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Serum uric acid and insulin secretion in diabetes mellitus.

In order to define the relationship, if any, between serum uric acid and insulin pattern in different types of diabetes mellitus, 4 groups of subjects (controls, and affected by type 1 and type 2 diabetes mellitus, with and without obesity) were considered. In each group, successively cleared of the long-term and complicated diabetic patients, serum and urinary uric acid and insulin secretion (serum C-peptide values) were determined. Serum uric acid and C-peptide values were higher in type 2 obese diabetic subjects vs the other groups of patients and controls (p < 0.001). No difference was found, on the contrary, between creatinine clearance and urinary excretion of uric acid among the groups. Moreover, serum uric acid values were in positive correlation (p < 0.02) with serum C-peptide values considering, among the diabetic subjects, only those with duration of diabetes less than 5 years and without micro-macrovascular complications. In conclusion, these data lead to presume that diabetic patients with short duration of disease and without complications show a different serum uric acid pattern, strictly related to beta-cellular secretion.

Adult↗

[Changes of serum and urinary uric-acid levels after portacaval anastomosis in the rat].

Significantly higher levels of uric acid in serum and urine together with increased urine volume and pH were observed in rats after portacaval end-to-side anastomosis in comparison to sham-operated and non-operated pair-fed controls. An increased supply of endogenous uric acid by reduced transformation of uric acid to allantoin and decreased uricase activity in the liver was assumed. Adaptation of enzyme activities of other metabolic pathways of the liver after PCA due to diminished blood and oxygen supply were described in previous experiments. This model seems suitable for other studies on hyperuricemia, hyperuricosuria and uric acid lithiasis.

Animals↗

Association between serum uric acid and some cardiovascular risk factors in a Chinese population.

The association between serum uric acid concentration and some cardiovascular risk factors was examined in a working Hong Kong Chinese population (mean age 38 years), consisting of 910 men and 603 women. There was no significant age-related rise in serum uric acid concentration. Positive associations were found between serum uric acid concentration and body mass index, waist hip ratio, systolic and diastolic blood pressure, urea, creatinine, protein, glucose (fasting and 2 hours after 75 g oral glucose load), 2 hour insulin, triglycerides, and apolipoprotein B in men. Similar, but fewer, associations were seen in women, with the addition of a positive association with age. In both sexes, serum uric acid was negatively associated with high-density lipoprotein cholesterol. These findings complement the well-known clinical association between gout and cardiovascular and metabolic diseases, such as hypertension, hyperlipidaemia and diabetes mellitus, and suggest that serum uric acid may be a marker for the presence of an adverse cardiovascular risk factor profile.

Adult↗

Urine uric acid and urine creatine ratio in acute renal failure.

The urine uric acid (UUA) and urine creatinine (UC) concentration ratio was studied in 23 patients with acute renal failure. The ratio was higher than 1 in 12 patients and lower than 1 in 11. The clinical characteristics of the first group of patients included the association of infectious disease with high fever, hyperbilirubinemia, nonoliguric renal failure, less reduction of creatinine clearance, and higher urinary excretion of uric acid when compared with the second group. Jaundice and perhaps overproduction of uric acid due to hypercatabolism are believed to be responsible for the high uric acid excretion and the high UUA-UC ratio.

Acute Kidney Injury↗

[Seasonal change in blood concentration of uric acid and its potential clinical implications].

OBJECTIVE: To determine whether uric acid in plasma of patients registered at a PCC varies with the season. DESIGN: Descriptive study, with two transversal cuts, one in winter and one in summer. SETTING: Health district on the outskirts of Valencia. PATIENTS: Selected at random from all patients over 18 with medical records, with appointments in January-February and July-August 1999. Sample size was calculated for paired data with an alpha error of 0.05 and beta error of 20%. The pertinent level of uraemia was set at 0.4 mg/dl. Variability was deduced from a mini-sample of 17 cases in a sample of 72 patients. The following were recorded: sex, age, BMI, blood count, glucaemia, total cholesterol, HDL-c, LDL-c, uric acid and triglycerides. Meteorological data were supplied by the Valencia Weather Centre. MEASUREMENTS AND MAIN RESULTS: Temperature (12.8 degrees C versus 25.8 degrees C), sun (9.9 hours a day versus 5.9) and relative humidity (67.1% versus 61.4%) were greater in summer than in winter. There were no differences in mean atmospheric pressure (760.1 mmHg versus 760.7). 75 patients with a mean age of 63 finished the study. Mean uric acid was higher in summer at 5.64 mg/dl (95% CI, 5.29-5.99) than in winter at 5.23 mg/dl (CI, 4.92-5.56). We found no significant differences in the BMI, red corpuscles, haematocrits, glucaemia, total or divided cholesterol, or triglycerides. CONCLUSION: Seasonal variation in the plasma concentration of uric acid was found in the sample studied.

Cross-Sectional Studies↗

Degradation of uric acid during autocatalytic oxidation of oxyhemoglobin induced by sodium nitrite.

The oxidation of oxyhemoglobin produced by sodium nitrite occurs in two stages: 1) an initial slow phase followed by 2) a rapid autocatalytic phase that carries the reaction to completion. The length of the slow phase is extended when uric acid is added to the reaction mixture. As the concentration of uric acid increases, the length of the slow phase increases until a concentration is reached at which the rate of methemoglobin formation is nearly linear until the reaction is complete. Further increases in the concentration of uric acid do not affect the rate of the reaction in the slow phase. At low concentrations of uric acid, where an autocatalytic phase is reached, uric acid is degraded during the reaction. At concentrations of uric acid that keep the reaction in the linear phase, the uric acid is not degraded. It is concluded that uric acid may protect oxyhemoglobin by reacting with HbO2H to yield [HbOH]+ and the urate radical. The urate radical may react with a second molecule of HbO2H and become oxidized. At higher concentrations, the radical may undergo electron transfer with oxyhemoglobin to regenerate the uric acid and form methemoglobin.

Animals↗

[The role of the renal dopaminergic and the prostaglandin systems in renal uric acid metabolism in patients with essential hypertension].

The present study aimed to elucidate the role of renal dopaminergic and prostaglandin (PG) systems in renal uric acid metabolism in essential hypertension. Mean arterial pressure (MAP), heart rate (HR), endogenous creatinine clearance (Ccr), serum uric acid (SUA), urinary excretions of uric acid (UUAV) and sodium (UNaV), fractional excretions of uric acid (FEUA) and sodium (FENa), plasma renin activity (PRA) and plasma aldosterone concentration (PAC) were measured before and after intravenous injection of a dopamine receptor antagonist, metoclopramide (MCP: 8 mg/m2.BSA), or before and after a single oral administration of prostaglandin synthesis inhibitor, indomethacin (IM: 75 mg), in 34 mild-to-moderate essential hypertensives (EHT). MCP injection or acute oral administration of IM caused significant decreases of UNaV and FENa in each group, whereas MAP, HR and SUA did not change in either group. Significant decreases in Ccr, UUAV and FEUA and increases in PRA and PAC were demonstrated by MCP injection, while no significant changes in these parameters were revealed by IM administration. There was a significant positive correlation between delta UUAV and delta Ccr or delta FEUA in both groups. In addition, a close positive correlation between delta UUAV and delta UNaV as well as between delta FEUA and delta FENa was found in the MCP group, but not in the IM group. On the other hand, no significant correlation was observed between delta UUAV and delta PRA or delta PAC in either MCP or IM administration. The decreases of UUAV and FEUA were significantly greater in MCP than in IM administration, despite similar changes in Ccr, UNaV and FENa between the two procedures. These data suggest that the endogenous renal dopaminergic system may contribute to renal uric acid metabolism, which is rather closely related to sodium handling in essential hypertension than the prostaglandin system. Furthermore, the attenuated renal dopaminergic activity may contribute to the elevation of serum uric acid level in patients with essential hypertension.

Adult↗