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Endocrinology and Metabolism |
1 Department of Nutrition, School of Public Health, Harvard University, Boston, MA; 2 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; 3 Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; 4 Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
aAddress correspondence to these authors at: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, 100. e-mail ytlee{at}ha.mc.ntu.edu.tw. Department of Nutrition, Harvard School of Public Health, Boston, MA. e-mail frank.hu{at}channing.harvard.edu.
Background: Previous cross-sectional studies have shown hyperuricemia to be prevalent among individuals with metabolic syndrome, but the evidence from prospective studies of an association between uric acid and diabetes risk is limited. We prospectively investigated the association between plasma concentrations of uric acid and the incidence of type 2 diabetes in Chinese individuals.
Methods: We conducted a community-based prospective cohort study of 2690 participants (age range, 35–97 years) in the Chin-Shan Community Cardiovascular Cohort Study, who were found to be free of diabetes and cardiovascular disease during baseline assessment at study entry in 1990. During a median 9.0-year follow-up, 548 participants developed type 2 diabetes.
Results: High plasma uric acid concentrations were associated with a higher prevalence of metabolic syndrome. After adjustment for age, sex, body mass index, and other covariates, the relative risks (RR) of diabetes according to uric acid quintile were 1.11, 1.29, 1.40, and 1.63 [95% confidence interval (CI), 1.20–2.23; P for trend <0.001]. After additional adjustment for metabolic syndrome, the RR for comparing the participants in the fifth and first uric acid quintiles was 1.40 (95% CI, 1.02–1.92; P for trend = 0.027). In joint analyses, participants who were in the highest uric acid quintile and also had metabolic syndrome had a 3.3-fold greater risk of diabetes (95% CI, 2.27–4.94) than those in the lowest uric acid quintile and without metabolic syndrome.
Conclusions: These findings suggest a modest positive association between plasma uric acid concentration and the incidence of type 2 diabetes in Chinese individuals. The association between hyperuricemia and diabetes was partly mediated through the metabolic syndrome.
The following articles in journals at HighWire Press have cited this article:
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  E. Oda and R. Kawai Serum Uric Acid Levels Improve Prediction of Incident Type 2 Diabetes in Individuals With Impaired Fasting Glucose: The Rancho Bernardo Study: Response to Kramer et al. Diabetes Care, October 1, 2009; 32(10): e125 - e125. [Full Text] [PDF]
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S. Kodama, K. Saito, Y. Yachi, M. Asumi, A. Sugawara, K. Totsuka, A. Saito, and H. Sone Association Between Serum Uric Acid and Development of Type 2 Diabetes Diabetes Care, September 1, 2009; 32(9): 1737 - 1742. [Abstract] [Full Text] [PDF]
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C. K. Kramer, D. von Muhlen, S. K. Jassal, and E. Barrett-Connor Serum Uric Acid Levels Improve Prediction of Incident Type 2 Diabetes in Individuals With Impaired Fasting Glucose: The Rancho Bernardo Study Diabetes Care, July 1, 2009; 32(7): 1272 - 1273. [Abstract] [Full Text] [PDF]
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 H. S. Kahn, Y. J. Cheng, T. J. Thompson, G. Imperatore, and E. W. Gregg Two Risk-Scoring Systems for Predicting Incident Diabetes Mellitus in U.S. Adults Age 45 to 64 Years Ann Intern Med, June 2, 2009; 150(11): 741 - 751. [Abstract] [Full Text] [PDF]
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 R. J. Johnson, S. E. Perez-Pozo, Y. Y. Sautin, J. Manitius, L. G. Sanchez-Lozada, D. I. Feig, M. Shafiu, M. Segal, R. J. Glassock, M. Shimada, et al. Hypothesis: Could Excessive Fructose Intake and Uric Acid Cause Type 2 Diabetes? Endocr. Rev., February 1, 2009; 30(1): 96 - 116. [Abstract] [Full Text] [PDF]
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 S. W. Muir, C. Harrow, J. Dawson, K. R. Lees, C. J. Weir, N. Sattar, and M. R. Walters Allopurinol Use Yields Potentially Beneficial Effects on Inflammatory Indices in Those With Recent Ischemic Stroke: A Randomized, Double-Blind, Placebo-Controlled Trial Stroke, December 1, 2008; 39(12): 3303 - 3307. [Abstract] [Full Text] [PDF]
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 D. I. Feig, D.-H. Kang, and R. J. Johnson Uric Acid and Cardiovascular Risk N. Engl. J. Med., October 23, 2008; 359(17): 1811 - 1821. [Full Text] [PDF]
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 W. Koenig and C. Meisinger Uric Acid, Type 2 Diabetes, and Cardiovascular Diseases: Fueling the Common Soil Hypothesis? Clin. Chem., February 1, 2008; 54(2): 231 - 233. [Full Text] [PDF]
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