Purine metabolism state in patients with type 1 diabetes mellitus

Authors

  • A. O. Cherniaieva State Institution “V. Danilevsky Institute for Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine https://orcid.org/0000-0002-2812-3323
  • M. R. Mykytiuk State Institution “V. Danilevsky Institute for Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine https://orcid.org/0000-0002-6169-7628
  • Yu. I. Karachentsev State Institution “V. Danilevsky Institute for Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine, Ukraine https://orcid.org/0000-0003-1317-6999
  • O. I. Pliekhova State Institution “V. Danilevsky Institute for Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine https://orcid.org/0000-0002-3158-506X
  • L. Yu. Serhiienko State Institution “V. Danilevsky Institute for Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine https://orcid.org/0000-0002-1474-222X

DOI:

https://doi.org/10.14739/2310-1210.2023.2.273721

Keywords:

type 1 diabetes mellitus, purine metabolism, purine bases, xanthine oxidase, hypoxanthineguanine phosphoribosyltransferase

Abstract

The aim of the study. To carry out a comprehensive analysis of the purine metabolism (PM) state and assess its features in patients with type 1 diabetes mellitus (DM).

Materials and methods. 181 patients with type 1 DM were examined (94 women and 87 men) aged 42.5 ± 12.1 years. Indicators of the carbohydrate metabolism state, creatinine (Cr) concentration by the method of Popper, purine bases (PBs) and the activity of xanthine oxidase (XO) by a photometric method, uric acid (UA) by a colorimetric method were determined in fasting venous blood. UA excretion was detected by the colorimetric method, Cr by an enzymatic method.

Renal UA clearance (RCUA), fractional UA clearance (FCUA), total UA tubular reabsorption (TTRUA) and hypoxanthine-guanine-phosphoribosyltransferase (HGPRT) activity were calculated. The comparison group, representative in terms of age and sex, included 25 healthy volunteers.

Results. PM changes in patients with type 1 DM were orientated towards an excessively increased catabolism and insufficient reutilization of PBs. The structure of the detected disorders was as follows: hyperuricemia (HU) (13.8 %), enhanced RCUA (42.8 %), increased XO activity (35.6 %) and inhibition of HGPRT activity (53.3 %). In about 56 % of the subjects, high concentrations of PBs were found, and HU was diagnosed only in every seventh subject.

It was identified that PB concentrations were negatively correlated with the level of XO activity. RCUA and XO activity levels were revealed to be of the greatest informational value for assessing the PM state in patients with type 1 DM. RCUA was significantly associated with the level of UA excretion and HGPRT activity. Relationships of RCUA and FCUA with HbAc1 levels were established. The higher the level of HbAc1, the greater the clearance of RCUA was, especially FCUA, which led to a significant decrease in TTRUA.

Conclusions. PM in type 1 DM is characterized by a high intensity, which is realized due to a decrease in anabolism, increased oxidation and suppression of PB reutilization. Uricemia inadequately reflects the level of UA production in patients with type 1 DM. The severity of PM disorders in type 1 DM patients is associated with the carbohydrate metabolism compensation state.

Author Biographies

A. O. Cherniaieva, State Institution “V. Danilevsky Institute for Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine”, Kharkiv

MD, PhD, Associate Professor of the Department of Endocrinology and Pediatric Endocrinology, Kharkiv National Medical University; Head of the Polyclinic of the State Institution “V. Danilevsky Institute for Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine”, doctor-endocrinologist of the highest category

M. R. Mykytiuk, State Institution “V. Danilevsky Institute for Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine”, Kharkiv

MD, PhD, DSc, Professor, Deputy Director for Scientific Work

Yu. I. Karachentsev, State Institution “V. Danilevsky Institute for Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine

MD, PhD, DSc, Professor, Director of the State Institution “V. Danilevsky Institute for Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine, Head of the Surgical Department; Head of the Department of Endocrinology and Pediatric Endocrinology Kharkiv National Medical University, Corresponding Member of the National Academy of Medical Sciences of Ukraine, doctor-surgeon of the highest category

O. I. Pliekhova, State Institution “V. Danilevsky Institute for Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine”, Kharkiv

PhD, DSc, Professor, Leading Researcher of the Department of Pathomorphology and Genetics of Endocrine Diseases

L. Yu. Serhiienko, State Institution “V. Danilevsky Institute for Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine”, Kharkiv

MD, PhD, DSc, Professor, Leading Researcher of the Department of Pathomorphology and Genetics of Endocrine Diseases

References

Ferreira, T. D. S., Fernandes, J. F. R., Araújo, L. D. S., Nogueira, L. P., Leal, P. M., Antunes, V. P., Rodrigues, M. L. G., Valença, D. C. T., Kaiser, S. E., & Klein, M. R. S. T. (2018). Serum Uric Acid Levels are Associated with Cardiometabolic Risk Factors in Healthy Young and Middle-Aged Adults. Arquivos brasileiros de cardiologia, 111(6), 833-840. https://doi.org/10.5935/abc.20180197

Kuwata, H., Okamura, S., Hayashino, Y., Tsujii, S., Ishii, H., & Diabetes Distress and Care Registry at Tenri Study Group (2017). Serum uric acid levels are associated with increased risk of newly developed diabetic retinopathy among Japanese male patients with type 2 diabetes: A prospective cohort study (diabetes distress and care registry at Tenri [DDCRT 13]). Diabetes/metabolism research and reviews, 33(7), 10.1002/dmrr.2905. https://doi.org/10.1002/dmrr.2905

Martínez-Sánchez, F. D., Vargas-Abonce, V. P., Guerrero-Castillo, A. P., Santos-Villavicencio, M. L., Eseiza-Acevedo, J., Meza-Arana, C. E., Gulias-Herrero, A., & Gómez-Sámano, M. Á. (2021). Serum Uric Acid concentration is associated with insulin resistance and impaired insulin secretion in adults at risk for Type 2 Diabetes. Primary care diabetes, 15(2), 293-299. https://doi.org/10.1016/j.pcd.2020.10.006

Su, H., Liu, T., Li, Y., Fan, Y., Wang, B., Liu, M., Hu, G., Meng, Z., & Zhang, Q. (2021). Serum uric acid and its change with the risk of type 2 diabetes: A prospective study in China. Primary care diabetes, 15(6), 1002-1006. https://doi.org/10.1016/j.pcd.2021.06.010

Xu, Y. L., Xu, K. F., Bai, J. L., Liu, Y., Yu, R. B., Liu, C. L., Shen, C., & Wu, X. H. (2016). Elevation of serum uric acid and incidence of type 2 diabetes: A systematic review and meta-analysis. Chronic diseases and translational medicine, 2(2), 81-91. https://doi.org/10.1016/j.cdtm.2016.09.003

Lu, J., He, Y., Cui, L., Xing, X., Liu, Z., Li, X., Zhang, H., Li, H., Sun, W., Ji, A., Wang, Y., Yin, H., & Li, C. (2020). Hyperuricemia Predisposes to the Onset of Diabetes via Promoting Pancreatic β-Cell Death in Uricase-Deficient Male Mice. Diabetes, 69(6), 1149-1163. https://doi.org/10.2337/db19-0704

Facchini, F., Chen, Y. D., Hollenbeck, C. B., & Reaven, G. M. (1991). Relationship between resistance to insulin-mediated glucose uptake, urinary uric acid clearance, and plasma uric acid concentration. JAMA, 266(21), 3008-3011.

Volpe, A., Ye, C., Hanley, A. J., Connelly, P. W., Zinman, B., & Retnakaran, R. (2020). Changes Over Time in Uric Acid in Relation to Changes in Insulin Sensitivity, Beta-Cell Function, and Glycemia. The Journal of clinical endocrinology and metabolism, 105(3), e651-e659. https://doi.org/10.1210/clinem/dgz199

Lutsyk, B D. (Ed.). (2011). Klinichna laboratorna diahnostyka [Clinical laboratory diagnostics]. Medytsyna. [in Ukrainian].

Peng, Y. F., Su, X. H., Han, M. M., Zhu, X. Y., & Li, L. (2018). Serum uric acid and high-risk pregnancy: an intriguing correlation in advanced pregnant women. Annals of translational medicine, 6(23), 451. https://doi.org/10.21037/atm.2018.11.03

Weingart, C., & Wirnsberger, G. H. (2021). Klinische Implikationen der geschätzten glomerulären Filtrationsrate [Clinical implications of the estimated glomerular filtration rate]. Zeitschrift fur Gerontologie und Geriatrie, 54(3), 205-210. https://doi.org/10.1007/s00391-021-01839-1

Ueda, S., Hirata, T., & Sakasegawa, S. I. (2022). Hypoxanthine-guanine phosphoribosyltransferase is activated via positive cooperativity between guanine and IMP. FEBS letters, 596(8), 1072-1080. https://doi.org/10.1002/1873-3468.14306

Hu, J., Xu, W., Yang, H., & Mu, L. (2021). Uric acid participating in female reproductive disorders: a review. Reproductive biology and endocrinology : RB&E, 19(1), 65. https://doi.org/10.1186/s12958-021-00748-7

Yanai, H., Adachi, H., Hakoshima, M., & Katsuyama, H. (2021). Molecular Biological and Clinical Understanding of the Pathophysiology and Treatments of Hyperuricemia and Its Association with Metabolic Syndrome, Cardiovascular Diseases and Chronic Kidney Disease. International journal of molecular sciences, 22(17), 9221. https://doi.org/10.3390/ijms22179221

Luo, Q., Cai, Y., Zhao, Q., Tian, L., Liu, Y., & Liu, W. J. (2022). Effects of allopurinol on renal function in patients with diabetes: a systematic review and meta-analysis. Renal failure, 44(1), 806-814. https://doi.org/10.1080/0886022X.2022.2068443

Downloads

Published

2023-03-28

How to Cite

1.
Cherniaieva AO, Mykytiuk MR, Karachentsev YI, Pliekhova OI, Serhiienko LY. Purine metabolism state in patients with type 1 diabetes mellitus. Zaporozhye medical journal [Internet]. 2023Mar.28 [cited 2024Apr.16];25(2):109-14. Available from: http://zmj.zsmu.edu.ua/article/view/273721

Issue

Vol. 25 No. 2 (2023): Zaporozhye medical journal

Section

Original research

License

Authors who publish with this journal agree to the following terms:

    1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.  Лицензия Creative Commons
    2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
    3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)