ASSOCIATION OF SERUM URIC ACID HIGH SENSITIVITY C-REACTIVE PROTEIN AND INSULIN RESISTANCE WITH METABOLIC SYNDROME IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Background: Metabolic syndrome (MetS) is common among patients with type 2 diabetes mellitus (T2DM) and is closely associated with insulin resistance, chronic low-grade inflammation, and altered uric acid metabolism. This study evaluated the association of serum uric acid (SUA), high-sensitivity C-reactive protein (hs-CRP), and insulin resistance with MetS in patients with T2DM. Materials and Methods: This hospital-based cross-sectional comparative study included 280 adults with T2DM, comprising 140 patients with MetS and 140 without MetS. MetS was defined according to harmonized/NCEP ATP III criteria using South Asian waist circumference cut-offs. Clinical and anthropometric parameters, fasting glucose, HbA1c, lipid profile, SUA, hs-CRP, and fasting insulin were assessed. Insulin resistance was estimated using the homeostatic model assessment for insulin resistance (HOMA-IR). Results: Patients with MetS had significantly higher BMI, waist circumference, blood pressure, triglycerides, and LDL-C and lower HDL-C compared with those without MetS. Mean SUA (6.72 ± 1.36 vs. 5.31 ± 1.18 mg/dL), hs-CRP (4.38 ± 2.16 vs. 2.27 ± 1.48 mg/L), fasting insulin (17.6 ± 7.2 vs. 11.4 ± 5.3 μIU/mL), and HOMA-IR (6.82 ± 3.29 vs. 4.18 ± 2.25) were significantly higher in the MetS group (all p<0.001). SUA, hs-CRP, and HOMA-IR showed significant positive correlations with BMI, waist circumference, blood pressure, and triglycerides and negative correlations with HDL-C. SUA correlated positively with hs-CRP (r=0.34) and HOMA-IR (r=0.40), while hs-CRP correlated with HOMA-IR (r=0.45; all p<0.001). All three biomarkers increased progressively with increasing numbers of MetS components (p <0.001). Conclusion: T2DM patients with MetS have significantly higher SUA, hs-CRP, and insulin resistance than those without MetS. Their intercorrelations and progressive increases with the number of MetS components suggest that hyperuricemia, systemic inflammation, and insulin resistance are closely interconnected features of cardiometabolic dysfunction. Combined assessment of these biomarkers may provide additional information regarding metabolic risk burden in patients with T2DM.