This article is more than 5 years old. Information may no longer be current.
Serum uric acid levels associated with diabetes risk in women
Healthy, normorglycemic Israeli women with high-normal baseline serum uric acid levels are more likely to develop type 2 diabetes vs. women with serum uric acid levels in the low-normal range, according to recent findings.
“The healthy composition of this subgroup lends support to the centrality of [serum uric acid] elevations in the increased diabetes risk, more than observed in previous studies,” Michal Shani, MD, MPH, of Clalit Health Services in Israel, and colleagues wrote. “In this distinctly defined normoglycemic lean population, it is very unlikely that an early metabolic derangement caused hyperinsulinemia, and, as a byproduct, decreased reabsorption and thus increased plasma urate levels. In other words, although association by itself cannot demonstrate causality, the design of our study decreases the possible bias of reverse causality.”
In an analysis of electronic patient medical records, Shani and colleagues examined data from 30,302 Israeli adults (20,037 women) aged 40 to 70 years insured by Clalit Health Services between 2002 and 2011 who underwent baseline health examinations, which included measurements of serum uric acid levels. Patients with hyperuricemia, impaired fasting glucose, overweight or obesity, CVD or renal disorders were excluded. Researchers followed patients up to a new diagnosis of diabetes during the study period. Primary outcome was OR of developing type 2 diabetes among patients grouped by baseline serum uric acid measurements of 3 to 4 mg/dL (in women only), 4 to 5 mg/dL, 5 to 6 mg/dL and 6 to 6.8 mg/dL vs. those with a low measurement (2-3 mg/dL for women; 3-4 mg/dL for men).
Over the 10-year study period, 792 participants (2.61%) developed type 2 diabetes — 3.26% of the men and 2.28% of the women. In an unadjusted model, researchers found that women with low baseline serum uric acid levels between 4 and 5 mg/dL had an increased risk for developing type 2 diabetes (HR = 1.88; 95% CI, 1.34-2.63), with the risk gradually increasing for those with values between 5 and 6 mg/dL (HR = 3.32; 95% CI, 2.27-4.85), a range still considered normal for women. The association was not observed for men.
After adjustment for age, BMI, socioeconomic status, smoking and baseline eGFR and glucose, serum uric acid levels between 4 and 5 mg/dL in women were associated with a 61% increased risk for incident diabetes (95% CI, 1.1–2.3). The OR increased to 2.67 for women with a serum uric acid level in the highest normal range (between 5 and 6 mg/dL; 95% CI, 1.8–3.97). Men had a nonsignificant risk elevation in the same model for baseline serum uric acid levels between 6 and 6.8 mg/dL, according to researchers (HR = 1.35; 95% CI, 0.88-2.07).
Among men, there was a comparable incident diabetes risk for those with a baseline serum uric acid level between 6 and 8 mg/dL (HR = 1.35; 95% CI, 0.9 –2.1).
When serum uric acid was treated as a continuous variable, researchers found that each 1-mg/dL increment was associated with a 1.43 times increased risk for future diabetes in women (95% Cl, 1.3-1.57) and no increased risk in men (adjusted OR = 1.11; 95% CI, 0.99-1.23). – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.