Relative and attributable diabetes risk associated with hyperuricemia in US veterans with gout

Abstract

Background: Hyperuricemia is known to be a risk factor for incident type 2 diabetes mellitus, but the absolute magnitude of the association is not known. We aimed to evaluate the strength of association between hyperuricemia and the risk of developing diabetes among the US veterans with gout.Methods: Patients (age ≥ 18 years) with ≥2 clinical encounters with gout diagnoses, no history of inflammatory diseases or diabetes and two serum urate (sUA) measurements between 1 January 2002 and 1 January 2011 were selected. Diabetes was identified using International Classification of Disease-9-Clinical Modification codes, use of anti-diabetic medications or HbA1c ≥6.5%. sUA levels were assessed at 6-month cycles (hyperuricemia: sUA >7 mg/dl). Accumulated hazard curves for time to first diabetes diagnosis were derived from Kaplan–Meier (KM) analysis. Risk of diabetes associated with hyperuricemia was estimated using a Cox proportional hazards model. Population attributable fraction (AF) of new-onset diabetes within 1 year was estimated using logistic regression.Results: Among 1923 patients, average age was 62.9 years, body mass index was 30.6 kg/m2, and follow-up time was 80 months. Diabetes rates from KM were 19% for sUA ≤ 7 mg/dl, 23% for 7 mg/dl < sUA ≤ 9 mg/dl and 27% for sUA > 9 mg/dl at the end of follow-up period (P < 0.001). Hyperuricemia was associated with a significantly higher risk of developing diabetes, after adjusting for confounding factors (hazard ratio: 1.19, 95% confidence interval: [1.01–1.41]). Approximately, 8.7% of all new cases of diabetes were statistically attributed to hyperuricemia.Conclusions: Among veterans, hyperuricemia was associated with excess risk for developing diabetes. Approximately, 1 in 11 new cases of diabetes were statistically attributed to hyperuricemia.

Plasma Metabolomics Signature of Gout and Asymptomatic Hyperuricemia

“…Unlike previous studies, this study excluded the obesity, hyperlipidemia, hypertension, etc., which could be better re ect the differences of the above three groups metabolites. We still observed that blood glucose and systolic blood pressure were higher in the gout or hyperuricemia groups than in the healthy controls, which indicated that uric acid was related to glucose and salt metabolism [12][13][14][15].…”

Approximate Mortality Risks between Hyperuricemia and Diabetes in the United States

“…Our data indicate all-cause and CVD mortality risks elevated across UA levels in non-diabetes adults, but the U-shaped relationship between UA level and all-cause mortality is reflected in the participants with diabetes ( Table 3). It is still debated whether hyperuricemia is an independent risk factor for CVD or merely associated with other risk factors, including hypertension [25], renal disease [26], hyperlipidemia [27], and diabetes [28]. In patients with gout, ULT would be cost-effective [22].…”

The rs13129697 polymorphism of the SLC2A9 gene, but not rs7442295 is associated with impaired glucose tolerance/impaired fasting glucose complicated with hyperuricaemia in Han Chinese males

“…Since the increase of SUA concentration resulted in risk for developing T2DM, large numbers of studies have linked HUA with T2DM [7,22]. Many researches had demonstrate that approximately 8.7% of all new cases of T2DM were statistically ascribed to HUA [23,24]. Ogbera et al reported a 25% prevalence of HUA in Nigerian patients with T2DM, while in Chinese T2DM patients, HUA prevalence was 36.1% in women and 28.4% in men [25,26].…”