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.
This study aimed to examine gender differences in the association between serum uric acid (SUA) and the risk of prediabetes in a longitudinal cohort. A total of 8237 participants in the Beijing Health Management Cohort study were recruited and surveyed during 2008–2009, and followed up in 2011–2012 and 2014–2015 surveys. Generalized estimating equation (GEE) models were used to evaluate the association between SUA and prediabetes. Furthermore, subgroup analyses assessed the primary outcome according to status of abdominal obesity, age and status of hypertension. During six years of follow-up, we identified 1083 prediabetes events. The GEE analyses confirmed and clarified the association between SUA and prediabetes (RR = 1.362; 95% CI = 1.095–1.696; p = 0.006) after adjusting for other potential confounders, especially in females (RR = 2.109; 95% CI = 1.329–3.347; p = 0.002). In addition, this association was stronger in the subgroup of females aged ≥48 years old (RR = 2.384; 95% CI = 1.417–4.010; p = 0.001). The risk for prediabetes increased significantly with increasing SUA for females in the Chinese population. This association was strongly confirmed in older females aged ≥48 years old rather than in younger females, which may provide clues for pathogenic mechanisms of gender differences in the association between SUA and prediabetes.
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