Skip to main content
Top
Published in: Endocrine 1/2011

01-08-2011 | Original Article

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

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

Published in: Endocrine | Issue 1/2011

Login to get access

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.
Literature
1.
go back to reference 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)PubMedCrossRef 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)PubMedCrossRef
2.
go back to reference 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)PubMedCrossRef 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)PubMedCrossRef
3.
go back to reference 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)PubMedCrossRef 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)PubMedCrossRef
4.
go back to reference 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)PubMedCrossRef 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)PubMedCrossRef
5.
go back to reference 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)PubMedCrossRef 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)PubMedCrossRef
6.
go back to reference 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 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
7.
go back to reference 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)PubMedCrossRef 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)PubMedCrossRef
8.
go back to reference 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)CrossRef 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)CrossRef
9.
go back to reference 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)PubMedCrossRef 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)PubMedCrossRef
10.
go back to reference 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)PubMedCrossRef 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)PubMedCrossRef
11.
go back to reference 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)PubMedCrossRef 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)PubMedCrossRef
12.
go back to reference 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)PubMedCrossRef 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)PubMedCrossRef
13.
go back to reference 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)PubMedCrossRef 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)PubMedCrossRef
14.
go back to reference 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)PubMedCrossRef 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)PubMedCrossRef
15.
go back to reference 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)PubMedCrossRef 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)PubMedCrossRef
16.
go back to reference 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)PubMedCrossRef 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)PubMedCrossRef
17.
go back to reference 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)PubMedCrossRef 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)PubMedCrossRef
18.
go back to reference 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)PubMedCrossRef 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)PubMedCrossRef
19.
go back to reference 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)PubMedCrossRef 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)PubMedCrossRef
20.
go back to reference 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)CrossRef 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)CrossRef
21.
go back to reference 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)PubMedCrossRef 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)PubMedCrossRef
22.
go back to reference P. Dandona, A. Aljada, A. Bandyopadhyay, Inflammation: the link between insulin resistance, obesity and diabetes. Trends. Immunol. 25, 4–7 (2004)PubMedCrossRef P. Dandona, A. Aljada, A. Bandyopadhyay, Inflammation: the link between insulin resistance, obesity and diabetes. Trends. Immunol. 25, 4–7 (2004)PubMedCrossRef
23.
go back to reference 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 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
24.
go back to reference G.K. Glantzounis, E.C. Tsimoyiannis, A.M. Kappas, D.A. Galaris, Uric acid and oxidative stress. Curr. Pharm. Des. 11, 4145–4151 (2005)PubMedCrossRef G.K. Glantzounis, E.C. Tsimoyiannis, A.M. Kappas, D.A. Galaris, Uric acid and oxidative stress. Curr. Pharm. Des. 11, 4145–4151 (2005)PubMedCrossRef
25.
go back to reference W.S. Waring, Uric acid: an important antioxidant in acute ischaemic stroke. QJM 95, 691–693 (2002)PubMedCrossRef W.S. Waring, Uric acid: an important antioxidant in acute ischaemic stroke. QJM 95, 691–693 (2002)PubMedCrossRef
26.
go back to reference 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)PubMedCrossRef 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)PubMedCrossRef
27.
go back to reference 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)PubMedCrossRef 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)PubMedCrossRef
28.
go back to reference 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)PubMedCrossRef 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)PubMedCrossRef
29.
go back to reference T.M. Wallace, J.C. Levy, D.R. Matthews, Use and abuse of HOMA modeling. Diabetes Care 27, 1487–1495 (2004)PubMedCrossRef T.M. Wallace, J.C. Levy, D.R. Matthews, Use and abuse of HOMA modeling. Diabetes Care 27, 1487–1495 (2004)PubMedCrossRef
30.
go back to reference P. Arner, Insulin resistance in type 2 diabetes: role of fatty acids. Diabetes Metab. Res. Rev. 28, S5–S9 (2002)CrossRef P. Arner, Insulin resistance in type 2 diabetes: role of fatty acids. Diabetes Metab. Res. Rev. 28, S5–S9 (2002)CrossRef
Metadata
Title
Serum uric acid associates with the incidence of type 2 diabetes in a prospective cohort of middle-aged and elderly Chinese
Authors
Tiange Wang
Yufang Bi
Min Xu
Yun Huang
Yu Xu
Xiaoying Li
Weiqing Wang
Guang Ning
Publication date
01-08-2011
Publisher
Springer US
Published in
Endocrine / Issue 1/2011
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-011-9449-2

Other articles of this Issue 1/2011

Endocrine 1/2011 Go to the issue