Abstract
Background Hyperuricemia is known to be a risk factor for diabetes. However, information is limited regarding the association between changes in hyperuricemia and the risk of diabetes. Methods A total of 15,403 participants who were free of diabetes at the time of 2009 and 2011 surveys in the Beijing Health Management Cohort (BHMC) study were recruited and followed up until 2016. Participants were classified into four groups according to 2-year changes in hyperuricemia: no hyperuricemia, remittent hyperuricemia, incident hyperuricemia, and persistent hyperuricemia. Modified Poisson regression models were used to evaluate the effect of 2-year changes in hyperuricemia on the risk of diabetes. Results During the 5-year follow-up, we identified 841 new cases of diabetes (216 women). Remittent hyperuricemia and incident hyperuricemia had a 35% and 48% higher risk for developing diabetes compared with no hyperuricemia. Especially, persistent hyperuricemia was associated with a 75% higher risk of diabetes (RR = 1.75, 95% CI = 1.47-2.08). Compared with minor serum uric acid (SUA) change, over 10% decline and over 30% increase in SUA levels were subsequently associated with lower (RR = 0.84, 95% CI = 0.72-0.99) and higher (RR = 1.71, 95% CI = 1.27-2.30) diabetes risk, respectively. Conclusions Changes in hyperuricemia, especially persistent hyperuricemia, are more appropriate to reflect the risk of diabetes than a single measurement of hyperuricemia at baseline. Strategies aiming at preventing hyperuricemia are urgently needed to reduce the increasing burden of diabetes.
Highlights
Diabetes is an increasingly important metabolic disorder globally [1]
Sex, Body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), TG, high-density lipoprotein cholesterol (HDLC), physical activity, smoking, alcohol consumption, and family history of diabetes at baseline were significantly associated with changes in hyperuricemia from 2009 to 2011 (P < 0 05)
The risk of diabetes became the highest in the persistent hyperuricemia group using no hyperuricemia as the reference group after adjusting for other potential confounding factors (RR = 1.75, 95% confidence interval (CI) = 1.47-2.08)
Summary
Diabetes is an increasingly important metabolic disorder globally [1]. In 2017, 451 million adults are estimated to have diabetes, and this number is expected to rise to 693 million by 2045 worldwide [2]. Abnormalities in uric acid metabolism result in hyperuricemia [5,6,7]. Information is limited regarding the association between changes in hyperuricemia and the risk of diabetes. Modified Poisson regression models were used to evaluate the effect of 2-year changes in hyperuricemia on the risk of diabetes. Persistent hyperuricemia was associated with a 75% higher risk of diabetes (RR = 1.75, 95% CI = 1.47-2.08). Compared with minor serum uric acid (SUA) change, over 10% decline and over 30% increase in SUA levels were subsequently associated with lower (RR = 0.84, 95% CI = 0.72-0.99) and higher (RR = 1.71, 95% CI = 1.27-2.30) diabetes risk, respectively. Especially persistent hyperuricemia, are more appropriate to reflect the risk of diabetes than a single measurement of hyperuricemia at baseline. Strategies aiming at preventing hyperuricemia are urgently needed to reduce the increasing burden of diabetes
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