diabetes mellitus, uric acid, metabolic phenotype, obesity, hypoxanthine-guanine-phosphoribosyltransferase


Background. Uric acid (UA) metabolism disorders have been considered in recent years among the polymetabolic changes in type 2 diabetes mellitus and metabolic syndrome. UA dysmetabolism has been shown to be associated with pathophysiological phenotypes accompanied by general and/or visceral obesity and by a high cardiovascular and renal risk. However, hyperuricemia does not always occur, and urinary urate excretion studies may reveal hyperproduction and hyperexcretion of UA. The aim of our study was to establish the features of body composition and metabolic phenotype, including uricemia, insulinemia, serum lipid spectrum in patients with type 2 diabetes depending on gender, obesity and abdominal fat.

Materials and methods. We examined 47 type 2 diabetіс patients (25 men and 22 women), aged 30 to 82 years. Patients (men and women separately) were divided into subgroups: non-obese (BMI < 30 kg/m2) and obese (BMI > 30 kg/m2). Anthropometric and body composition parameters were determined: % of total fat and water, abdominal fat level, segmental distribution of fat and muscle mass by bioelectric impedance. Serum and urine UA levels were determined, UA clearance, fractional excretion relative to creatinine, hypoxanthine guanine phosphoribosyltransferase (HGFRT) activity, and carbohydrate metabolism parameters (fasting blood glucose, HbA1c, hydrochloride, insulin) were evaluated.

Results. In obese patients, compared with non-obese persons, at the background of higher levels of insulin and HOMA-IR, higher scores of visceral fat, total fat content, bone mass, body fat mass were recorded. The level of uricemia in both subgroups of both genders was within the gender norm, despite the increased or close to the upper limit of normal UA daily production. In the subgroup of men with the obesity phenotype, compared with non-obese persons, an increase in uricemia and triglycerides was found, which may be due to the influence of anabolic factors found in this group, which activate the processes of purine and fatty acid biosynthesis de novo. In obese women, compared with the non-obese subgroup, there was a significantly higher UA clearance and fractional urate excretion, due to which the level of uricemia is maintained within normal limits.

Conclusion. The study of uric acid metabolism and lipid spectrum in men and women with type 2 diabetes depending on the phenotype of obesity revealed a difference in the mechanisms that cause disorders of purine and lipid metabolism and the character of fat accumulation associated with changes in anabolic-catabolic balance, including insulin levels and the activity of the anabolic pathway of purine recycling.


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How to Cite

Прибила, О., Зінич, О., Кушнарьова , Н., Ковальчук, А., Корпачев, В., Шупрович, А., & Шишкань-Шишова, К. (2022). PECULIARITIES OF URIC ACID METABOLISM IN MEN AND WOMEN WITH TYPE 2 DIABETES MELLITUS DEPENDING ON PHENOTYPES. Problems of Endocrine Pathology, 79(1), 57-64.