Serum uric acid levels and incidence of impaired fasting glucose and type 2 diabetes mellitus: a meta-analysis of cohort studies.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational cohort studies
PubMed 23608549 · doi:10.1016/j.diabres.2013.03.026
What was done
A systematic review and meta-analysis of cohort studies was conducted to evaluate the relationship between serum uric acid (SUA) levels and incident impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2DM). Fixed- or random-effects models were applied based on between-study heterogeneity. Dose-response relationships were evaluated using restricted cubic spline models and multivariate random-effects meta-regression. The analysis pooled 12 studies comprising 15 results, 6,340 cases, and 62,834 participants.
What was found
Comparing the highest with lowest SUA levels yielded a pooled multivariate-adjusted relative risk (RR) of 1.54 (95% CI: 1.41-1.68; I2 = 42.2%) for IFG and T2DM combined, and an RR of 1.67 (95% CI: 1.51-1.86) for T2DM alone. A nonlinear dose-response relationship was identified (P < 0.01). Adjusted RRs (95% CI) for IFG and T2DM across specific SUA levels were 1.02 (0.95-1.10) for 2.5 mg/dl, 1.04 (0.94-1.15) for 3.5 mg/dl, 1.10 (0.99-1.22) for 4.5 mg/dl, 1.25 (1.16-1.35) for 5.5 mg/dl, 1.43 (1.31-1.55) for 6.5 mg/dl, 1.50 (1.38-1.63) for 7.5 mg/dl, and 1.49 (1.34-1.67) for 8.5 mg/dl.
Why it matters
This review demonstrates a clear nonlinear dose-response relationship between baseline uric acid concentrations and dysglycemia, showing elevated risk beginning around 5.5 mg/dl.
Limits
All included data derive from observational cohort designs, precluding causal inference. The abstract does not report participant demographics, follow-up durations, geographic distribution, or specific adjustment covariates across the included studies.
Cited by
- supports A serum uric acid level around 5.2 to 5.5 mg/dL is an inflection point above which the risk for diabetes, obesity, and kidney disease begins to rise significantly.