A patented kinetic uricase method was evaluated for serum uric acid assay. Initial absorbance of the reaction mixture before uricase action (A(0)) was obtained by correcting the absorbance at 293 nm measured before the addition of uricase solution, and background absorbance (A(b)) was predicted by an integrated method. Uric acid concentration in reaction solution was calculated from A, the difference between A(0) and A(b), using the absorptivity preset for uric acid. This kinetic uricase method exhibited CV<4.3% and recovery of 100%. Lipids, bilirubin, hemoglobin, ascorbic acid, reduced glutathione and xanthine <0.32 mmol/L in serum had no significant effects. A linearly responded to 1.2 to 37.5 micromol/L uric acid in reaction solution containing 15 microl serum. The slope of linear response was consistent with the absorptivity preset for uric acid while the intercept was consistent with that for serum alone. Uric acid concentrations in clinic sera by different uricase methods positively correlated to each other. By Bland-Altman analysis, this kinetic uricase method accorded with that by quantifying the total change of UV absorbance on the completion of uricase reaction. These results demonstrated that this kinetic uricase method is reliable for serum uric acid assay with enhanced resistance to both xanthine and other common errors, wider range of linear response and much lower cost.
Humans ; Kinetics ; Reagent Kits, Diagnostic ; Spectrophotometry, Ultraviolet ; Urate Oxidase ; chemistry ; Uric Acid ; blood ; metabolism

BACKGROUNDEvidences show that subclinical chronic inflammation is involved in the pathogenesis of diabetic nephropathy. The aim of this study was to examine the relationship between serum C-reactive protein (CRP), serum uric acid, and albuminuria in Chinese type 2 diabetic patients.

METHODSA total of 1162 type 2 diabetic patients were recruited. All participants had relevant clinical and laboratory measurements. CRP was measured using a particle enhanced immunoturbidimetric assay.

RESULTSIn the multiple linear regression model, natural log-transformed CRP (lnCRP) and uric acid were independent predictors of natural log-transformed urinary albumin to creatinine ratio (lnACR) (β = 0.18, 95% CI 0.10-0.27, P < 0.001 and β = 0.18, 95% CI 0.09-0.27, P < 0.001). The interaction of lnCRP with uric acid was also associated with lnACR (β = 0.04, 95% CI 0.02-0.06, P < 0.001). In the full-adjusted logistic regression model, the OR for albuminuria of the patients in the third tertile levels of CRP and uric acid was 3.94 compared with patients in the first tertile levels of CRP and uric acid (95% CI 1.73-8.94, P < 0.001).

CONCLUSIONSElevated serum CRP and increased serum uric acid level were associated with albuminuria in Chinese type 2 diabetic patients. Moreover, CRP and uric acid had an interactive effect on albuminuria.

Albuminuria ; blood ; C-Reactive Protein ; metabolism ; Creatinine ; blood ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 ; blood ; metabolism ; Female ; Humans ; Male ; Uric Acid ; blood

Hyperuricemia mice model was established with uricase inhibitor (potassium oxonate) and uric acids in serum were observed. Polydatin (5, 10, 20 mg · kg(-1)) and benzbromarone (16.7 mg · kg(-1)) were given ig for 7 d in mice. Kidney tissues were used to detect gene contents ofurate anion transporter 1 (URAT1), organic anion transporter 1 (OAT1) and organic anion transporter 3 (OAT3) by real-time-PCR. The results showed that polydatin and benzbromarone can significantly reduce uric acid in blood of hyperuricemia mice (P < 0.05), compared with the model group. URAT1, OAT1 and OAT3 contents of the kidney in hyperuricemia mice changed significantly (P < 0.05), compared with the blank group. Polydatin can significantly inhibit the changing trends in these genes induced by potassium oxonate in a dose-dependent manner, the difference was significant (P < 0.05), compared with the model group. Those indicated that polysatin could reduce the level of the serum uric acid through promoting uric acid excretion.
Animals ; Disease Models, Animal ; Glucosides ; pharmacology ; Hyperuricemia ; drug therapy ; Kidney ; drug effects ; metabolism ; Mice ; Stilbenes ; pharmacology ; Uric Acid ; blood

OBJECTIVETo compare therapeutic effects of electroacupuncture (EA) treatment and medication on acute gouty arthritis (AGA), so as to search for a therapeutic method for treatment of gout with renal insufficiency.

METHODSNinety cases of AGA were randomly divided into an EA group, an allopurinol group and a probenecid group, 30 cases in each group. The EA group were treated by EA at Sanyinjiao (SP 6), Fenglong (ST 40), Yinlingquan (SP 9), once a day; the allopurinol group by oral administration of Allopurinol, twice a day, 100 mg each time and the probenecid group by oral administration of Probenecid, twice daily, 0.25 g each time. Contents of blood uric acid (BUA) and urinary uric acid (UUA) in each group were detected.

RESULTSIn all groups, there were significant differences in BUA and UUA levels before and after treatment (P < 0.01). There was no significant difference between the EA group and the allopurinol group in blood uric acid level after treatment (P > 0.05) and there was no significant difference between the EA group and the probenecid group in the urinary innary uric acid level (P > 0.05). Comparison of therapeutic effects among the 3 groups indicated that the mean rank was 56.23 in the EA group, 43.17 in the allopurinol group and 37.10 in the probenecid group, indicating that the therapeutic effect in the EA group was better than that in the allopurinol group, and the allopurinol group was better than that in the probenecid group.

CONCLUSIONEA can reduce the production of uric acid and promote the excretion of uric acid and has a better treatment effect. And there are no harmful effects on renal function. EA is an effective therapeutic method for treatment of gout with renal insufficiency.

Acute Disease ; Adult ; Aged ; Arthritis, Gouty ; metabolism ; therapy ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Uric Acid ; blood ; urine

BACKGROUNDRecently, it has been suggested that the serum uric acid (SUA) level decreased in diabetic patients. The aim of this study was to explore the association between SUA level and different state of glucose metabolism and glomerular filtration rate (GFR) reflected by the simplified Modification of Diet in Renal Disease (MDRD) equation and to test the hypothesis that high MDRD is one of the determinants of SUA level.

METHODSThis cross-sectional study included 2373 subjects in Beijing who underwent a 75 g oral glucose tolerance test (OGTT) for screening of diabetes. According to the states of glucose metabolism, they were divided into normal glucose tolerance, impaired glucose regulation and diabetes.

RESULTSMultiple stepwise linear regression analysis showed that adjusted by gender, SUA was positively correlated with body mass index (BMI), waist/hippo ratio, systolic blood pressure (SBP) and triglyceride, meanwhile negatively correlated with age, hemoglobin A1c, fasting insulin and MDRD. There was an increasing trend in SUA concentration and a decreasing trend in MDRD when the levels of fasting plasma glucose (FPG) increased from low to high up to the FPG level of 8.0 mmol/L; thereafter, the SUA concentration started to decrease with further increases in FPG levels, and the MDRD started to increase with further increases in FPG levels.

CONCLUSIONThis study confirmed the previous finding that SUA decreased in diabetes and provided the supporting evidence that the increased MDRD might contribute to the fall of SUA.

Adult ; Aged ; Blood Glucose ; metabolism ; Cross-Sectional Studies ; Female ; Glomerular Filtration Rate ; physiology ; Humans ; Linear Models ; Male ; Middle Aged ; Uric Acid ; blood

Following contents were reviewed in this article: More and more experimental studies related with chronic uratic nephropathy were carried out in recent years. In most of these studies, the animal models were established mainly from viewpoints of gene recombination, urinary uric acid inhibition and blood uric acid production promoting. TCM showed good effects in lowering blood uric acid, regulating levels of cytokines and postponing interstitial fibrosis. However, further studies on Chinese herbs and their extracts is necessary.
Animals ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Hyperuricemia ; blood ; Kidney Diseases ; etiology ; Mice ; Phytotherapy ; Purines ; metabolism ; Rats ; Uric Acid ; blood

OBJECTIVETo explore the association of elevated serum uric acid with metabolic disorders and the risk factors of hyperuricemia in type 2 diabetes mellitus (T2DM).

METHODSThe clinical and laboratory data of 159 T2DM patients aged 40-80 years with a Scr level of 51-159 µmol/L (0.6-1.8 mg/dl) were analyzed to explore the association of hyperuricemia (HUA) with metabolic disorders and identify the risk factors of HUA.

RESULTSForty out of 159 T2DM patients (25.2%) were found to have HUA. Univariate analysis showed that male gender, a body mass index ≤25 kg/m(2), hypertension, serum creatinine ≤110 µmol/L, blood urea nitrogen ≤7.0 mmol/L, microalbuminuria :11.2 mg/L, triglyceride :1.70 mmol/L, high-density lipoprotein <1.04 mmol/L, low density lipoprotein ≤3.37 mmol/L were all risk factors of HUA (P<0.05) in T2DM. Binary logistic regression analysis identified serum creatinine, body mass index and triglyceride as independent risk factors of HUA in T2DM. The main risk factors related to HUA had high incidences in T2DM. Patients with HUA had a significantly higher incidences of coronary artery disease, carotid atherosclerosis, cerebral infarction, diabetic nephropathy and diabetic retinopathy than those with normal uric acid level (P<0.05).

CONCLUSIONSeveral risk factors contribute to the occurrence of elevated serum uric acid in T2DM, and metabolic disorders and complications are also closely associated with HUA.

Adult ; Aged ; Aged, 80 and over ; Diabetes Mellitus, Type 2 ; complications ; metabolism ; Female ; Humans ; Hyperuricemia ; etiology ; metabolism ; Male ; Middle Aged ; Risk Factors ; Uric Acid ; blood

BACKGROUNDPrevious studies have demonstrated that serum uric acid (UA) is an independent predictor of incident type 2 diabetes mellitus (T2DM) in general populations. This study aimed to investigate specific characteristics of UA and its relationship between UA and blood glucose and other risk factors in the Chinese population.

METHODSA total of 946 subjects were included in this study. UA, glucose, insulin, fractional excretion of UA (FEua), creatinine clearance rate (Ccr), hemoglobin A1c (HbA1c), fructosamine (FA), blood pressure and lipids were studied and also reexamined after the patients underwent two weeks of combined therapeutics.

RESULTSUA levels were the highest in subjects with impaired glucose regulation (IGR), followed by subjects with normoglycemia (NGT) and finally by subjects with T2DM. The level of the 2-hour postprandial insulin and the area under the curve for insulin (AUCins) showed a similar tendency. The UA levels initially increased with increasing fasting blood glucose (FBG) and postprandial blood glucose (PPBG) levels, up to 7 mmol/L and 10 mmol/L, respectively, and thereafter decreased at higher FBG and PPBG levels. Compared with subjects in the lower serum UA quartile, subjects in the upper quartile of serum UA levels had higher weights, triglyceride levels, and creatinine levels as well as lower Ccr and FEua levels. Compared with women's group, UA levels were higher, and FEua levels were lower in men's group. Sex, body mass index (BMI), mean arterial blood pressure (MAP), serum triglycerides (TG), FA and Ccr were independent correlation factors of UA. UA decreased and FEua increased after the patients underwent a combined treatment.

CONCLUSIONSUA increased initially and then decreased as glucose levels increased from NGT to IGR and T2DM. Compared with NGT and T2DM, IGR subjects had higher SUA levels, which related to its high levels of insulin. Under T2DM, male gender, BMI, MAP, Ccr, TG and FA are independent correlation factors of UA. Glucose-lowering, antihypertensive, lipemia-regulating combined treatments were of advantage to decline of SUA of T2DM.

Adult ; Blood Glucose ; metabolism ; Body Mass Index ; Diabetes Mellitus, Type 2 ; blood ; Fasting ; blood ; Female ; Glucose Intolerance ; blood ; Humans ; Insulin ; blood ; Male ; Middle Aged ; Postprandial Period ; Uric Acid ; blood

INTRODUCTIONHyperuricaemia in tumour lysis syndrome (TLS) can cause acute renal failure (ARF), necessitating dialysis. Recombinant urate oxidase (rasburicase) converts uric acid to soluble allantoin, which is excreted easily.

CASE REPORTAn 8-year-old boy with stage 3 Burkitt's lymphoma, TLS was successfully treated with hyper-hydration, diuretics and rasburicase, without dialysis. This is the first paediatric case in Kandang Kerbau Women's & Children's Hospital (KKH) in which rasburicase was used. We review the literature on the effectiveness of urate oxidase in avoiding dialysis in TLS.

TREATMENT AND OUTCOMEOur patient developed rapidly rising serum uric acid (SUA) and progressive renal impairment. Hyper-hydration and rasburicase (0.2mg/kg) were administered. SUA rapidly decreased from 1308 to 437 mmol/L within 12 hours. Urate oxidase has shown better results than allopurinol. There was a need for dialysis in 0.4% to 1.7% of patients with haematological malignancies given rasburicase, compared to 20% in patients given allopurinol.

CONCLUSIONSRasburicase can reverse renal insufficiency. Though expensive, it may be cost-effective by lowering incidence of dialysis, shortening the duration of intensive care and hospitalisation, allowing early chemotherapy.

Burkitt Lymphoma ; complications ; Child ; Humans ; Hyperuricemia ; drug therapy ; Male ; Renal Dialysis ; Singapore ; Treatment Outcome ; Tumor Lysis Syndrome ; physiopathology ; urine ; Urate Oxidase ; metabolism ; pharmacology ; Uric Acid ; analysis ; blood

Objective To explore the relationship between insulin resistance (IR) indexes and hyperuricemia (HUA) among the people with hypertension. Methods From July to August in 2018,hypertension screening was carried out in Wuyuan county,Jiangxi province,and the data were collected through questionnaire survey,physical measurement,and biochemical test.Logistic regression was performed to analyze the relationship between HUA and IR indexes including metabolic score for IR (METS-IR),triglyceride-glucose (TyG) index,TyG-body mass index (BMI),TyG-waist circumference (WC),visceral adiposity index (VAI),triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C),and lipid accumulation product (LAP).The penalty spline method was used for the curve fitting between IR indexes and HUA.The area under the receiver operating characteristic curve (AUC) was employed to reveal the correlation between each index and HUA. Results The 14 220 hypertension patients included 6 713 males and 7 507 females,with the average age of (63.8±9.4) years old,the average uric acid level of (418.9±120.6) mmol/L,and the HUA detection rate of 44.4%.The HUA group had higher proportions of males,current drinking,current smoking,diabetes,and using antihypertensive drugs,older age,higher diastolic blood pressure,WC,BMI,homocysteine,total cholesterol,TG,low-density lipoprotein cholesterol,blood urea nitrogen,creatinine,aspartate aminotransferase,alanine aminotransferase,total protein,albumin,total bilirubin,direct bilirubin, METS-IR, TyG, TyG-BMI, TyG-WC, VAI, TG/HDL-C, and LAP, and lower systolic blood pressure and HDL-C than the normal uric acid group (all P<0.05).Multivariate Logistic regression showed that METS-IR (OR=1.049,95%CI=1.038-1.060, P<0.001), TyG (OR=1.639,95%CI=1.496-1.797, P<0.001), TyG-BMI (OR=1.008,95%CI=1.006-1.010, P<0.001), TyG-WC (OR=1.003,95%CI=1.002-1.004, P<0.001), lnVAI (OR=1.850, 95%CI=1.735-1.973, P<0.001), ln(TG/HDL-C) (OR=1.862,95%CI=1.692-2.048, P<0.001),and lnLAP (OR=1.503,95%CI=1.401-1.613,P<0.001) were associated with the risk of HUA.Curve fitting indicated that METS-IR,TyG,TYG-BMI,TYG-WC,lnVAI,ln(TG/HDL-C),and lnLAP were positively correlated with HUA (all P<0.001),and the AUC of TyG index was higher than that of other IR indexes (all P<0.05). Conclusion Increased IR indexes,especially TyG,were associated with the risk of HUA among people with hypertension.
Male ; Female ; Humans ; Middle Aged ; Aged ; Insulin Resistance ; Hyperuricemia ; Uric Acid ; Hypertension/complications* ; Glucose ; Obesity, Abdominal/epidemiology* ; Triglycerides ; Bilirubin ; Cholesterol ; Blood Glucose/metabolism*