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Serum uric acid associates with the incidence of type 2 diabetes in a prospective cohort of middle-aged and elderly Chinese

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Abstract

This study is to prospectively investigate the association between serum uric acid and the incidence of type 2 diabetes in middle-aged and elderly Chinese. This study consisted of 924 non-diabetic adults aged 40 years or older at baseline. Subjects who received antidiabetic therapies and those who responded positively to the 75-g oral glucose tolerance test according to the 1999 World Health Organization criteria were diagnosed as having type 2 diabetes. Ninety-eight subjects developed type 2 diabetes during the 3.5-year follow-up. The hazard ratio (HR) for incident diabetes was 1.50 [95% confidence interval (CI) 1.18–1.92] for the highest sex-specific quartile of serum uric acid compared with the lowest after controlling for confounders. Participants with hyperuricemia had an HR of 1.95 (95% CI 1.11–3.44) for incident diabetes compared with those without hyperuricemia. Compared with the lowest quartile, the highest quartile had an HR for incident diabetes of 2.45 (95% CI 1.39–4.33) in men and 1.39 (95% CI 1.04–1.84) in women after fully adjustment. Adding serum uric acid to a model of conventional risk factors for diabetes improved the area under the curve for prediction of type 2 diabetes by 5%. Serum uric acid was an independent predictor of incident type 2 diabetes in middle-aged and elderly Chinese.

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References

  1. P.J. Cannon, W.B. Stason, F.E. Demartini, S.C. Sommers, J.H. Laragh, Hyperuricemia in primary and renal hypertension. N. Engl. J. Med. 275, 457–464 (1966)

    Article  PubMed  CAS  Google Scholar 

  2. E.S. Ford, C. Li, S. Cook, H.K. Choi, Serum concentrations of uric acid and the metabolic syndrome among US children and adolescents. Circulation 115, 2526–2532 (2007)

    Article  PubMed  CAS  Google Scholar 

  3. Y.P. Siu, K.T. Leung, M.K. Tong, T.H. Kwan, Use of allopurinol in slowing the progression of renal disease through its ability to lower serum uric acid level. Am. J. Kidney Dis. 47, 51–59 (2006)

    Article  PubMed  CAS  Google Scholar 

  4. K.R. Tuttle, R.A. Short, R.J. Johnson, Sex differences in uric acid and risk factors for coronary artery disease. Am. J. Cardiol. 87, 1411–1414 (2001)

    Article  PubMed  CAS  Google Scholar 

  5. U.M. Khosla, S. Zharikov, J.L. Finch, T. Nakagawa, C. Roncal, W. Mu, K. Krotova, E.R. Block, S. Prabhakar, R.J. Johnson, Hyperuricemia induces endothelial dysfunction. Kidney Int. 67, 1739–1742 (2005)

    Article  PubMed  Google Scholar 

  6. D. Roy, M. Perreault, A. Marette, Insulin stimulation of glucose uptake in skeletal muscles and adipose tissues in vivo is NO dependent. Am. J. Physiol. 274, E692–E699 (1998)

    PubMed  CAS  Google Scholar 

  7. Y.Y. Sautin, T. Nakagawa, S. Zharikov, R.J. Johnson, Adverse effects of the classic antioxidant uric acid in adipocytes: NADPH oxidase-mediated oxidative/nitrosative stress. Am. J. Physiol. Cell. Physiol. 293, C584–C596 (2007)

    Article  PubMed  CAS  Google Scholar 

  8. S.D. Lin, D.H. Tsai, S.R. Hsu, Association between serum uric acid level and components of the metabolic syndrome. J. Chin. Med. Assoc. 69, 512–516 (2007)

    Article  Google Scholar 

  9. D. Conen, V. Wietlisbach, P. Bovet, C. Shamlaye, W. Riesen, F. Paccaud, M. Burnier, Prevalence of hyperuricemia and relation of serum uric acid with cardiovascular risk factors in a developing country. BMC Public Health 4, 9 (2004)

    Article  PubMed  CAS  Google Scholar 

  10. A. Onat, H. Uyarel, G. Hergenc, A. Karabulut, S. Albayrak, I. Sari, M. Yazici, I. Keles, Serum uric acid is a determinant of metabolic syndrome in a population-based study. Am. J. Hypertens. 19, 1055–1062 (2006)

    Article  PubMed  CAS  Google Scholar 

  11. A. Dehghan, M. van Hoek, E.J. Sijbrands, A. Hofman, J.C. Witteman, High serum uric acid as a novel risk factor for type 2 diabetes. Diabetes Care 31, 361–362 (2008)

    Article  PubMed  CAS  Google Scholar 

  12. C.K. Kramer, D. von Mühlen, S.K. Jassal, 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 32, 1272–1273 (2009)

    Article  PubMed  CAS  Google Scholar 

  13. Y. Taniguchi, T. Hayashi, K. Tsumura, G. Endo, S. Fujii, K. Okada, Serum uric acid and the risk for hypertension and type 2 diabetes in Japanese men: the Osaka Health Survey. J. Hypertens. 19, 1209–1215 (2001)

    Article  PubMed  CAS  Google Scholar 

  14. H. Nan, Q. Qiao, S. Söderberg, J. Pitkaniemi, P. Zimmet, J. Shaw, G. Alberti, U. Uusitalo, V. Pauvaday, P. Chitson, J. Tuomilehto, Serum uric acid and incident diabetes in Mauritian Indian and Creole population. Diabetes Res. Clin. Pract. 80, 321–327 (2008)

    Article  PubMed  CAS  Google Scholar 

  15. N. Nakanishi, M. Okamoto, H. Yoshida, Y. Matsuo, K. Suzuki, K. Tatara, Serum uric acid and risk for development of hypertension and impaired fasting glucose or Type II diabetes in Japanese male office workers. Eur. J. Epidemiol. 18, 523–530 (2003)

    Article  PubMed  CAS  Google Scholar 

  16. J. Xiang, X. Li, M. Xu, J. Hong, Y. Huang, J. Tan, X. Lu, M. Dai, B. Yu, G. Ning, Zinc Transporter-8 gene (SLC30A8) is associated with type 2 diabetes in Chinese. J. Clin. Endocrinol. Metab. 93, 4107–4112 (2008)

    Article  PubMed  CAS  Google Scholar 

  17. M. Xu, X. Li, J. Wang, X. Wang, Y. Huang, Q. Cheng, H. Huang, R. Li, J. Xiang, J. Tan, M. Dai, G. Ning, Retinol-binding protein 4 is associated with impaired glucose regulation and microalbuminuria in a Chinese population. Diabetologia 52, 1511–1519 (2009)

    Article  PubMed  CAS  Google Scholar 

  18. M.J. Pencina, R.B. Agostino, Overall C as a measure of discrimination in survival analysis: model specific population value and confidence interval estimation. Stat. Med. 23, 2109–2123 (2004)

    Article  PubMed  Google Scholar 

  19. R.J. Johnson, D.H. Kang, D. Feig, S. Kivlighn, J. Kanellis, S. Watanabe, K.R. Tuttle, B. Rodriguez-Iturbe, J. Herrera-Acosta, M. Mazzali, Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension 41, 1183–1190 (2003)

    Article  PubMed  CAS  Google Scholar 

  20. M.R. Hayden, S.C. Tyagi, Uric acid: a new look at an old risk marker for cardiovascular disease, metabolic syndrome, and type 2 diabetes mellitus: the urate redox shuttle. Nutr. Metab. 1, 10 (2004)

    Article  Google Scholar 

  21. L.G. Sanchez-Lozada, V. Soto, E. Tapia, C. Avila-Casado, Y.Y. Sautin, T. Nakagawa, M. Franco, B. Rodriguez-Iturbe, R.J. Johnson, Role of oxidative stress in the renal abnormalities induced by experimental hyperuricemia. Am. J. Physiol. Renal. Physiol. 295, F1134–F1141 (2008)

    Article  PubMed  CAS  Google Scholar 

  22. P. Dandona, A. Aljada, A. Bandyopadhyay, Inflammation: the link between insulin resistance, obesity and diabetes. Trends. Immunol. 25, 4–7 (2004)

    Article  PubMed  CAS  Google Scholar 

  23. L.G. Sanchez-Lozada, E. Tapia, C. Avila-Casado, V. Soto, M. Franco, J. Santamaria, T. Nakagawa, B. Rodriguez-Iturbe, R.J. Johnson, J. Herrera-Acosta, Mild hyperuricemia induces glomerular hypertension in normal rats. Am. J. Physiol. Renal. Physiol. 283, F1105–F1110 (2002)

    PubMed  Google Scholar 

  24. G.K. Glantzounis, E.C. Tsimoyiannis, A.M. Kappas, D.A. Galaris, Uric acid and oxidative stress. Curr. Pharm. Des. 11, 4145–4151 (2005)

    Article  PubMed  CAS  Google Scholar 

  25. W.S. Waring, Uric acid: an important antioxidant in acute ischaemic stroke. QJM 95, 691–693 (2002)

    Article  PubMed  CAS  Google Scholar 

  26. M.E. Suliman, R.J. Johnson, E. García-López, A.R. Qureshi, H. Molinaei, J.J. Carrero, O. Heimburger, P. Barany, J. Axelsson, B. Lindholm, P. Stenvinkel, J-shaped mortality relationship for uric acid in CKD. Am. J. Kidney Dis. 48, 761–771 (2006)

    Article  PubMed  CAS  Google Scholar 

  27. D.H. Kang, S.K. Park, I.K. Lee, R.J. Johnson, Uric acid induced C-reactive protein expression: implication on cell proliferation and nitric oxide production of human vascular cells. J. Am. Soc. Nephrol. 16, 3553–3562 (2005)

    Article  PubMed  CAS  Google Scholar 

  28. J. Kanellis, S. Watanabe, J.H. Li, D.H. Kang, P. Li, T. Nakagawa, A. Wamsley, D. Sheikh-Hamad, H.Y. Lan, L. Feng, R.J. Johnson, Uric acid stimulates monocyte chemoattractant protein-1 production in vascular smooth muscle cells via mitogen-activated protein kinase and cyclooxygenase-2. Hypertension 41, 1287–1293 (2003)

    Article  PubMed  CAS  Google Scholar 

  29. T.M. Wallace, J.C. Levy, D.R. Matthews, Use and abuse of HOMA modeling. Diabetes Care 27, 1487–1495 (2004)

    Article  PubMed  Google Scholar 

  30. P. Arner, Insulin resistance in type 2 diabetes: role of fatty acids. Diabetes Metab. Res. Rev. 28, S5–S9 (2002)

    Article  Google Scholar 

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Acknowledgments

This study would not have been possible without the involvement of the participants. We are very grateful to Lu Qi from Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA for critical reading of the manuscript. This study was supported by the grants from Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Chinese Public Health (No. 1994DP131044), National Science Foundation of China (No. 30911120493), National Key New Drug Creation and Manufacturing Program (2008ZX09312/019), the National Key Project of Scientific and Technical Supporting Programs Funded by Ministry of Science & Technology of China (No. 2008BAI52B03) and Shanghai Committee of Science and Technology (No. 08dj1400602).

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai, 200025, China

    Tiange Wang, Yufang Bi, Min Xu, Yun Huang, Yu Xu, Xiaoying Li, Weiqing Wang & Guang Ning

  2. State Key Laboratory of Medical Genomics, E-Institute of Shanghai Universities, Shanghai, 200025, China

    Xiaoying Li & Guang Ning

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  1. Tiange Wang
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  2. Yufang Bi
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  3. Min Xu
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  4. Yun Huang
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  5. Yu Xu
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  6. Xiaoying Li
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  7. Weiqing Wang
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  8. Guang Ning
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Correspondence to Weiqing Wang.

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Wang, T., Bi, Y., Xu, M. et al. Serum uric acid associates with the incidence of type 2 diabetes in a prospective cohort of middle-aged and elderly Chinese. Endocrine 40, 109–116 (2011). https://doi.org/10.1007/s12020-011-9449-2

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  • DOI: https://doi.org/10.1007/s12020-011-9449-2

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