Serum Uric Acid Level as a Harbinger of Type 2 Diabetes: A Prospective Observation in Taiwan

Abstract

Background: Current evidence suggests an association of uric acid with diabetes risk, but it is still unclear whether uric acid is merely a risk marker or an independent risk factor. We evaluate the impact of serum uric acid (SUA) levels on the future risk of developing type 2 diabetes, independent of other factors. Methods: A population-based cohort study was conducted among 4130 participants who were found to be free of type 2 diabetes at baseline recruitment in 2002. Baseline SUA measured in 2002 was longitudinally related to the incident type 2 diabetes that occurred during the follow-up period between 2002 and 2007. Hazard ratios (HRs) and 95% confidence intervals (CIs) derived from Cox proportional hazards models were used to quantify the association. Results: There was a graded increase in the incidence of type 2 diabetes among individuals with increasing levels of SUA. In the whole study cohort, compared to quartile 1, the multivariable-adjusted HRs (95% CIs) of type 2 diabetes in quartile 2, quartile 3, and quartile 4 were 1.69 (0.76–3.76), 1.86 (0.88–4.26), and 1.94 (1.05–4.05), respectively (P for trend = 0.004). This positive gradient for the risk of type 2 diabetes across quartiles of SUA was evident in both genders and across age groups. Conclusions: This study supports that high uric acid concentrations are associated with increased diabetes risk, independent of other known risk factors. These data expand on well-established associations between SUA level and metabolic syndrome, and extend the link to the future risk of type 2 diabetes.

Association between plasma uric acid and insulin resistance in type 2 diabetes: A Mendelian randomization analysis

“…In addition to causing gout, many studies have shown that hyperuricemia is also closely related to insulin resistance, and diabetes [27,28]. However, its function is a matter of debate [29].…”

Obesity-Induced Insulin Resistance Is Mediated by High Uric Acid in Obese Children and Adolescents

“…Viewed separately, a close relationship between SUA and IR has long been appreciated, which may be another mechanism to explain IR in obese people. Emerging evidence has shown that hyperuricemia is linked with IR and the subsequent promotion and development of T2DM ( 9 , 31 , 32 ). Similar to these studies, we found that the SUA level was higher in the high HOMA-IR group, and SUA was also an independent risk factor for HOMA-IR.…”

“…This hints that obese children oversecrete insulin in response to increasing insulin resistance to maintain the FBG in the normal range. However, this condition is strongly associated with alterations that represent an increased risk for the development of metabolic disorders and the occurrence of diabetes in adulthood ( 3 , 9 ).…”

“…Obesity diagnosed by body mass index (BMI) has been reported to result in hyperuricemia in more cross-sectional studies (9,10). Recent studies have found that hyperuricemia not only leads to gout arthritis and nephropathy but may also be related to IR, type 2 diabetes and cardiovascular morbid events (9,(11)(12)(13). Thus, SUA interacts with other factors in the modulation of obesity and IR.…”

Tea consumption and serum uric acid levels among older adults in three large-scale population-based studies in China

“…Hyperuricemia (HUA) is a major risk factor for several chronic conditions such as gout [1], cardiovascular diseases (CVDs) [2], diabetes [3], and hypertension [4]. HUA is also associated with increased hospitalization risks and healthcare expenditures [5].…”