High serum uric acid level is an independent risk factor for the development of type 2 diabetes, according to data from a large population-based study.
In a study of 4,536 people who were free of diabetes at baseline, those who had serum uric acid levels that were in the top quartile were 68% more likely to develop type 2 diabetes than were those in the lowest quartile after adjusting for potential confounders, according to a report in the journal Diabetes Care.
The population-attributable risk of high serum uric acid for diabetes was 0.24, indicating that, “One-quarter of diabetes cases can be attributed to a high serum uric acid level,” reported Dr. Abbas Dehghan and colleagues of Erasmus Medical Center in Rotterdam, the Netherlands (Diabetes Care 2008; 31:361–2).
The participants were part of the Rotterdam Study, a population-based, prospective cohort study involving subjects aged 55 years and older who were followed for a mean of 10.1 years.
During that time, 462 of the participants developed diabetes, giving an incidence rate of 10.1/1,000 person-years.
After adjustment for age, sex, body mass index, waist circumference, HDL cholesterol level, and systolic and diastolic blood pressure, participants with serum uric acid levels above 370 micromol/L had a hazard ratio of 1.68, compared with those with levels of 267 micromol/L or below. The difference was statistically significant.
Although gout and renal disorders are currently the only confirmed consequences of hyperuricemia, findings from other studies have implicated high serum uric acid as a potential risk factors for hypertension, stroke, and cardiovascular disease, and the current study has now added type 2 diabetes to the list.
The importance of this finding is that “lowering serum uric acid in subjects in the highest quartile may decrease the incidence of diabetes by 24%, if the relationship is causal,” the investigators wrote.