Purpose: Diabetes mellitus is one of the biggest public health problems in the industrialized world. Early markers that can predict incidence of diabetes would be helpful in instituting preventive strategies. The purpose of this study was to test the hypothesis that hyperuricemia can be used as an early marker of type 2 diabetes mellitus independent of obesity, physical activity, and other known risk factors.
Method: 5,012 diabetes-free men (46%) and women (54%) between ages 18 and 30 at baseline were prospectively followed for 15 years with regular visits every 2 to 3 years. The outcome of interest was incidence of diabetes fulfilling the American Diabetes Association criteria or need for any hypoglycemic medications. The independent variable of interest was serum uric acid level (sUA) at baseline. The relationship between sUA concentration and the risk for subsequent diabetes was studied using logistic regression models adjusted for the effects of age, gender, ethnicity, body mass index (BMI), diastolic blood pressure, smoking, fasting glucose concentration, family history of diabetes, and a physical activity score.
Results: Half (51%) of subjects were African-American. The mean±SD of age (years), BMI (kg/m2), diastolic blood pressure (mm Hg), and physical activity score (1 to 5 scale of increasing activity level ) were 24.8±3.6, 22.4±4.8, 68.6±9.6, and 3.3±1.1, respectively, at baseline. In multivariable regression models, the highest category of sUA (≥7.0 mg/dL) had statistically higher risk of developing type 2 diabetes, even after excluding patients who met the World Health Organization criteria for metabolic syndrome (Table). When sUA was examined as a continuous variable, each unit increase in sUA was associated with increased overall risk of type 2 diabetes (odds ratio 1.18; 95% confidence interval: 1.04-1.35) and among those without metabolic syndrome (1.22 [1.07-1.38]).
Conclusion: In this study, increased levels of sUA appear to be associated with increased overall risk of type 2 diabetes among our cohort of young adults. These data expand on well-established, cross-sectional associations between hyperuricemia, and the metabolic syndrome and may extend the link to the future risk of type 2 diabetes in young adults.
Disclosure: M. Bennett, None; B. J. Pandya, Takeda, 3 ; E. Krishnan, Savient, 1, Takeda, 2 ; A. Hariri, Takeda, 3 ; L. Chung, None; H. K. Choi, Takeda, 2, Takeda, 9, Savient, 9, Centocor, Inc., 9 ; O. Dabbous, Takeda, 3 .