Association Between Serum Uric Acid and Development of Type 2 Diabetes
- Satoru Kodama, MD, PHD,
- Kazumi Saito, MD, PHD,
- Yoko Yachi, RD,
- Mihoko Asumi, MS,
- Ayumi Sugawara, RD,
- Kumiko Totsuka, RD,
- Aki Saito, RD and
- Hirohito Sone, MD, PHD, FACP
- From the Department of Internal Medicine, University of Tsukuba Institute of Clinical Medicine, Ibaraki, Japan.
- Corresponding author: Hirohito Sone, hsone{at}md.tsukuba.ac.jp.
Abstract
OBJECTIVE To systematically evaluate the association between serum uric acid (SUA) level and subsequent development of type 2 diabetes.
RESEARCH DESIGN AND METHODS We searched Medline (31 March from 1966 to 2009) and Embase (31 March from 1980 to 2009) for observational cohort studies examining the association between SUA and the risk of type 2 diabetes by manual literature search. Relative risks (RRs) for each 1 mg/dl increase in SUA were pooled by using a random-effects model. The studies included were stratified into subgroups representing different study characteristics, and meta-regression analyses were performed to investigate the effect of these characteristics on the association between SUA level and type 2 diabetes risk.
RESULTS The search yielded 11 cohort studies (42,834 participants) that reported 3,305 incident cases of type 2 diabetes during follow-up periods ranging from 2.0 to 13.5 years. The pooled RR of a 1 mg/dl increase in SUA was 1.17 (95% CI 1.09–1.25). Study results were consistently significant (i.e., >1) across characteristics of participants and study design. Publication bias was both visually and statistically suggested (P = 0.03 for Egger's test, 0.06). Adjustment for publication bias attenuated the pooled RR per mg/dl increase in SUA (RR 1.11 [95% CI 1.03–1.20]), but the association remained statistically significant (P = 0.009).
CONCLUSIONS The current meta-analysis suggests that SUA level is positively associated with the development of type 2 diabetes regardless of various study characteristics. Further research should attempt to determine whether it is effective to utilize SUA level as a predictor of type 2 diabetes for its primary prevention.
Footnotes
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Received February 19, 2009.
- Accepted June 13, 2009.
- © 2009 by the American Diabetes Association.
