Uric Acid as a Biomarker and a Therapeutic Target in Diabetes

• Published in: Canadian journal of diabetes Vol. 39; no. 3; pp. 239 - 246
• Main Authors: Lytvyn, Yuliya, HBSc, Perkins, Bruce A., MD, MPH, Cherney, David Z.I., MD, PhD
• Format: Journal Article
• Language: English
• Published: Canada Elsevier Inc 01.06.2015
• Subjects: acide urique; Biomarkers - blood; Cardiovascular Diseases - epidemiology; cardiovascular dysfunction; diabetes mellitus; Diabetes Mellitus - blood; Diabetes Mellitus - drug therapy; Diabetic Nephropathies - physiopathology; Diabetic Nephropathies - prevention & control; diabetic nephropathy; diabète sucré; dysfonctionnement cardiovasculaire; Endocrinology & Metabolism; Enzyme Inhibitors - pharmacology; Enzyme Inhibitors - therapeutic use; Humans; kidney disease; maladie rénale; néphropathie diabétique; Other; Oxidative Stress - physiology; Risk Factors; uric acid; Uric Acid - blood; Xanthine Oxidase - antagonists & inhibitors; Xanthine Oxidase - drug effects; maladie rénale; diabète sucré; dysfonctionnement cardiovasculaire; néphropathie diabétique; acide urique; kidney disease; diabetes mellitus; cardiovascular dysfunction; uric acid; diabetic nephropathy
• ISSN: 1499-2671; 2352-3840
• DOI: 10.1016/j.jcjd.2014.10.013

Abstract Diabetic nephropathy is a long-standing microvascular complication of diabetes mellitus and is the leading cause of end stage renal disease in developed countries. Current therapeutic strategies used to prevent or delay diabetic nephropathy exert limited clinical protective effects and can have serious adverse effects. Thus, identification of new pharmacologic agents that protect against the initiation and progression of complications of diabetes is of the utmost importance. Uric acid (UA) recently emerged as an inflammatory factor that increases oxidative stress and promotes activation of the renin angiotensin aldosterone system. As a consequence, higher UA levels are associated with various stages of the onset and progression of diabetic nephropathy, including metabolic, cardiovascular and kidney function abnormalities. If UA-lowering drugs, such as the xanthine oxidase inhibitors, block the mechanisms responsible for micro- and macrovascular injury in diabetes, these agents could represent a critical step toward preventing the progression of diabetes. This review focuses on the evidence that supports serum UA levels as a biomarker of renal and cardiovascular risk and as a potential additional therapeutic target in diabetes.