renal clearance of uric acid; Uric acid; Urinary excretion rate of glucose.

Fig. 1

Adjusted odds ratios of hyperuricaemia across the UEGL quartiles UEGL urinary excretion rate of glucose, Q1 quartile 1 (P0, P25), Q2 quartile 2 (P25, P50), Q3 quartile 3 (P50, P75), Q4 quartile 4 (P75, P100). The odds ratio adjusted for sex, age, body mass index, diabetes mellitus duration, smoking, hypertension, haemoglobin A1c, total cholesterol, triglyceride, high-density lipoprotein cholesterol, and estimated glomerular filtration rate was calculated using the lowest UEGL Q1 subgroup as a reference