Changes in insulin and lipid metabolism in males with asymptomatic hyperuricaemia

Abstract

Objectives: To define the effect of asymptomatic hyperuricaemia on various facets of glucose, insulin, and lipoprotein metabolism.

Design: Case control study in health volunteers.

Setting: The volunteers for this study were selected on the basis of their laboratory results from a larger population participating in a general survey in one large factory.

Subjects: The study population consisted of 40 healthy males: 20 with asymptomatic hyperuricaemia (serum uric acid concentration equal to or greater than 420 mmol l-1) and 20 with normal serum uric acid concentrations (180-320 mmol l-1). The two groups were similar in terms of age, general obesity (estimated by body mass index), smoking and alcohol intake, and estimate of work and leisure time activity.

Interventions: All subjects received a 75 g oral glucose challenge, with blood taken before and at frequent intervals thereafter.

Main outcome measures: Fasting plasma glucose, insulin, and lipid concentrations and plasma glucose and insulin responses to the oral glucose challenge.

Results: By selection, mean (+/- SEM) serum uric acid concentration was higher in the hyperuricaemic individuals (454 +/- 7 vs. 274 +/- 12 mmol l-1). In addition, the plasma insulin response to oral glucose was increased in individuals with asymptomatic hyperuricaemia (P < 0.005) as were both systolic (136 +/- 3 vs. 126 +/- 3 mmHg, P < 0.05) and diastolic (91 +/- 1 vs. 82 +/- 1, P < 0.01) blood pressure. Furthermore, subjects with asymptomatic hyperuricaemia were dyslipidaemic (higher plasma TG and cholesterol and lower HDL-cholesterol concentrations) as compared to the normouricaemic control group (P < 0.07-0.005).

Conclusions: These results provide a possible explanation for the well-known association of hyperuricaemia with coronary heart disease, as well as suggesting that hyperuricaemia be added to the cluster of metabolic and haemodynamic abnormalities associated with insulin resistance and/or hyperinsulinaemia and designated as Syndrome X.