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

Q: What are the key findings of this study?

Higher serum uric acid was independently associated with hypertension in newly diagnosed diabetic patients.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Newly diagnosed diabetes mellitus (n=305). Intervention: Highest serum uric acid tertile (T3: >5.64 mg/dl) vs. Lowest serum uric acid tertile (T1: <4.52 mg/dl). Primary outcome: Prevalence of hypertension (SBP ≥140 mmHg and/or DBP ≥90 mmHg) (OR 1.287, 95% CI 1.057-1.592, p=<0.01).

Q: What does this research mean for the field?

Higher serum uric acid levels are independently associated with an increased prevalence of hypertension in patients with newly diagnosed diabetes mellitus. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To determine the prevalence of hyperuricemia and evaluate the relationship between serum uric acid levels and hypertension in patients with newly diagnosed diabetes mellitus.

Singh Sk; Rina Singh; Santosh Kumar Singh; Mir Asif Iquebal; Sarika Jaiswal; Archana Singh

doi:10.2147/dmso.s363311

June 1, 2022Diabetes Metabolic Syndrome and ObesityOpen Access

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

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Key result

Higher serum uric acid linked to ~29% higher hypertension odds in newly diagnosed diabetes.

OR 1.287
95% CI 1.057-1.592
P<0.01
n=305

Figures

Why the study?

Elevated serum uric acid is associated with hypertension and diabetes globally, but evidence from India was lacking.

Is elevated serum uric acid independently associated with hypertension in patients with newly diagnosed diabetes mellitus in eastern India?

Key Points

To determine the prevalence of hyperuricemia and evaluate the relationship between serum uric acid levels and hypertension in patients with newly diagnosed diabetes mellitus.
Cross-sectional study at a tertiary center in eastern India enrolling 305 newly diagnosed diabetic patients (212 males, 93 females; mean age 46.76 ±0.61 years).
Hypertension was categorized by ADA criteria (normotensive <140/90 mmHg; hypertensive ≥140/90 mmHg) and participants were stratified into serum uric acid (SUA) tertiles (T1: <4.52 mg/dl, T2: 4.52–5.64 mg/dl, T3: >5.64 mg/dl).
Relationships were assessed using Pearson's correlation and multiple logistic regression models adjusting for age, sex, glomerular filtration rate (GFR), and body mass index (BMI).
Overall prevalence was 12.13% for hyperuricemia (11.79% in males, 12.90% in females) and 44.59% for hypertension (44.34% in males, 45.16% in females).
Mean systolic blood pressure increased from 126.89±1.82 mmHg in T1 to 132.79±1.75 mmHg in T3 (P <0.014), and diastolic blood pressure increased from 80.67±1.00 mmHg in T1 to 85.84±1.07 mmHg in T3 (P <0.001); SUA correlated positively with SBP (r = 0.135, P <0.018) and DBP (r = 0.181, P <0.001).
In the fully adjusted model controlling for age, sex, GFR, and BMI, higher SUA tertile was independently associated with hypertension, with an odds ratio of 1.287 (95% CI 1.057–1.592) for T3 versus T1 (P <0.01 for trend).

Study Design

Type

Cross-Sectional (n=305)

Multicenter

No

Structured PICO

Is elevated serum uric acid independently associated with hypertension in patients with newly diagnosed diabetes mellitus in eastern India?

P

Population

305 adults with newly diagnosed diabetes mellitus (duration <1 year, mean age 46.76 years, 30.5% female) at a single tertiary center in eastern India, free of cardiac, renal, or hepatic disease.

E

Exposure

Elevated serum uric acid levels categorized into tertiles: Tertile 2 (4.52-5.64 mg/dl, n=102) and Tertile 3 (>5.64 mg/dl, n=101)

C

Comparator

Lowest serum uric acid tertile: Tertile 1 (<4.52 mg/dl, n=102)

O

Outcome

Prevalence of hypertension (defined as SBP ≥140 mmHg and/or DBP ≥90 mmHg based on ADA criteria) and its independent association with serum uric acid tertilessurrogate

Main Result

Odds Ratio: 1.287 (95% CI 1.057–1.592)

Absolute Event Rate: 50.5% vs 36.27%

p-value: p=<0.01

Limitations

Cross-sectional nature prevents assessing cause-effect relationship
Moderate sample size and single-center design may introduce bias
Inability to analyze dietary patterns which influence serum uric acid levels
Moderate sample size from a single center may introduce bias
Dietary patterns were not analyzed despite their influence on serum uric acid levels

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Implication

This cross-sectional study demonstrates a high prevalence of hypertension (44.59%) and hyperuricemia (12.13%) in newly diagnosed Indian diabetic patients, with serum uric acid independently associated with hypertension.

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.

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Cite This Study

Sk et al. (2022) conducted a cross-sectional in Newly diagnosed diabetes mellitus (n=305). Highest serum uric acid tertile (T3: >5.64 mg/dl) vs. Lowest serum uric acid tertile (T1: <4.52 mg/dl) was evaluated on Prevalence of hypertension (SBP ≥140 mmHg and/or DBP ≥90 mmHg) (OR 1.287, 95% CI 1.057-1.592, p=<0.01). Higher serum uric acid was independently associated with hypertension in newly diagnosed diabetic patients.

synapsesocial.com/papers/6a7af58202ab7a73dd032733 https://doi.org/10.2147/dmso.s363311

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

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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