Background:Hyperuricemia, characterised by elevated levels of serum uric acid (SUA), has been linked to an increased risk of metabolic disorders, including type 2 diabetes. Understanding the relationship between SUA, beta-cell function, and insulin resistance is crucial for elucidating the pathophysiology of these conditions, especially in the Indian population, where such data is limited. Objective: This study aimed to explore the interrelations between serum uric acid levels, beta-cell function, and insulin resistance in an Indian cohort. Methods: A cross-sectional study was conducted involving a representative sample of adults from an Indian population. Participants were stratified into sex-specific SUA quartiles. Key measurements included BMI, serum creatinine, lipid profiles, fasting insulin, HOMA1-B (beta-cell function), and HOMA1-IR (insulin resistance). Partial correlation coefficients were calculated to assess the associations between SUA and various metabolic parameters. Results:Significant differences were observed across SUA quartiles in terms of age, BMI, serum creatinine, HDL cholesterol, LDL cholesterol, triglycerides, total cholesterol, fasting insulin, HOMA1-B, and HOMA1-IR (all p-values < 0.05). Higher SUA levels were associated with increased BMI, serum creatinine, triglycerides, fasting insulin, HOMA1-B, and HOMA1-IR. Additionally, partial correlation analysis revealed positive correlations between SUA and BMI (r=0.065, p=0.026), fat mass (r=0.065, p=0.026), serum creatinine (r=0.277, p<0.001), triglycerides (r=0.084, p=0.004), fasting insulin (r=0.130, p<0.001), and HOMA1-B (r=0.078, p=0.008). Negative correlations were found between SUA and vitamin B12 (r=-0.117, p=0.000071), GFR (r=-0.113, p<0.001), total cholesterol (r=-0.068, p=0.021), LDL cholesterol (r=-0.080, p=0.006), HDL cholesterol (r=-0.071, p=0.016), and HbA1c (r=-0.170, p<0.001). Conclusions: Elevated serum uric acid levels are significantly associated with increased beta-cell function and insulin resistance among Indian adults. These findings suggest that hyperuricemia could be an early marker for metabolic dysfunction, highlighting the need for early intervention strategies in this population. Further longitudinal studies are warranted to establish causal relationships and to explore the potential benefits of uric acid-lowering therapies in preventing metabolic diseases.

The authors have declared no competing interest.

Funded by Answer Genomics Pvt Ltd.

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All data produced in the present study are available upon reasonable request to the authors