Study On The Correlation Between Serum Uric Acid And Blood Glucose Metabolism In Newly Diagnosed Type 2 Diabetes

Objective:There is a correlation between uric acid and blood glucose levels,although the causes and mechanisms of this relationship require further study.We explored the dependent condition of the relationship between uric acid and blood glucose.Methods:We retrospectively studied 605 newly-diagnosed type 2 diabetes patients.We measured patient serum uric acid(SUA),transaminase,creatinine,and lipids profiles etc,and we detected glycosylated hemoglobin(HbAlc)to evaluate the plasma glucose level.We then conducted oral glucose tolerance tests(OGTTs)and insulin release tests(0,30,60,120min)on each patient.The total insulin level(InsAUC120),the early phase insulin secretion index(INSR30),the total insulin secretion index(INSR120)and the islet beta cell function index(HOMA-?)was calculated.Multiple regression analysis was performed to identify the correlation among serum uric acid,HbAlc,and the total insulin level(InsAUC120).We analyzed the relationship between the serum uric acid and insulin secretion index as well as the relationship between the serum uric acid pancreatic beta cell function index with pearson correlation analysis.Result:Serum uric acid showed statistically significant difference in regard to sex,which in male group is significantly higher than that in female group.No matter male or female,the concentration of serum uric acid showed a positive relationship with AUCIns120 after adjusting for age,BMI,SBP,DBP,triglycerides,creatinine and HbAlc by multiple regression analysis.After adjusting for age,BMI,SBP,DBP,triglycerides,creatinine and serum uric acid,the serum concentration of HbAlc showed a negative relationship with the AUCIns120.But we found that there is not regression relationship between serum uric acid and HbA1c after adjustment for factors including age,BMI,SBP,DBP,triglycerides,creatinine and AUCIns120! The concentration of serum uric acid was inversely correlated with HbAlc levels in the high insulin group,regardless of patient sex.However,no associations were found in low insulin group.Patients with hyperuricemia had higher the early phase insulin secretion index(INSR30),the total insulin secretion index(INSR120)and the islet beta cell function index(HOMA-?).Pearson correlation analysis showed that no matter both male and female group,serum uric acid was positively correlated with insulin secretion index and pancreatic beta cell function index.Conclusions:The negative correlation between uric acid and HbAlc is conditional in newly-diagnosed type 2 diabetes patients and is related to hyperinsulinemia.Therefore,uric acid is likely only useful as a biomarker of blood glucose in patients exhibiting hyperinsulinemia.Uric acid level can be considered as the serum marker of insulin secretion ability of the beta cell in newly diagnosed type 2 diabetes.Objective:The status of duodenal jejunal bypass(DJB)in the treatment of type 2 diabetes has been extensively elucidated,but the mechanism is still unclear.Our study is to explore the pathways of the glucose metabolism improvement after duodenal jejunal bypass(DJB)in diabetic rats.Methods:Twenty-four non obese type 2 diabetic rats(GK rats)and normal rats(SD rats)were divided into DJB operation group and sham operation group.Weight,fasting blood glucose,fasting insulin,oral glucose tolerance test(OGTT)and insulin release test were performed,and the area under insulin curve and insulin sensitivity index(HOMA-IS)were calculated.The gene expressions of the key enzymes of intestinal gluconeogenesis-glucose-6-phosphatase(Glc6Pase)and phosphoenolpyruvate(PEPCK)were assessed.The sodium-glucose cotransporter 3(sglt3)at portal vein wall as well as the insulin receptor substrate 2(IRS-2)and glucose transporter 2(GLUT2)in hepatocyte were detected.Results:The blood glucose of GK rats began to decrease in the first week after DJB,and the blood glucose of GK rats at eighth week after operation was significantly lower than that of preoperative.The weight of the rats in all groups decreased in the first weekend after operation,which began to rise in the second week,and was significantly higher at eighth week after operation than that of preoperative.The level of fasting insulin in the operation group of GK rats was gradually increased after operation,which higher than that in the sham operation group,but there were no statistical difference.The key gluconeogenic enzymes(PEPCK and G-6-Pase)mRNA expressions in distal jejunum tissue of GK rats in surgery group were significantly higher than that in the sham operation group at the end of the 8th week after operation.Regardless of the surgery group and sham operation group,the intestinal G-6-Pase mRNA expressions of GK rats were significantly higher than that of SD rats.The expression levels of sodium-glucose cotransporter 3(sglt3)in portal vein and the key proteins of hepatic insulin signaling pathway,insulin receptor substrate 2(IRS-2)and glucose transporter 2(GLUT2),of GK rat operation group were significantly increased and the remaining rats had no obvious changes.Conclusion:The DJB surgery can increase the level of intestinal gluconeogenesis of GK rat,which can up-regulate the key molecules in the insulin signaling pathway through the activation of glucose sensor(sglt3)at portal vein wall and thus plays an important role in improvement of peripheral glucose metabolism.