Uric acid levels are associated with microvascular endothelial dysfunction in patients with Type 1 diabetes1

Matheus, Alessandra Saldanha de Mattos; Tibiriçá, Eduardo; Silva, P. B. da; Matta, Maria de Fátima Bevilacqua da; Gomes, Marı́lia B.

doi:10.1111/j.1464-5491.2011.03349.x

Cited by 34 publications

(31 citation statements)

References 28 publications

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“…Salem et al reported that hyperuricemia could be regarded as an independent risk factor for ED in addition to the established ones [31]. ED is a common disease characterized by endothelial dysfunction, and uric acid itself causes endothelial dysfunction via decreased nitric oxide production and decreased vasodilator response to acetylcholine [32, 33]. Experimental studies also showed that uric acid can reduce endothelial nitric oxide bioavailability via multiple mechanisms, including scavenging by uric acid induced oxidative stress, the stimulation of arginase and direct scavenging [34–37].…”

Section: Discussionmentioning

confidence: 99%

Association between Gout and Erectile Dysfunction: A Systematic Review and Meta-Analysis

Liu

Song

et al. 2016

PLoS ONE

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BackgroundThe aim of this systematic review and meta-analysis was to assess the possible association between gout and erectile dysfunction (ED).MethodsStudies were identified by extensively searching EMBASE, Pubmed, CENTRAL and ISI Web of Science. Four electronic databases were searched from their inception date to the latest issue (March 2016), without language restriction. Each reviewer screened articles independently and was blinded to the findings of the other reviewer. Data was extracted in adherence to the predetermined data collection form and meta-analysis was conducted via RevMan 5.3.ResultsFive studies involving 56465 patients (mean age: 49.11 years) with gout and 155636 non-gout subjects (mean age: 48.76 years) were selected. The combination of unadjusted odds ratio (OR) showed that patients with gout were 1.44 times more likely to be diagnosed with ED when compared with control (95% confidence interval (95%CI) 1.20, 1.72). After adjustment for age and comorbidities, the heightened risk to develop ED was still present (1.18, 95%CI 1.02, 1.38). Subgroup-analysis by age showed statistically significant association of gout and ED in all age groups. However, evidence supporting a causal effect of gout on ED was insufficient.ConclusionThe findings of this review indicated a positive association of gout and ED, but this work is hampered by the heterogeneity among included studies, to some extent. Future studies with larger community-based homogeneous population and randomized controlled trials aimed to evaluate the effect of gout treatment on ED associated outcomes are needed at this point.

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Section: Discussionmentioning

confidence: 99%

Association between Gout and Erectile Dysfunction: A Systematic Review and Meta-Analysis

Liu

Song

et al. 2016

PLoS ONE

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“…Based on the criteria mentioned in the “Methods” section 22 studies were suitable for inclusion. 6 of the 22 studies did not make a distinction in the types of diabetes [54–59], 6 were conducted in T1DM [52, 53, 60–63] and 11 in T2DM patients [12, 43, 63–70]. …”

Section: Resultsmentioning

confidence: 99%

The association between diabetes and dermal microvascular dysfunction non-invasively assessed by laser Doppler with local thermal hyperemia: a systematic review with meta-analysis

Fuchs

Dupon

Schaap

et al. 2017

Cardiovasc Diabetol

100

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Background/IntroductionDiabetes and cardiovascular disease develop in concert with metabolic abnormalities mirroring and causing changes in the vasculature, particularly the microcirculation. The microcirculation can be affected in different parts of the body of which the skin is the most easily accessible tissue.PurposeThe association between diabetes and dermal microvascular dysfunction has been investigated in observational studies. However, the strength of the association is unknown. Therefore we conducted a systematic review with meta-analysis on the association between diabetes and dermal microvascular dysfunction as assessed by laser Doppler/laser speckle contrast imaging with local thermal hyperaemia as non-invasive indicator of microvascular functionality.Methods PubMed and Ovid were systematically searched for eligible studies through March 2015. During the first selection, studies were included if they were performed in humans and were related to diabetes or glucose metabolism disorders and to dermal microcirculation. During the second step we selected studies based on the measurement technique, measurement location (arm or leg) and the inclusion of a healthy control group. A random effects model was used with the standardised mean difference as outcome measure. Calculations and imputation of data were done according to the Cochrane Handbook.ResultsOf the 1445 studies found in the first search, thirteen cross-sectional studies were included in the meta-analysis, comprising a total of 857 subjects. Resting blood flow was similar between healthy control subjects and diabetes patients. In contrast, the microvascular response to local skin heating was reduced in diabetic patients compared to healthy control subjects [pooled effect of −0.78 standardised mean difference (95% CI −1.06, −0.51)]. This effect is considered large according to Cohen’s effect size definition. The variability in effect size was high (heterogeneity 69%, p < 0.0001). However, subgroup analysis revealed no difference between the type and duration of diabetes and other health related factors, indicating that diabetes per se causes the microvascular dysfunction.ConclusionOur meta-analysis shows that diabetes is associated with a large reduction of dermal microvascular function in diabetic patients. The local thermal hyperaemia methodology may become a valuable non-invasive tool for diagnosis and assessing progress of diabetes-related microvascular complications, but standardisation of the technique and quality of study conduct is urgently required.Electronic supplementary materialThe online version of this article (doi:10.1186/s12933-016-0487-1) contains supplementary material, which is available to authorized users.

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“…However, uric acid has also been associated with endothelial dysfunction [39]. A study in individuals with type 1 diabetes showed that uric acid was associated with a reduced endothelium-dependent vasodilator response, but not with the endothelium-independent response of the skin microcirculation [20].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, alterations in the cutaneous microcirculation have been identified in patients with type 2 diabetes mellitus (T2DM) [17], chronic heart failure [18] and hypertension [19]. Although the microcirculation of the skin may be a representative model to study generalized microcirculatory function, only one previous study assessed the association with uric acid [20]. This study showed that higher uric acid concentrations were associated with a reduced endothelium-dependent vasodilator response in patients with type 1 diabetes [20].…”

Section: Introductionmentioning

confidence: 89%

“…Although the microcirculation of the skin may be a representative model to study generalized microcirculatory function, only one previous study assessed the association with uric acid [20]. This study showed that higher uric acid concentrations were associated with a reduced endothelium-dependent vasodilator response in patients with type 1 diabetes [20].…”

Section: Introductionmentioning

confidence: 92%

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Uric acid and skin microvascular function

Wijnands

Houben

Muris

et al. 2015

Journal of Hypertension

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Uric acid levels are associated with microvascular endothelial dysfunction in patients with Type 1 diabetes1

Cited by 34 publications

References 28 publications

Association between Gout and Erectile Dysfunction: A Systematic Review and Meta-Analysis

Association between Gout and Erectile Dysfunction: A Systematic Review and Meta-Analysis

The association between diabetes and dermal microvascular dysfunction non-invasively assessed by laser Doppler with local thermal hyperemia: a systematic review with meta-analysis

Uric acid and skin microvascular function

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