Serum uric acid and disorders of glucose metabolism: the role of glycosuria

Hyperuricemia has been associated with hypertension, diabetes mellitus, and metabolic syndrome. We studied the association between hyperuricemia and glycemic status in a nonrandomized sample of primary care patients. This was a cross-sectional study of adults ≥20 years old who were members of a community-based health care program. Hyperuricemia was defined as a value >7.0 mg/dL for men and >6.0 mg/dL for women. The sample comprised 720 participants including controls (n=257) and patients who were hypertensive and euglycemic (n=118), prediabetic (n=222), or diabetic (n=123). The mean age was 42.4±12.5 years, 45% were male, and 30% were white. The prevalence of hyperuricemia increased from controls (3.9%) to euglycemic hypertension (7.6%) and prediabetic state (14.0%), with values in prediabetic patients being statistically different from controls. Overall, diabetic patients had an 11.4% prevalence of hyperuricemia, which was also statistically different from controls. Of note, diabetic subjects with glycosuria, who represented 24% of the diabetic participants, had a null prevalence of hyperuricemia, and statistically higher values for fractional excretion of uric acid, Na excretion index, and prevalence of microalbuminuria than those without glycosuria. Participants who were prediabetic or diabetic but without glycosuria had a similarly elevated prevalence of hyperuricemia. In contrast, diabetic patients with glycosuria had a null prevalence of hyperuricemia and excreted more uric acid and Na than diabetic subjects without glycosuria. The findings can be explained by enhanced proximal tubule reabsorption early in the course of dysglycemia that decreases with the ensuing glycosuria at the late stage of the disorder.

Health status of the elderly in the Marigot Health District, Dominica

The health status and the prevalence of hypertension, diabetes mellitus, glaucoma and visual disorders of 123 elderly people (56 men, 67 women) in the Marigot Health District, Dominica, were assessed by means of four questionnaires; collection of data from their medical records; physical examination, measurement of blood pressure, visual acuity and intra-ocular pressure (IOP); and testing for glucosuria. The overall health status was good, but 20were dependent on care. 74were independent in the activities in daily life, with only moderate limitations in activities. The health status decreased considerably in those over 75 years of age. There were slight perceived differences in health status between men and women. About 40of the study population were known to be hypertensive, and another 13had an elevated blood pressure on examination. Diabetes mellitus was present in 15. 20had a visual acuity of 0.1 or below, and 10had an elevated IOP. During the study, a considerable number of new cases of hypertension, diabetes mellitus and elevated IOP were diagnosed. 50of the study population who were on medication used this more than as prescribed. This study indicates a high prevalence of the secondary complications of hypertension, diabetes mellitus, cataract, glaucoma and osteo-arthritis that cause disability and dependency in the elderly population. Education, diagnosis at an early stage and appropriate treatment of these disorders may prevent or delay their development. We sugggest the development of a programme oriented approach of primary health care for the elderly to support this.

Is glycosuria a reliable indicator of adequacy of glucose infusion rate in preterm infants?

Adequacy of glucose infusion may be monitored via the glycosuria levels, as there is a relationship between glycemia and glycosuria regulated by the renal glucose threshold. In the neonatal period, however, this relationship is not so clear. Objective: To evaluate the ocurrence of glycosuria in pretern infants submitted to glucose infusion and to verify the relationship between glycosuria and blood glucose level. Design: Accuracy study. Setting: Neonatal intensive care unit of General Maternity Hospital. Patients: 40 pretern newborns receiving glucose infusion. Procedures: 511 concomitant determinations of glycemia and glycosuria were performed. These 511 pairs were divided into stable and unstable, according to the clinical status of the newborn at the time of data collection, and they were studied in relation to the gestational age, bith weight and glucose infusion rate. Results: The results revealed a greater frequency of glycosuria in gestational age = 30 weeks, birth weight < 1500 g and glucose infusion rate > 6 mg/kg/min. Eight (25.8 per cent) episodes of positive glycosuria occurred in the obsence of hyperglycemia, indicating only a moderate concordance between them. Conclusion: Glycosuria alone is an unreliable marker of blood glucose concentration and adequacy of glucose infusion rate. It is therefore necessary to monitor blood glucose levels in infants submitted to continous glucose infusion.

Prevalence of glycosuria in rural areas in two upper egyptian governorates - a community - based study

The known caseload of diabetes worldwide is increasing at an alarming rate, its prevalence had tripled in six years. Early diagnosis is more important than tight control to contain fast rising worldwide costs of the disease in terms of life and wealth. A simple blood or urine test could detect early diabetes mellitus. This work aimed to measure the prevalence of diabetes mellitus in a wide geographic rural area in two Upper Egyptian Governorates in a community based study [cross-sectional]. A random sample of 3756 urine specimens was examined by means of dipsticks. The overall prevalence of glucosuria was 4.82%, the age of 35 years or more was the most vulnerable one for it. Multiple regression analysis of possible variables related to glucosuria beside age were leucocyturia and proteinuria

Poluiçäo por cádmio de lesäo renal em habitantes de Santo Amaro da purificaçäo, Bahia / Pollution due to cadmium and renal injury in inhabitants of Santo Amaro da Purificaçäo, Bahia

Uma fundiçäo primária de chumbo que vem funcionando na Cidade de Santo Amaro da Purificaçäo desde 1960, poluiu a bacia do rio Subaé com pelo menos 400 toneladas de cádmio. Foram revistos os estudos sobre níveis de cádmio em águas, sendimentos e fauna no rio Subaé, em amostras de verduras locais e em populaçöes humanas da área. A hipótese de que a exposiçäo dos habitantes locais aos altos níveis ambientais de cádmio pudesse causar lesäo renal (proteinúria e glicosúria) foi investigada. Em Santo Amaro, 131 mulheres idosas foram estudadas, bem como 122 indivíduos de uma área de referência. As taxas de prevalência de proteinúria e de glicosúria em mulheres de Santo Amaro foram baixas e semelhantes àquelas observadas na populaçäo da área de referência