DETERMINATION OF THE EFFECT OF HYPERURICEMIA ON THE DEVELOPMENT OF INSULIN RESISTANCE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND GOUT
Summary. Type 2 diabetes mellitus (T2DM) is a multifactorial disease, the main pathophysiological link of which is determined by a chronic metabolic disorder characterized by resistance of the body’s peripheral cells to insulin. Researching the influence of hyperuricemia on the progression of insulin resistance (IR) is important, due to the possibility of forming a further prognostic assessment of the development of T2DM on the background of gout. The purpose: to establish the presence of relationships between the uricemia and the levels of AMPK, chemerin and IR markers (blood insulin and HOMA index). Materials and methods. 100 patients participated in the study, who were divided into 2 groups: 1 group — patients with gout and T2DM, n=70; 2 group — patients with a monocourse of gout, n=30, control group (CG) — relatively healthy individuals, n=20. All patients were estimated for the levels of serum chemerin, AMPK, insulin, and uric acid according to generally accepted methods; the HOMA-IR index was calculated mathematically. Pearson’s linear correlation coefficient (r) and variance analysis were used for statistical analysis. The results. Patients of group 1 had the highest levels of insulin and the HOMA index, as well as the lowest level of AMPK — 40.26±21.29 μU/ml, 11.04±6.23 and 8.56±4.01 ng/ml, appropriately (p <0.0001). The level of chemerin was 12.51±3.92 ng/ml and 9.86±2.66 ng/ml (p<0.0012) among patients of group 1 and 2, appropriately. Both groups showed persistent hyperuricemia (515.7±91.59 μmol/l and 496.4±77.61 μmol/l in groups 1 and 2, appropriately), and CG was characterized by normouricemia (299.0±29.21 μmol/l). Correlation analysis revealed high and medium strength relationships between the level of uricemia and markers of carbohydrate metabolism and IR. Conclusions. The presence of a direct relationship between the average strength of uricemia and the level of chemerin and a strong inverse correlation between the level of uric acid and AMPK among patients of both studied groups was established, as well as a direct relationship of average strength between indicators of uric acid and insulin in patients with a monocourse of gout.
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