Indicies of body composition and uric acid metabolism as markers of metabolic phenotype in normouricemic type 2 diabetic man

The purpose of the workisto investigate the relationship between body composition parameters and uric acid metabolism and lipid spectrum in obese type 2 diabetic male compared with non-obese patients. Materials and methods. In 34 patients with type 2 diabetes, aged 45 to 75 years, with unsatisfactory glycemic control (HbA1c from 7.1 to 12.6 %), mainly with abdominal obesity, anthropometric parameters, characteristics of body composition (percentage of total and abdominal fat, segmental distribution of adipose and muscle tissue, by bioimpedance method), level of HbA1c, C-peptide, concentration of uric acid (UA), 24 h UA excretion, and serum lipid fractions were measured. Patients were divided into 2 groups depending on the degree of obesity: group 1—15 men with overweight without obesity (BMI 25.0—29.9 kg/m2); group2—19 obese men (BMI ≥ 30.0 kg/m2). The groups did not differ in age and disease duration. Results and discussion. Normouricemia was observed in almost all examined patients, without a significant difference in uricemia levels between two groups. In 42 % of obese patients, elevated UA excretion was significantly higher than in the non-obese group, which may reflect increased UA production during the day and increased urate elimination, which leads to normal uricemia. Comparison of body composition between groups with different phenotypes showed that obese patients had significantly higher percentages of total fat and visceral fat than non-obese individuals. Adipose tissue in both groups was evenly distributed between body segments. In obese patients, there was a significant increase in muscle mass, especially in the lower extremities, with some dehydration, as indicated by a decrease in the % water content. Conclusions. It has been shown that both variants of metabolic phenotypes in patients with type 2 diabetes (with and without obesity), under conditions of central fat accumulation and normouricemia, in many cases were accompanied by hyperexcretion of UA, which ensured the preservation of normal uricemia.