The Relationship Between Uric Acid And Cardiovascular Disease Risk Markers In Type Ii Diabetes At Mulago National Referral Hospital Kampala.

Abstract

Introduction: A relationship between hyperuricemia and Cardiovascular Disease (CVD) has been established since the 1900's and commonly increased uric acid levels are found in patients with cardiovascular disease and many prospective and cohort studies have demonstrated uric acid as a CVD risk factor. However a controversy exists as to whether uric acid is an independent risk factor to CVD. This study therefore aimed at determining the relationship between uric acid and CVD risk markers in type II DM patients Materials & methods: A total number of 217type II DM participants were recruited. A prospective cross sectional study design was done. Blood samples were collected and run for lipid profile, uric acid and fasting blood sugar using the COBAS 600 Chemistry analyzer at Mulago National Referral Hospital clinical chemistry laboratory. Results: We recruited 218 type 2 diabetic patients aged 20 – 90 years .Fifty-five (55/218; 25.2%) of the participants were males and the mean age of the participants was 49 years with 95% confidence interval of 47 – 51years. The mean fasting glucose level of the participants was 10.4 mmol/l. Most of the participants (n=111; 50.9%) had poor glycemic control with fasting glucose level greater than7.0mmol/l and15 (6.9%) of the participants had low blood glucose (lower than 3.8mmol/l). Up to 34.4% of the participants had increased Total cholesterol level higher than 5.7mmol/l, with reduced HDL level (<0.91mmol/L).36.7% of the participants had high levels of low density lipoprotein (> 3.37) and only 19.7% had higher levels of HDL. Only Total Cholesterol and Low Density Lipoprotein correlate with age but the rest of the variables i.e. Uric Acid, Fasting Blood Glucose, High Density Lipoprotein and Triglycerides do not have any correlation with age. The mean uric acid level of the participants was 4.84mg/dl with a 95% confidence interval of 4.66 – 5.03mg/dl. Males had higher uric acid levels compared to females (mean of 5.07mg/dl 95% CI 4.61 – 5.56mg/dl compared to 4.72mg/dl with 95% CI of 4.57 – 4.98mg/dl in females) p-value 0.0043. Conclusion: Despite the several population and cohort studies that demonstrated a relationship between uric acid and CVD risk markers, the present study demonstrated that there is no significant relationship between uric acid and CVD risk markers. We suggest that a population study with a bigger sample size be done to confirm the findings.