The Association between Serum Uric Acid and Development of Type 2 Diabetes Mellitus. A Meta-Analysis

Abstract

Objective To systematically evaluate the association between serum uric acid (SUA) level and subsequent development of type 2 diabetes mellitus (T2DM)

Research design and methods We searched MEDLINE (1966 to 2009 Mar 31) and EMBASE (1980 to 2009 Mar 31) for observational cohort studies examining the association between SUA and the risk of T2DM 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 and T2DM risk.

Results The search yielded 11 cohort studies (42,834 participants) that reported 3305 incident cases of T2DM 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% confidence interval (CI) 1.09-1.25). Study results were consistently significant (i.e. greater than 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 T2DM regardless of various study characteristics. Further research should attempt to determine whether it is effective to utilize SUA level as a predictor of T2DM for its primary prevention.