Are uric acid values surrogate for insulin resistance in apparently healthy subjects across a spectrum of body mass index?

Background: The concept of insulin resistance initially proposed in diabetic patients requiring high doses of insulin is now known to be associated with major public health problems, including obesity, hypertension, coronary artery disease, and metabolic syndrome. Serum uric acid (SUA) values are also elevated in the above conditions and proposed to reflect the insulin-resistant state. Objective: To determine whether SUA levels can be used as a surrogate for insulin resistance calculated as homeostatic model assessment insulin resistance (HOMA-IR) in apparently healthy, normal weight, overweight, and obese population. Materials and Methods: A cross-sectional study done in 150 subjects of both genders aged 20-40 years was divided equally based on their body mass index into three groups namely normal weight, overweight, and obese as per National Institutes of Health classification. Fasting plasma glucose, fasting serum insulin, and SUA were estimated. HOMA-IR was calculated. Results: Mean waist circumference, waist-hip ratio, fasting insulin, fasting glucose, uric acid, and HOMA-IR were found to be elevated in both overweight and obese groups. Mean uric acid levels were 4.9 mg/dL, 5.4 mg/dL, and 6.3 mg/dL and mean HOMA-IR values are 2.2, 3.3, and 7.3, respectively, in normal weight, overweight, and obese subjects. Significant correlation of uric acid with insulin resistance calculated as HOMA-IR was not found in any of the three groups. Conclusion: There was an incremental increase in fasting glucose, fasting insulin, uric acid, and HOMA-IR from normal weight to overweight to obese subjects in a systematic proportion. Significant correlation of uric acid with fasting insulin and insulin resistance was not seen and hence cannot be used as the surrogate marker for insulin resistance in the apparently healthy population.