Serum uric acid predicts progression of islet beta cell function decline in female patients with type 2 diabetes mellitus

Abstract

Abstract Background: It remains controversial whether serum uric acid (SUA) level can predict beta cell function decline in patients with type 2 diabetes mellitus. The present study aims to investigate the association between baseline SUA levels and longitudinal islet beta cell changes in a cohort of Chinese type 2 diabetes patients. Methods: In the present single-center longitudinal retrospective study, 473 type 2 diabetes patients who received standard 75g oral glucose tolerance test (OGTT) and insulin release test both at baseline and after follow-up were included. Beta cell function was assessed using the homeostasis model. Cox hazards regression analysis was used to evaluate the association between levels of SUA and decline of beta cell function. Results: At baseline, patients with higher SUA levels had higher triglyceride level (p=0.000), higher BMI (p=0.003), higher level of HbA1c (p=0.000) and HOMA-B (p=0.000). In contrast, during follow-up, a higher annual rate of decline in beta cell function (RHOMA-B) was found in females with the highest uric acid than patients with lower uric acid (p=0.017), but not in males (p=0.494). In addition, a positive correlation was observed between SUA and RHOMA-B in total (r=0.103, p=0.043) and in females (r=0.192, p=0.032). SUA levels were not correlated to RHOMA-B in males throughout. Consistently, multivariate analysis revealed that HOMA-IR (p=0.025) was the only one independent predictor of beta cell function decline in males, whereas elevated SUA (p=0.008) and age (p=0.009) were independently associated with longitudinal beta cell function impairment independently of potential confounders in females. Conclusions: An independent positive association between SUA and long-term beta cell function decline was demonstrated in female patients with type 2 diabetes, but not in males. A potential close association and interaction among uric acid metabolism, sexual hormones, and insulin secretion capability might exist in type 2 diabetes patients.