Serum uric acid and insulin sensitivity in adolescents and adults with and without type 1 diabetes

• Published in: Journal of diabetes and its complications 2014-05, Vol.28 (3), p.298-304
• Main Authors: Bjornstad, Petter, Snell-Bergeon, Janet K, McFann, Kimberly, Wadwa, R. Paul, Rewers, Marian, Rivard, Christopher J, Jalal, Diana, Chonchol, Michel B, Johnson, Richard J, Maahs, David M
• Format: Article
• Language: English
• Subjects: Acids; Adolescent; Adolescents and adults; Adult; Age; Age Factors; Body mass index; Case-Control Studies; Child; Cholesterol; Cross-Sectional Studies; Diabetes; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - physiopathology; Endocrinology & Metabolism; Female; Humans; Incidence; Insulin; Insulin Resistance - physiology; Insulin sensitivity; Longitudinal Studies; Male; Middle Aged; Risk Factors; Serum uric acid; Teenagers; Type 1 diabetes; Uric Acid - blood; Vascular Diseases - epidemiology; Vascular Diseases - etiology; Young Adult
• ISSN: 1056-8727; 1873-460X
• DOI: 10.1016/j.jdiacomp.2013.12.007

Abstract Hypothesis Decreased insulin sensitivity (IS) exists in type 1 diabetes. Serum uric acid (SUA), whose concentration is related to renal clearance, predicts vascular complications in type 1 diabetes. SUA is also inversely associated with IS in non-diabetics, but has not been examined in type 1 diabetes. We hypothesized SUA would be associated with reduced IS in adolescents and adults with type 1 diabetes. Methods The cross-sectional and longitudinal associations of SUA with IS were investigated in 254 adolescents with type 1 diabetes and 70 without in the Determinants of Macrovascular Disease in Adolescents with Type 1 Diabetes Study, and in 471 adults with type 1 diabetes and 571 without in the Coronary Artery Calcification in Type 1 diabetes (CACTI) study. Results SUA was lower in subjects with type 1 diabetes (p < 0.0001), but still remained inversely associated with IS after multivariable adjustments in adolescents (β ± SE: − 1.99 ± 0.62, p = 0.001, R2 = 2%) and adults (β ± SE: − 0.91 ± 0.33, p = 0.006, R2 = 6%) with type 1 diabetes, though less strongly than in non-diabetic controls (adolescents: β ± SE: − 2.70 ± 1.19, p = 0.03, R2 = 15%, adults: β ± SE: − 5.99 ± 0.75, p < 0.0001, R2 = 39%). Conclusion We demonstrated a significantly weaker relationship between SUA and reduced IS in subjects with type 1 diabetes than non-diabetic controls.