Prevalence of Hyperuricemia and the Relationship Between Serum Uric Acid and Hypertension in New Onset Diabetic Patients: A Cross-Sectional Indian Study

Abstract

Objective

Prevalence of hyperuricemia (HU) is increasing and it is associated with hypertension, metabolic syndrome, diabetes mellitus (DM), obesity, chronic kidney disease, gout and cardiovascular disease. Elevated level of serum uric acid (SUA) has been shown to be associated with hypertension and diabetes in many countries but there is lack of evidence from India. The aim of this study is to know the prevalence of HU and to know the relationship between SUA and hypertension in newly onset DM.

Methods

This is a cross-sectional study from a tertiary center. A total of 305 (males: 212; females: 93) newly diagnosed diabetic patients were enrolled. All patients were categorized as normotensive (<140/90) and hypertensive (≥140/90) based on ADA criteria. Based on SUA level participants were grouped into 3 tertile (T1: <4.52; T2: 4.52–5.64; T3: >5.64 mg/dl).

Results

The mean age, systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the patients were 46.76 ±0.61 years, 130.6±1.06 mmHg and 84.11±0.63 mmHg, respectively. The mean level of SUA was 5.14±0.073 mg/dl and level was significantly higher in males compared with females (P <0.000). Overall prevalence of HU and hypertension was 12.13% and 44.59%, respectively. There was an increase in the prevalence of hypertension across the SUA tertile. SBP and DBP significantly increased across the SUA tertile (P <0.014 and <0.001, respectively). A multiple logistic regression analysis revealed that SUA tertile was independently associated with presence of hypertension (P <0.01).

Conclusion

This first report on the population of the eastern part of India indicates a significant positive relationship between SUA and hypertension among the newly onset Indian diabetic patients. Therefore, routine measurement of SUA is recommended in newly onset hypertensive diabetic patients to prevent HU and its related complications.

Keywords:

• serum uric acid
• hypertension
• newly onset diabetes mellitus
• blood pressure
• prevalence

Abbreviations

HU, hyperuricemia; DM, diabetes mellitus; SUA, serum uric acid; SBP, systolic blood pressure; DBP, diastolic pressure; CVD, cardiovascular disease; UA, uric acid; IR, insulin resistance; MS, metabolic syndrome; CKD, chronic kidney disease; BMI, body mass index; WC, waist circumference; BP, blood pressure; GlyHbA1c, glycosylated hemoglobin A1c; GFR, glomerular filtration rate; FPG, fasting plasma glucose; HDL, high density lipoprotein; TG, triglyceride; TC, total cholesterol; LDL, low density lipoprotein; CHD, coronary heart disease; RASS, renin-angiotensin- aldosterone system; NO, nitric oxide; MACE, major adverse cardiovascular event; CAVI, cardio-ankle vascular index.

Acknowledgments

The authors gratefully acknowledge Vanshika Singh, Praveer Anand and Yogender Singh for their critical comments. Authors also wish to thank Prof Dinesh Kumar, Department of Biotechnology, Central University of Haryana, for his constant motivation and critical comments.

Author Contributions

SKS contributed in conceptualization, designing, acquisition of data and execution of the work. MAI and SJ analyzed the data. All authors made a significant contribution in interpretation. SKS took part in initial drafting, all authors contributed in revising the article and gave final approval of the version to be published. All authors have agreed on the journal to which the article has been submitted and further agreed to be accountable for all aspects of the work.

Disclosure

Authors have no conflicts of interest related to this work to disclose.