La hemoglobina glucosilada como marcador de riesgo de hiperuricemia en la población general / Glycosylated hemoglobin as a hyperuricemia risk marker in general population

Fundamento y objetivo: Evaluar la hipótesis de que valores elevados de glucemia se asocian con menores valores séricos de ácido úrico, en 2 poblaciones independientes. Pacientes y método:La primera población procede del Estudio Pizarra, estudio prospectivo con 1.226 sujetos que se clasificaron según su situación metabólica tras una sobrecarga oral de glucosa. Se midieron variables antropométricas, valores basales de insulina, ácido úrico y resistencia a la insulina según el Homeostasis Model Assessment (HOMA-IR). La segunda muestra procede de la base de datos del Hospital Universitario Carlos Haya (Málaga), que recoge 81.754 sucesivas peticiones analíticas de hemoglobina glucosilada (HbA1c) realizadas a lo largo de 30 meses.Resultados: En el Estudio Pizarra los valores de glucosa se relacionaron con los valores de ácido úrico en ambos sexos. En la segunda muestra los valores de ácido úrico de mujeres siguieron una relación en forma de campana con la HbA1c, incrementándose hasta valores de HbA1c del 7% y descendiendo a medida que la HbA1c aumentaba (p<0,0001). En varones se produjo un descenso lineal de los valores de ácido úrico con el incremento de la HbA1c (r=−0,19; p<0,0001), a partir de valores de HbA1c del 7%. El valor de odds ratio para hiperuricemia descendió de manera continua según aumentaban los valores de HbA1c. Conclusión: Este estudio muestra en ambas poblaciones una correlación no lineal entre los valores séricos de ácido úrico y los de glucosa, HbA1c y HOMA-IR, siendo esta tendencia especialmente marcada en mujeres. El riesgo de hiperuricemia y gota podría ser mayor en las personas con estados prediabéticos o con diabetes mejor controlados que en diabéticos mal controlados (AU)

Background and objectives: To evaluate the association between high levels of glycemia and low serum uric acid levels in two independent population-based samples. Patients and methods: The first sample was taken from the Pizarra Study, a population-based prospective study of 1.226 persons classified according to their glycometabolic status, as measured from an oral glucose tolerance test. Variables recorded included anthropometric data, serum fasting insulin, uric acid (UA) and HOMA-IR. The second sample was obtained from the Central Laboratory Database, which includes 81,754 laboratory requests for HbA1c carried out over 30 months. We selected those that included measurements of UA, triglycerides and albuminuria Results: In the Pizarra Study, the fasting glucose levels showed a bell-shaped relation with serum UA levels in men andmore especially in women (P < 0.0001). In the second sample, the UA levels in women showed a bell-shaped relation with HbA1c, increasing as the HbA1c rose to 7% and then falling with the further increase of HbA1c (P < 0.0001). Men experienced a linear decrease in UA levels as the HbA1c rose (r = 0.19; P < 0.0001), though only with effect from HbA1c values > 7%. The odds ratio for hyperuricemia ( 6 mg/dL in women and 7 mg/dL in men) fell continuously as the HbA1c levels rose. Conclusions: This study, undertaken in two different populations, showed that serum UA levels are nonlinearlycorrelated with the levels of glucose, HbA1c and HOMA-IR, especially in women. The risk ofhyperuricemia and gout may be higher in persons with prediabetic states or with better-controlleddiabetes than in persons with poorly-controlled diabetes (AU)

[Glycosylated hemoglobin as a hyperuricemia risk marker in general population]. / La hemoglobina glucosilada como marcador de riesgo de hiperuricemia en la población general.

BACKGROUND AND OBJECTIVES: To evaluate the association between high levels of glycemia and low serum uric acid levels in two independent population-based samples. PATIENTS AND METHODS: The first sample was taken from the Pizarra Study, a population-based prospective study of 1.226 persons classified according to their glycometabolic status, as measured from an oral glucose tolerance test. Variables recorded included anthropometric data, serum fasting insulin, uric acid (UA) and HOMA-IR. The second sample was obtained from the Central Laboratory Database, which includes 81,754 laboratory requests for HbA(1c) carried out over 30 months. We selected those that included measurements of UA, triglycerides and albuminuria. RESULTS: In the Pizarra Study, the fasting glucose levels showed a bell-shaped relation with serum UA levels in men and more especially in women (P<0.0001). In the second sample, the UA levels in women showed a bell-shaped relation with HbA(1c), increasing as the HbA(1c) rose to 7% and then falling with the further increase of HbA(1c) (P<0.0001). Men experienced a linear decrease in UA levels as the HbA(1c) rose (r=-0.19; P<0.0001), though only with effect from HbA(1c) values > 7%. The odds ratio for hyperuricemia (≥ 6mg/dL in women and ≥ 7mg/dL in men) fell continuously as the HbA(1c) levels rose. CONCLUSIONS: This study, undertaken in two different populations, showed that serum UA levels are non-linearly correlated with the levels of glucose, HbA(1c) and HOMA-IR, especially in women. The risk of hyperuricemia and gout may be higher in persons with prediabetic states or with better-controlled diabetes than in persons with poorly-controlled diabetes.