Serum Uric Acid as a Harbinger of Metabolic Outcome in Subjects With Impaired Glucose Tolerance
The Finnish Diabetes Prevention Study
- Leo Niskanen, MD, PHD1,
- David E. Laaksonen, MD, PHD, MPH1,
- Jaana Lindström, MS, PHD2,
- Johan G. Eriksson, MD, PHD2,
- Sirkka Keinänen-Kiukaanniemi, MD, PHD3,
- Pirjo Ilanne-Parikka, MD4,
- Sirkka Aunola, PHD5,
- Helena Hämäläinen, MD, PHD6,
- Jaakko Tuomilehto, MD, PHD27,
- Matti Uusitupa, MD, PHD8 and
- for the Finnish Diabetes Prevention Study Group
- 1Department of Medicine, Kuopio University Hospital, Kuopio, Finland
- 2Diabetes and Genetic Epidemiology Unit, Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland
- 3Department of Public Health Science and General Practice, Unit of General Practice, Oulu University Hospital, Oulu, Finland
- 4Finnish Diabetes Association and Tampere University Hospital Research Unit, Tampere, Finland
- 5Laboratory for Population Research, Department of Health and Functional Capacity, National Public Health Institute, Turku, Finland
- 6Research Department, Social Insurance Institution, Turku, Finland
- 7Department of Public Health, University of Helsinki, Helsinki, Finland
- 8Department of Clinical Nutrition, University of Kuopio, Kuopio, Finland
- Address correspondence and reprint requests to Leo Niskanen, MD, Department of Medicine, Kuopio University Hospital, Bld nro 5, FIN-70210, Kuopio, Finland. E-mail: leo.niskanen{at}kuh.fi
Serum uric acid is the major product of purine metabolism (1). In cross-sectional studies, uric acid correlates with components of the metabolic syndrome: hypertension, obesity, low HDL cholesterol, hypertriglyceridemia, hyperinsulinemia, and insulin resistance (2–4). Although determination of uric acid is widely available and inexpensive, it has been overlooked as a marker of disturbed glucose metabolism. We studied its role in predicting changes in glucose tolerance and insulin levels and in the development of type 2 diabetes in the Finnish Diabetes Prevention Study.
RESEARCH DESIGN AND METHODS
The design of the Finnish Diabetes Prevention Study has been previously described in detail (5). Briefly, 40- to 65-year-old overweight or obese individuals with impaired glucose tolerance were eligible. Impaired glucose tolerance was defined as a 2-h plasma glucose at 7.8–11.0 mmol/l after oral glucose (75 g) with a fasting glucose <7.8 mmol/l (6). The protocol was approved by the ethics committee of the National Public Health Institute (Helsinki, Finland). All participants gave written informed consent.
In all, 522 individuals from five study centers were randomly assigned to the intervention (n = 265) or control (n = 257) groups. Serum uric acid concentrations were measured at baseline and at least once during the follow-up in 475 of the 522 participants, and these 475 are included in the present study. The original trial ended after an average follow-up of 3.2 years. In this study, follow-up …
