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Lowering serum urate does not improve endothelial function in patients with type 2 diabetes
W S Waring1, J A McKnight, D J Webb
1Clinical Pharmacology Unit, University of Edinburgh, Edinburgh, UK. s.waring@ed.ac.uk
Diabetologia
|October 12, 2007
Summary
Lowering serum uric acid in type 2 diabetes patients did not improve endothelial function. This study suggests that reducing uric acid alone may not be sufficient to restore vascular health in this high-risk population.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Metabolic Syndrome
Background:
- Endothelial dysfunction is a key contributor to cardiovascular risk in type 2 diabetes.
- Elevated serum uric acid is associated with endothelial dysfunction and proposed as an independent cardiovascular risk factor in type 2 diabetes.
Purpose of the Study:
- To investigate whether lowering serum uric acid concentrations can restore endothelial function in patients with type 2 diabetes.
- To assess the direct vascular effects of acute uric acid reduction.
Main Methods:
- A randomized, placebo-controlled, crossover study involving ten patients with type 2 diabetes and ten healthy controls.
- Intravenous urate oxidase was administered to lower uric acid levels.
- Forearm blood flow responses to vasodilators and vasoconstrictors, and arterial stiffness (augmentation index) were measured.
Main Results:
- Urate oxidase significantly reduced serum uric acid by 64% in both groups.
- No significant improvements in forearm blood flow responses to acetylcholine or L-NMMA were observed.
- Baseline augmentation index was significantly higher in type 2 diabetes patients, but urate oxidase had no effect on this measure.
Conclusions:
- Short-term, substantial lowering of serum uric acid did not directly improve endothelial function or arterial stiffness.
- Reducing uric acid alone may not be an effective strategy for improving vascular health in patients with type 2 diabetes.
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