Abstract

Objective – There is limited information on whether increased serum uric acid levels are independently associated with cardiovascular mortality in type 2 diabetes. We assessed the predictive role of serum uric acid levels on all-cause and cardiovascular mortality in a large cohort of type 2 diabetic individuals.

Research Design and Methods – The cohort included 2,726 type 2 diabetic outpatients, who were followed for a mean period of 4.7 years. The independent association of serum uric acid levels with all-cause and cardiovascular mortality was assessed by Cox proportional-hazards models and adjusted for conventional risk factors and several potential confounders.

Results – During follow-up, 329 (12.1%) patients died, 44.1% (n=145) of whom for cardiovascular causes. In univariate analysis, higher serum uric acid levels were significantly associated with increased risk of all-cause (hazard ratio [HR] 1.19, 95% confidence intervals 1.12-1.27, p<0.001) and cardiovascular (HR 1.25, 1.16-1.34, p<0.001) mortality. After adjustment for age, gender, body mass index, smoking, hypertension, dyslipidemia, diabetes duration, hemoglobin A1c, medications use (allopurinol, hypoglycemic, anti-hypertensive, lipid-lowering and anti-platelet drugs), estimated glomerular filtration rate and albuminuria, the association of serum uric acid with cardiovascular mortality remained statistically significant (HR 1.27, 1.01-1.61, p=0.046), whereas the association of serum uric acid with all-cause mortality did not.

Conclusions – Higher serum uric acid levels are associated with increased risk of cardiovascular mortality in type 2 diabetic patients, independently of several potential confounders, including renal function measures.