CORRELATES OF SERUM URIC ACID CONCENTRATION AND ASSOCIATION WITH HYPERTENSION STATUS IN TYPE 1 DIABETES

Trevor J. Orchard1, Tina Costacou1

1 Department of Epidemiology, University of Pittsburgh

Background: Serum uric acid has been positively related to hypertension in the general population although an inverse association was recently reported in a type 1 diabetes study. We thus sought to assess correlates of serum uric acid concentration as well as its association with both systolic blood pressure (SBP) and hypertension in a cohort of childhood-onset type 1 diabetes.

Methods: Adults with type 1 diabetes participating in the 25-year follow-up assessment of the Epidemiology of Diabetes Complications (EDC) study of childhood-onset diabetes were selected for study (n=175, mean age 51 and duration 43 years). Hypertension was defined as blood pressure >140/90 mm/Hg or hypertension medication use. Multivariable linear models were constructed to assess correlates of serum uric acid. Multivariable linear and logistic models were also constructed to assess the independent relationship between serum uric acid and SBP and hypertension, respectively.

Results: Mean serum uric acid in this population was 4.5 mg/dL (SD 1.3).  Female gender and estimated glomerular filtration rate (eGFR) were inversely while non-HDL cholesterol and albumin to creatinine ratio (ACR) were positively correlated to uric acid concentrations.  Adjusting for duration (and thus for age in this cohort), uric acid was directly related to SBP (β=1.94, p=0.04).  However, further adjustment for ACR rendered this relationship non-significant (β=1.15, p=0.24).  The prevalence of hypertension was 33.7%.  Serum uric acid showed a borderline significant direct association with hypertension status after multivariable adjustments (OR=1.28, p=0.06).

Conclusions: Female gender, non-HDL cholesterol, eGFR, and ACR were independent correlates of uric acid, which was positively associated with hypertension status.  We were thus unable to confirm the reported inverse association.

Correlates of serum uric acid concentration and association with hypertension status in type 1 diabetes