THE CORRELATION BETWEEN

URIC ACID AND HBA1C WITH NLR

VALUES IN DM TYPE 2 PATIENTS
Suryanto, Suci Aprilia
 BACKGROUND

• World Health Organization (WHO) reminded the

prevalence of diabetes in Indonesia has the potential to
increase dramatically from 8.4 million people in 2000 to
21.3 million sufferers in 2030 (Perkumpulan
Endokrinologi Indonesia, 2015).
• Based on the provincial data obtained, the prevalence of
diabetes in Yogyakarta is the highest prevalence compared
to the prevalence of other cities in Indonesia with a
percentage of 2.6% (Riset Kesehatan Dasar RI, 2013).
 BACKGROUND
• NLR increases with increasing severity of glucose
intolerance and is found to be positively correlated with
insulin resistance which means that in patients with
diabetes mellitus an inflammatory response occurs
(Gokulakrishnan et al., 2008).
• Hyperinsulinemia occurs in elevated serum uric acid levels
because insulin plays a role in increasing uric acid
reabsorption in the proximal tubule of the kidney (Zhao et
al., 2009).
• The higher the HbA1c level, the higher the risk of
complications, and vice versa (Stratton, IM, 2000).
 OBJECTIVE

To determine the correlation between uric acid levels

and HbA1C with NLR values in patients with type 2
diabetes mellitus
• Design: analytic observational with cross
sectional approach

• Sample: Patients diagnosed with diabetes

mellitus type 2 based on medical record
September 2015 to August 2017 at PKU
Muhammadiyah Yogyakarta Hospital. The METHOD
sample was 48 people.

• Data Analysis: used Saphiro-Wilk for

normality test. Correlation test used
spearman test because the data was not
normal.
RESULTS
RESULTS
 • This study found that patients with type 2 diabetes mellitus were more
females than males. The women are at a higher risk of developing type
2 diabetes mellitus compared to men (Alghadir et al, 2014; Awad et
al, 2013)
• The average age of patients with type 2 diabetes is 57 years and that
includes the adult category (Hestiana, 2017).

DISCUSSION
 • Uric acid levels have a average value of 6.27 mg/dL which is
interpreted as normal. The highest value of uric acid in the body has the
risk of incident diabetes risk (Male: 6-6,8 mg/dL, Female: 5-6 mg/dL)
(Shani et al, 2016)
• The Hb1Ac levels of type 2 DM patients in this study had an average of
8.76% which means that the average respondent had uncontrolled type
2 DM (>7%). Uncontrolled blood sugar levels in type 2 DM patients
are affected by carbohydrate intake that exceeds the needs. (Edgren
AR, 2004).

DISCUSSION
 • NLR levels of type 2 DMP patients in this study had an average value
of 6.23% which means the NLR is above the normal or high range
(0.78-3.53%). The process of increasing neutrophil levels can mediate
insulin resistance, one of them through excessive inflammation. While
the reason for the low lymphocyte value in subjects with insulin
resistance is because the body decreases the number of CD8+
lymphocytes to suppress the body's anti-inflammatory environment
(Chernecky C & Berger JB, 2012).

DISCUSSION
 • NLR is often influenced by biological conditions such as dehydration,
the severity of the metabolic syndrome, or other factors such as the
treatment and processing of blood samples. Along with an increase in
living standards, elements that cause an increase in uric acid levels also
become common. Low solubility of uric acid in the blood will result in
damage to the vascular endothelium when crystallization and settles on
the vascular wall. Increased uric acid levels also encourage lipid
oxidation and free radical formation, reduce nitric oxide production,
and damage the endothelium (Azab et al, 2012).

DISCUSSION
 • HbA1c is an indicator of glucose regulation and an increase in HbA1c is
associated with an increased risk of cardiovascular complications in T2DM
patients. Leukocytes play an important role in cholesterol accumulation,
endothelial dysfunction and atherogenesis (Sefil et al, 2014).

DISCUSSION
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