Effect of Serum Uric Acid in Augmentation of Insulin Secretion and Improvement of HbA1c in Diabetic Patients: Proposed Statistical Regression Models for Uric Acid, HbA1c and Insulin

Currently serum uric acid is not considered a metabolic biomarker in diabetes. The purpose of the current study was to find the significant associations, correlations and to develop regression models between uric acid, HbA1c, and serum insulin among diabetic patients. The study enrolled type-1 and type-2 diabetic patients for 30 months. For HbA1c and uric acid, patients were divided into two groups: HbA1c <7% or HbA1c ≥7%, UA < 6.5 mg/dl or UA ≥ 6.5mg/dl, respectively. For measurement of insulin levels, patients on diet/metformin only were selected. Data for 1205 patients were analyzed which included 754 (62.6%) males, 451 (37.4%) females, 92 (7.6%) type-1, and 1113 (92.4%) type-2diabetic subjects. For the group HbA1c < 7%, uric acid levels were higher (mean 5.8±4.7) as compared to HbA1c > 7% (mean 4.8±1.5); for the group UA < 6.5 mg/dl, serum insulin levels were lower (mean 39±15.7) as compared to the group with UA≥ 6.5 mg/dl (mean 73.4±20.5). Uric acid was significantly and inversely correlated with HbA1c (r = 0.13, p-value < 0.0001) and positively correlated with serum insulin (r = 0.293, p-value = 0.005). Regression models for uric acid and HbA1c was found to be HbA1c = 10.235 + (-0.094 × uric acid); p-value < 0.000 and for uric acid with insulin was observed to be Serum insulin = -9.650 + (11.595 × uric acid); p-value 0.005. Higher levels of uric acid are associated with lower HbA1c both in type-1 and type-2 diabetic patients. Uric acid is involved in the augmentation of insulin secretion in type-2 subjects.