Renal clearance of uric acid is linked to insulin resistance and lower excretion of sodium in gout patients

Inefficient renal excretion of uric acid is the main pathophysiological mechanism for hyperuricemia in gout patients. Polymorphisms of renal tubular transporters linked with sodium and monosaccharide transport have yet to be demonstrated. We intended to evaluate the impact of insulin resistance, eva...

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Bibliographic Details
Published in:Rheumatology international 2015-09, Vol.35 (9), p.1519-1524
Main Authors: Perez-Ruiz, Fernando, Aniel-Quiroga, Maria Angeles, Herrero-Beites, Ana María, Chinchilla, Sandra Pamela, Erauskin, Gorka Garcia, Merriman, Toni
Format: Article
Language:English
Subjects:
Adult
Female
Gout - complications
Gout - metabolism
Gout - physiopathology
Humans
Hypertension - complications
Hypertension - metabolism
Hypertension - physiopathology
Hyperuricemia - complications
Hyperuricemia - metabolism
Hyperuricemia - physiopathology
Insulin resistance
Insulin Resistance - physiology
Kidney - metabolism
Kidney - physiopathology
Male
Medicine
Medicine & Public Health
Middle Aged
Original Article - Observational Research
Rheumatology
Sodium - metabolism
Uric Acid - metabolism
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Summary:Inefficient renal excretion of uric acid is the main pathophysiological mechanism for hyperuricemia in gout patients. Polymorphisms of renal tubular transporters linked with sodium and monosaccharide transport have yet to be demonstrated. We intended to evaluate the impact of insulin resistance, evaluated with the homeostasis model assessment (HOMA), through a transversal study of non-diabetic patients with gout, with normal renal function, not treated with any medication but colchicine as prophylaxis. One hundred and thirty-three patients were evaluated. Clearance of uric acid was inversely correlated with insulin resistance and directly correlated with fractional excretion of sodium. In multivariate analysis, hypertension and hyperlipidemia, in addition to insulin resistance and fractional excretion of sodium, were associated with renal clearance of uric acid. HOMA cutoff for efficient versus inefficient renal handling of uric acid was 2.72, close to that observed in studies of reference population. The impact of insulin resistance and renal handling of sodium on renal clearance of uric acid may help to explain why hyperuricemia is more commonly associated with diabetes and hypertension.
ISSN:0172-8172
1437-160X
DOI:10.1007/s00296-015-3242-0