Risk of Developing Diabetes Increases With Rising Serum Uric Acid Levels

Serum uric acid is a strong and independent risk factor for diabetes, according to findings published in the February issue of Diabetes Care.

"Serum uric acid is positively associated with serum glucose in healthy subjects," Dr. Jacqueline C. M. Witteman and colleagues from Erasmus Medical Center, Rotterdam, the Netherlands, write. "However, this association is not consistent between healthy and diabetic individuals, as a low serum level of uric acid is reported in the hyperglycemic state," they note. "Since most individuals experience a phase of impaired glucose tolerance before progression to diabetes, it is not clear whether raised serum uric acid predicts the risk of type 2 diabetes."

To investigate, the researchers used data from the Rotterdam Study, a large population-based, prospective cohort study among subjects aged 55 years and older. Included in the study were 4536 subjects free from diabetes at baseline.

The mean serum uric acid level measured at baseline was 323.7 micromol/L (range, 107 to 756 micromol/L). Among the participants, 462 developed diabetes during a mean follow-up of 10.1 years.

The age- and sex-adjusted hazard ratios for diabetes were 1.30, 1.63, and 2.83 for the second, third, and fourth quartiles of serum uric acid, in comparison with the first quartile. On multivariate analysis, the corresponding hazard ratios dropped to 1.08, 1.12, and 1.68, the researchers report.

"Our findings, together with those from previous literature, indicate that lowering uric acid may be a novel treatment target for preventing diabetes and justify a prospective clinical trial on the possible benefits of the measurement and lowering of serum uric acid on multiple chronic disease end points," Dr. Witteman and colleagues conclude.

Diabetes Care 2008;31:361-362.