Hemoglobin A1c (HbA1c) continues to serve as the primary retrospective marker to assess
glycemic management, but the inability to monitor daily blood glucose fluctuations
remains a persistent concern
Uric acid is the final enzymatic product of purine nucleoside and free base degradation.
Elevated levels of serum uric acid (SUA) are widely recognized as a risk factor for
macrovascular and microvascular complications. Hyperuricemia is particularly common in
patients with hyperlipidemia.
It has been established that SUA levels are proportional to triglyceride (TG), total
cholesterol (TC), and low-density lipoprotein (LDL) levels. SUA promotes the oxidation of
LDL, which is considered to be a key event in atherosclerotic plaque formation. The
findings of several epidemiological studies have thus provided evidence to indicate a
clear independent association between elevated SUA levels and an increased incidence of
atherosclerotic disease or mortality Decreased serum levels of High-density lipoprotein
cholesterol (HDL-c) are proposed to be related to worse metabolic status and reduced
HDL-c is even a marker of metabolic syndrome.
A combination of these two metabolic parameters uric acid to HDL-c ratio (UHR) which is a
more useful predictor of metabolic deterioration High-density lipoprotein- cholesterol
acts by reducing proinflammatory responses triggered by monocytes, effectively
restricting monocyte proliferation, activation and migration, and plays a role in the
anti-oxidant mechanism. In contrast, reduced levels of HDL-c in the blood stream imply a
worsening metabolic profile and are a component of the metabolic syndrome Uric acid can
cause atherosclerosis and insulin resistance by reducing nitric oxide production,
promoting vascular smooth muscle proliferation, and resulting in endothelial dysfunction.
Additionally, low levels of HDL-c play a role in the development of metabolic syndrome
and insulin resistance.
More recently, the uric acid-to-HDL-c ratio (UHR) has been identified as a marker that
increases in inflammatory conditions . Monocytes and macrophages play crucial roles in
damage to pancreatic islet cells, islet inflammation and impaired insulin signaling in
T2DM. The monocyte/ HDL-c ratio (MHR) has been proposed as an indicator of ongoing
low-grade metabolic inflammation and has been suggested studies to be used as a marker
for cardiovascular disease and chronic kidney disease .