Study on the effect of serum uric acid on metabolic disorders

Abstract

Objective To evaluate the prediction value of serum uric acid level in the occurrence of multiple metabolic disorders. Methods The subjects are from the Health Management Centre, Tianjin Medical University General Hospital. Four kinds of metabolic diseases, namely type 2 diabetes mellitus, hypertension, hyperlipidemia, and nonalcoholic fatty liver disease (NAFLD), were analyzed by four-cohort analysis. Sample sizes were 56 915, 47 387, 31 431, and 35 203. The average follow-up time for each cohort was (3.56±2.32), (3.31±2.24), (2.70±1.95), (2.90±1.76) years, respectively. In each cohort, the population was divided into two groups, depending on the occurrence of type 2 diabetes, hypertension, hyperlipidemia, and NAFLD during follow-up. All relevant variables were tested for baseline and follow-up, including laboratory tests, lifestyle questionnaire, and physical examination. Statistical analysis by Cox proportional hazard regression model was performed for the relationships between the fifth percentile of the distribution of serum uric acid levels and incidence of type 2 diabetes, hypertension, hyperlipidemia, and NAFLD. Results During the follow-up period, the incidence of type 2 diabetes, hypertension, hyperlipidemia, and NAFLD were 3.5%, 17.6%, 33.4%, and 15.7%, respectively. After adjustment for confounding factors, with the increase in serum uric acid level, the hazard ratios (95%CI) of type 2 diabetes were 1.00, 0.82 (0.70, 0.95), 0.80 (0.69, 0.92), 0.77 (0.67, 0.88), and 0.83 (0.72, 0.95) (P=0.02). Meanwhile, higher risk of hypertension, hyperlipidemia, and NAFLD were associated with elevated serum uric acid level. In the group with the highest serum uric acid level in each cohort, the hazard ratio (95%CI) of hypertension, hyperlipidemia, and NAFLD were 1.17 (1.09, 1.25), 1.20 (1.13, 1.28), and 1.56 (1.43, 1.70), respectively (P< 0.01), as compared to the group with the lowest level. Conclusion Serum uric acid levels have a positive predictive value for the occurrence of hypertension, hyperlipidemia, and NAFLD, but have a negative predictive value for type 2 diabetes. Key words: Uric acid; Nutritional and metabolic diseases; Cohort studies