High serum uric acid and increased risk of type 2 diabetes: a systemic review and meta-analysis of prospective cohort studies

• Published in: PloS one Vol. 8; no. 2; p. e56864
• Main Authors: Lv, Qin, Meng, Xian-Fang, He, Fang-Fang, Chen, Shan, Su, Hua, Xiong, Jing, Gao, Pan, Tian, Xiu-Juan, Liu, Jian-She, Zhu, Zhong-Hua, Huang, Kai, Zhang, Chun
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 20.02.2013; Public Library of Science (PLoS)
• Subjects: Acids; Alcohol use; Bias; Cohort analysis; Computer Science; Confidence intervals; Development and progression; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2 - blood; Disease Susceptibility; Exercise; Health risk assessment; Health risks; Heterogeneity; Hospitals; Humans; Hypertension; Medicine; Meta-analysis; Metabolic disorders; Metabolic syndrome; Mortality; Multivariate analysis; Nephrology; Neurosciences; Nutrition; Older people; Prospective Studies; Publication Bias; Regression analysis; Risk; Risk analysis; Risk factors; Science; Statistical analysis; Studies; Type 2 diabetes; Uric acid; Uric Acid - blood; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0056864

Current evidence suggests high serum uric acid may increase the risk of type 2 diabetes, but the association is still uncertain. The aim of the study was to evaluate the association between serum uric acid and future risk of type 2 diabetes by conducting a meta-analysis of prospective cohort studies. We conducted a systematic literature search of the PubMed database through April 2012. Prospective cohort studies were included in meta-analysis that reported the multivariate adjusted relative risks (RRs) and the corresponding 95% confidence intervals (CIs) for the association between serum uric acid and risk of type 2 diabetes. We used both fix-effects and random-effects models to calculate the overall effect estimate. The heterogeneity across studies was tested by both Q statistic and I(2) statistic. Begg's funnel plot and Egger's regression test were used to assess the potential publication bias. We retrieved 7 eligible articles derived from 8 prospective cohort studies, involving a total of 32016 participants and 2930 incident type 2 diabetes. The combined RR of developing type 2 diabetes for the highest category of serum uric acid level compared with the lowest was 1.56(95% CI, 1.39-1.76). Dose-response analysis showed the risk of type 2 diabetes was increased by 6% per 1 mg/dl increment in serum uric acid level (RR 1.06, 95% CI: 1.04-1.07). The result from each subgroup showed a significant association between serum uric acid and risk of type 2 diabetes. In sensitive analysis, the combined RR was consistent every time omitting any one study. Little evidence of heterogeneity and publication bias was observed. Our meta-analysis of prospective cohort studies provided strong evidence that high level of serum uric acid is independent of other established risk factors, especially metabolic syndrome components, for developing type 2 diabetes in middle-aged and older people.