Objective To explore the relationship between serum uric acid level and β cells function in patients with type 2 diabetes mellitus (T2DM).

Methods A total of 304 patients with T2DM admitted to Zhongshan Hospital, Fudan University (Xiamen Branch) from January 2018 to April 2020 were selected and divided into two groups based on their blood uric acid levels: the normal uric acid group (NUA group, n=245) and the hyperuricemia group (HUA group, n＝59). Function of β cell insulin secretion was identified by the acute insulin response to arginine stimulation. The clinical characteristics and the results of β-cell insulin secretion function were compared between the two groups. Multivariable linear regression models were used to examine the association of serum uric acid levels with the insulin secretion function of β cells.

Results The patients in HUA group had significantly higher weight, BMI, waist circumference, hip circumference, HOMA-β and HOMA-IR but lower HbA_1c, CREA, eGFR and HDL-C (all P < 0.05) than those in NUA group. During the arginine stimulation test, 0-min, 2-min, 4-min and 6-min insulin (I0, I2, I4, I6), 0-min, 2-min, 4-min and 6-min C-peptide (CP0, CP2, CP4, CP6), ΔI, ΔCP, ΔI/G, ΔCP/G, area under curve of insulin and C-peptide were significantly higher in HUA group. And the 0-min, 2-min, 4-min, 6-min plasma glucose (G0, G2, G4, G6) were lower in HUA group than those in the NUA group (all P < 0.05). Multivariate linear regression analysis showed that after adjusting for multiple related risk factors, the serum uric acid levels were positively correlated with ΔI (β＝0.029, 95%CI 0.002-0.056, P＝0.035).

Conclusions The insulin secretory function of pancreatic β-cells in T2DM patients with hyperuricemia is better than that in T2DM patients with normal uric acid levels. Serum uric acid level in T2DM patients is an independent influencing factor of pancreatic β-cell function.