Hyperuricemia and insulin resistance

Abstract

The associates of gout-obesity, hypertriglyceridemia, glucose intolerance, and hypertension, strikingly resemble those of insulin resistance. In the present study we determined whether hyperuricemia is associated with insulin resistance and, if so, whether this association can be explained by other components of the syndrome. For this purpose we quantitated insulin sensitivity (euglycemic clamp) in 37 nondiabetic subjects (aged 30-68 yr) exhibiting varying degrees of the metabolic syndrome (body mass index, 21.5-35.7 kg/m2; serum triglycerides, 0.4-22.0 mmol/L; high density lipoprotein cholesterol 0.38-1.86 mmol/L; blood pressure, 190-100/116-60 mm Hg). In simple linear regression analysis, the serum uric acid concentration (range, 182-568 mumol/L) was inversely correlated with insulin sensitivity (rate of glucose utilization; r = -0.61; P < 0.001) and positively with serum triglycerides (r = 0.68; P < 0.001), but not with body mass index, age, or the plasma glucose concentration. In multiple linear regression analysis, both insulin sensitivity (P < 0.05) and serum triglycerides (P < 0.005) were independently associated with the serum uric acid concentration, and together explained 50% of its variation. Addition of body mass index or age to the model did not improve the degree of explanation. Acute elevation of serum triglycerides about 3-fold, of plasma FFA about 9-fold, or of serum insulin about 28-fold had no effect on the serum uric acid concentration in healthy volunteers. The data indicate that hyperuricemia is indeed an inherent component of the metabolic syndrome and could also be used as a simple marker of insulin resistance.

Beneficial effects of weight loss associated with moderate calorie/carbohydrate restriction, and increased proportional intake of protein and unsaturated fat on serum urate and lipoprotein levels in gout: a pilot study

“…In keeping with the latter, IR is inversely related to the urinary uric acid clearance and the latter is inversely related to SU concentrations 22. Indeed, SU may serve as a surrogate marker of IR 1. Although raised TG levels are a hallmark of IR9 and appear to exist intrinsically in gout,23 a low calorie diet in hyperuricaemic-hypertriglyceridaemic patients resulted in a reduction in serum TG concentrations together with an increased uric acid clearance and a decrease in SU levels, which did not occur in normolipidaemic-hyperuricaemic patients 24.…”

“…Gout and the insulin resistance (IR) syndrome have several features in common 1. Insulin resistance is associated with obesity, hypertension, glucose intolerance, coronary artery disease (CAD), increased triglyceride (TG) levels, decreased high density lipoprotein cholesterol (HDL-C) concentrations, increased C:HDL-C ratios, low density lipoprotein cholesterol (LDL-C), and uric acid levels, and atherogenic small, dense LDL-C particles 2…”

Fructose and uric acid in diabetic nephropathy

“…In contrast, type 2 diabetes and the metabolic syndrome are often associated with higher SUA concentrations [37, 38], although some studies have reported the presence of hypouricaemia in type 2 diabetes [39, 40]. The increase might be accounted for by the presence of insulin resistance and hyperinsulinaemia.…”

Contribution of polymorphisms in the apolipoprotein AI-CIII-AIV cluster to hyperlipidaemia in patients with gout

“…A high concentration of uric acid is closely related to hyperinsulinaemia, glucose intolerance, hypertension, dyslipidaemia, very high levels of triglycerides, low levels of high density lipoprotein (HDL) cholesterol, and obesity (especially abdominal adiposity). [4][5][6][7][8][9][10][11][12] Regarding the association that has already been demonstrated between hyperuricaemia and hyperlipidaemia, we have previously shown the existence of two groups of hyperuricaemic patients-those in whom the hyperuricaemia is associated with hyperlipidaemia, who could be considered to have the metabolic syndrome, and those having no association with any metabolic disorder. 13 We have also reported that hyperuricaemic-hypertriglyceridaemic patients have high levels of very low density lipoprotein (VLDL) components, a reduced fractionated excretion of uric acid, and an increased ratio of CIII to CII apolipoproteins.…”