Insulin resistance and hyperuricemia in patients with type 1 diabetes mellitus: clinical and biochemical correlates

Abstract

Background. Some patients with type 1 diabetes mellitus (DM) have clinical symptoms that are characteristic of the type 2 DM: obesity, insulin resistance, hypertension, hyperuricemia (HU), dyslipidemia, or the metabolic syndrome, which has been called double diabetes. It is associated with an increased frequency of chronic micro- and macrovascular complications (nephropathy, arteriosclerosis obliterans and ischemic heart disease). The purpose of the study is quantitative assessment of insulin resistance severity using indirect (non-insulin) methods and determination of its correlation with serum uric acid (UA) levels in patients with type 1 DM. Materials and methods. One hundred and eighty-one patients with type 1 DM were examined, their average age was 42.5 ± 12.1 years. Anthropometric research was conducted. Indirect methods for quantitative assessment of insulin resistance were used. The analysis was conducted using non-parametric and parametric statistical methods. Results. In patients with HU, anthropometric indices were significantly higher than in those with normouricemia, which indicated an abdominal type of fat deposition. In HU, a more pronounced insulin resistance was observed compared to that in normouricemia. It was found that in type 1 DM, the serum UA level positively correlated with body mass index, waist circumference, waist-to-hip ratio, triglycerides/high-density lipoprotein cholesterol and negatively with the estimated rate of glucose utilization, sensitivity to insulin and the natural logarithm of the rate of glucose utilization. A group of variables with the greatest contribution to the variation of the serum UA level was selected by stepwise multifactorial regression analysis of models from the studied predicates. Conclusions. It has been shown that patients with type 1 DM and HU have a significantly more severe insulin resistance. There was a correlation between anthropometric and calculated indices, reflecting the severity of insulin resistance, with the serum level of UA. The group of predicates with the greatest contribution to the variance of the serum UA level in patients with type 1 DM was selected.