Abnormal Uric Acid Levels and Gestational Diabetes Mellitus: Is there a link?

The relationship between elevated uric acid (UA) levels and adverse pregnancy outcomes has been well-documented. However, there is currently insufficient evidence to suggest that high uric acid levels are directly associated with a greater risk of gestational diabetes mellitus (GDM). Recent systematic reviews have indicated a potential link between GDM and elevated serum UA levels, prompting a need for further investigation into this association.

The mechanisms underlying insulin resistance due to hyperuricemia are similar in pregnant and non-pregnant women. Hyperuricemia may cause an increase in insulin resistance and GDM. This typically occurs after the activation of oxidative transformations in adipose tissues via the production of UA by adipocytes, decreased nitric oxide release by endothelial cells, and increased involvement of inflammatory cytokines. 

Additional research should firmly demonstrate a link between hyperuricemia and GDM. We must also identify the specific pathophysiological mechanisms that underlie this association and the role of various predisposing factors that may contribute to the progression of GDM in the presence of elevated UA levels. Understanding these factors could significantly enhance early diagnosis and screening processes, which will spare both the mother and the fetus from the possibility of adverse effects.

 Jankar JS, Manglaram A, Ahmed T, et al. Revisiting the link between abnormal uric acid levels and gestational diabetes mellitus: A systematic review. Indian J Obstet Gynecol Res 2024;11(3):315-324