Hyperuricemia and albuminuria in patients with type 2 diabetes mellitus

Hyperuricemia is an independent risk factor for kidney dysfunction in diabetic patients. On the other hand, albuminuria is considered as the proxy of early stages of diabetic nephropathy. We investigated the correlation between hyperuricemia and albuminuria in patients with diabetes mellitus. In a cross-sectional study of 1275 patients [555 men and 720 women] with type 2 diabetes mellitus, serum uric acid and urinary albumin-creatinine ratio were determined. Other metabolic parameters including lipid profile, hemoglobin A1c, glomerular filtration rate, body mass index, blood pressure, blood glucose were assessed, as well. The mean age of the patients was 52.45 +/- 10.11 years old. Serum uric acid levels for normoalbuminuric, microalbuminuric, and macroalbuminuric patients were 4.49 +/- 1.22 mg/dL, 4.84 +/- 1.52 mg/dL, and 6.15 +/- 1.68 mg/dL, respectively. Among patients with clinical metabolic syndrome, 233 [27.5%] were in the forth upper quartile of uric acid level [> 5.3 mg/dL], but in diabetic patients without this syndrome, only 80 [18.7%] were in this group. There was a significant relationship between hyperuricemia and serum triglyceride, fasting blood glucose, hemoglobin A1c, glomerular filtration rate, and serum creatinine levels [P < .001]. No significant correlation was found between hyperuricemia and cholesterol levels, age, duration of diabetes mellitus, and body mass index. Serum uric acid level correlated positively with urinary albumin-creatinine ratio [P = .04]. We showed that higher serum uric acid concentrations were associated with a greater probability of albuminuria in patients with type 2 diabetes mellitus

Elevated serum C-reactive protein level and microalbuminuria in patients with type 2 diabetes mellitus

Microalbuminuria is a marker of vascular endothelial damage. In addition, it is reported that high serum levels of C-reactive protein [CRP] is a novel cardiovascular risk factor that impairs endothelial function. The aim of this study was to evaluate the relationship between microalbuminuria and elevated serum level of high-sensitivity CRP [HS-CRP] in type 2 diabetic patients. We measured serum levels of HS-CRP in 87 patients with type 2 diabetes mellitus. They were divided into a microalbuminuric group [n = 45] and those with a 24-hour urine albumin less than 30 mg/d [n = 42]. The relationship of serum HS-CRP level with albuminuria and other characteristics of the patients was assessed. Patients with microalbuminuria were significantly older and affected by diabetes mellitus longer than those without microalbuminuria. Also, their mean HS-CRP was significantly higher [4.98 +/- 1.45 mg/L versus 2.82 +/- 2.10 mg/L; P < .001]. The Pearson correlation test showed a significant correlation between HS-CRP level and urine albumin level [r = 0.43; P < .001]. The specificity and sensitivity of HS-CRP for detection of microalbuminuria in were 78.5% and 68.8%, respectively, and the positive and negative predictive values were 77.5% and 70.2%, respectively. In type 2 diabetic patients, microalbuminuria is accompanied by elevated HS-CRP, suggesting activation of inflammatory pathways in progression of renal and cardiovascular atherosclerotic disease. As an easier and cheaper test for assessment of diabetic nephropathy, we recommend further studies on HS-CRP in diabetic patients