Urine Glucose Excretion Attenuates the Association Between Lipid Accumulation Product and Serum Uric Acid in Subjects with Prediabetes

Abstract

Purpose

Obesity is known to be strongly associated with hyperuricemia. Moreover, the impact of urine glucose excretion (UGE) on serum uric acid (UA) levels has gained much more attention in recent years. Yet concern is raised about whether UGE influences the relationship between obesity and hyperuricemia. The aim of this study was to assess the effect of UGE on the association between lipid accumulation product (LAP), a novel marker of visceral adipose accumulation, and UA in subjects with prediabetes.

Materials and Methods

Data were obtained from a cross-sectional study. A total of 3645 subjects with prediabetes were included in the present study. The separate and joint associations of LAP and UGE with hyperuricemia were examined using logistic regression analyses.

Results

LAP was positively associated with UA in both genders. Subgroup analysis based on UGE revealed that the association was strongest in subjects with low UGE (r = 0.328, p < 0.001), whereas the positive association was weakened, but still remained significant in subjects with moderate and high UGE. High LAP was significantly associated with an increased odds ratio for hyperuricemia after adjustment for potential confounders in the overall population (OR = 2.07, 95% CI: 1.66–2.58, p < 0.001). However, a downward trend in odds ratios for hyperuricemia was observed across UGE categories. In addition, the joint association analysis confirmed that the relationship between LAP and hyperuricemia was attenuated by UGE.

Conclusion

The positive association between LAP and UA appears to be attenuated by UGE, indicating that promoting UGE may be an effective strategy for controlling UA levels, especially for people with obesity who are at increased risk for hyperuricemia.

Keywords:

• prediabetes
• lipid accumulation product
• uric acid
• urine glucose excretion

Abbreviations

UA, uric acid; LAP, lipid accumulation product; BMI, body mass index; UGE, urine glucose excretion; WC, waist circumference; HR, heart rate; FPG, fasting plasma glucose; 2h-PG, 2 h plasma glucose; HbA1c, hemoglobin A1c; TC, total cholesterol; TG, triglyceride; ALT, alanine aminotransferase; AST, aspartate transaminase; BUN, blood urea nitrogen; SGLT2, sodium-glucose cotransporter 2; L-LAP, low LAP; H-LAP, high LAP; OR, odds ratio; CI, confidence interval.

Ethics Approval and Informed Consent

This study was approved by the ethical review committee of the Jiangsu Provincial Center for Disease Control and Prevention (JSJK2016‑B003‑03). Informed consent was obtained from all subjects included in the study.

Data Sharing Statement

The data used to support the findings of this study are available from the corresponding author upon request.

Acknowledgments

We owe our sincere thanks to the local research teams and colleagues for assistance in participant recruitment. We are grateful to many residents of Jiangsu Province who participated in this study. We thank all the staff who were involved in this study for their important contributions.

Author Contributions

All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This study was supported by grants from the National Natural Science Foundation of China (Grant No. 81774117 and No.81573911), National Key R&D Program of China (2016YFC1305700), National Key Scientific Instrument and Equipment Development Project of China (No. 51627808). The funders had no roles in study design, data collection, data analysis, interpretation, or writing the manuscript.