Ya Zhou,1,* Haixiao Wang,2,* Weiyi Gao2 

1Department of endocrinology, qilu Hospital (Qingdao), cheeloo College of Medicine, Shandong University, Qingdao, Shandong, People’s Republic of China; 2Department of Health Care, qilu Hospital (Qingdao), cheeloo College of Medicine, Shandong University, Qingdao, Shandong, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Weiyi Gao, Department of Health Care, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 hefei Road, Qingdao, Shandong, 266035, People’s Republic of China, Tel +86-18561811110, Email gaoweiyiqdql@sina.com

Purpose: Uric acid and blood glucose are important indicators of metabolic disorders. Numerous studies have elucidated the association between them, but the focus on their relationship through examination of urinary glucose and uric acid excretion has been limited. In this study, we conducted a comprehensive analysis on these indicators to explain the relationship.
Patients and Methods: This study involved the recruitment of 2498 patients who underwent fractional excretion of uric acid (FEUA) testing during their hospitalization at the Health Department of Qilu Hospital (Qingdao), Shandong University, between January 2017 and November 2023, with 1416 subjects being included in the final analysis. The included subjects were analyzed based on different genders. One-way analysis of variance, multiple linear regression analysis, and restricted cubic spline were adopted for data analysis.
Results: Higher FEUA and lower serum uric acid (SUA) levels were observed in diabetic patients with urinary glucose than in diabetic patients without urinary glucose and the nondiabetic population. FEUA exhibited a proportional increase with elevated blood glucose levels, even including cases that lacked urinary glucose. After adjustment for potential confounding factors, SUA levels did not increase with the increase in fasting blood glucose (FBG) levels, and once FBG levels surpassed a certain threshold leading to glucosuria, FEUA was further elevated, accompanied with a subsequent reduction in SUA levels. There is a stronger linear relationship between SUA or FEUA and FBG levels in women than that in men after adjusting for confounding factors.
Conclusion: Hyperglycemia is not considered a risk factor for hyperuricemia. Regardless of the presence of urinary glucose, elevated blood glucose levels can stimulate renal excretion of uric acid. Upon reaching a threshold that induces glucosuria, the SUA levels decrease substantially. Meanwhile, there are some differences in the relationship between SUA or FEUA and FBG among different genders.

Keywords: FEUA, serum uric acid, diabetes, glycosuria, non-linear relationship