Op-Med is a collection of original articles contributed by Doximity members.
Dr. Petter Bjornstad presented “Adiposity, Insulin Resistance, and Type 2 Diabetes Mellitus—What is New in Risk Factors and Biomarkers” at the 78th Scientific Sessions for the American Diabetes Association(June 22–26) in Orlando, FL.
Doximity discussed the research with Dr. Bjornstad at ADA 2018. Below is a transcript of the video interview.
Doximity: What might clinicians find the most surprising about this presentation?
Bjornstad: I think they would be most surprised by the high prevalence of hyperuricemia in youth onset type 2.
These are adolescents with a mean age of 13-14 and they only had type 2 diabetes for 7 to 8 months. Despite that the boys had 50% prevalence of hyperuricemia. I also think they’d be surprised to know that hyperuricemia and elevated serum uric acid are really strong risk factors both for hypertension and for diabetic kidney disease over seven years.
Doximity: What is the most important clinical implication of your research?
Bjornstad: We need better risk factors and we also need more therapeutic targets in youth onset type 2 diabetes, which is a unique population in that they’re very high risk of complications, both cardiovascular disease and diabetic kidney disease.
Serum uric acid and hypouricemia are potential therapeutic targets both to stratify the adolescents in terms of their long-term risk, but also for further trials in terms of developing serum uric acid lowering therapies to at least try to impede the development of these complications.
Doximity: How do these biomarkers and risk factors affect adolescents uniquely?
Bjornstad: Uniquely, I think, is that it is so much higher than what we thought. I think most people thought that hyperuricemia is something you see [mostly] in middle-aged or older individuals with type 2 diabetes.
Remember, these are really young [individuals]_—_they’re 13-14 years of age and had their disease for a really short amount of time. Despite that they’re having 50% of the boys, so half of the boys with type 2, actually have hyperuricemia. You typically think [such results] would be limited to older adults, so I think that’s pretty unique.
The other unique thing we found is that there are definitely not only sex differences, meaning the boys had higher risk, but also actually non-hispanic whites had definitely the highest relationship between serum uric acid and hypertension and diabetic kidney disease.