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. 2017 Jun 20;12(6):e0179482.
doi: 10.1371/journal.pone.0179482. eCollection 2017.

The association between serum uric acid and the incidence of prediabetes and type 2 diabetes mellitus: The Rotterdam Study

Niels van der Schaft  1 , Adela Brahimaj  1 , Ke-Xin Wen  1 , Oscar H Franco  1 , Abbas Dehghan  1
Affiliations

The association between serum uric acid and the incidence of prediabetes and type 2 diabetes mellitus: The Rotterdam Study

Niels van der Schaft et al. PLoS One. .

Abstract

Background: Limited evidence is available about the association between serum uric acid and sub-stages of the spectrum from normoglycaemia to type 2 diabetes mellitus. We aimed to investigate the association between serum uric acid and risk of prediabetes and type 2 diabetes mellitus.

Methods: Eligible participants of the Rotterdam Study (n = 8,367) were classified into mutually exclusive subgroups of normoglycaemia (n = 7,030) and prediabetes (n = 1,337) at baseline. These subgroups were followed up for incident prediabetes (n = 1,071) and incident type 2 diabetes mellitus (n = 407), respectively. We used Cox proportional hazard models to determine hazard ratios (HRs) for incident prediabetes among individuals with normoglycaemia and incident type 2 diabetes mellitus among individuals with prediabetes.

Results: The mean duration of follow-up was 7.5 years for incident prediabetes and 7.2 years for incident type 2 diabetes mellitus. A standard deviation increment in serum uric acid was significantly associated with incident prediabetes among individuals with normoglycaemia (HR 1.10, 95% confidence interval (CI) 1.01; 1.18), but not with incident type 2 diabetes mellitus among individuals with prediabetes (HR 1.07, 95% CI 0.94; 1.21). Exclusion of individuals who used diuretics or individuals with hypertension did not change our results. Serum uric acid was significantly associated with incident prediabetes among normoglycaemic women (HR 1.13, 95% CI 1.02; 1.25) but not among normoglycaemic men (HR 1.08, 95% CI 0.96; 1.21). In contrast, serum uric acid was significantly associated with incident type 2 diabetes mellitus among prediabetic men (HR 1.23, 95% CI 1.01; 1.48) but not among prediabetic women (HR 1.00, 95% CI 0.84; 1.19).

Conclusions: Our findings agree with the notion that serum uric acid is more closely related to early-phase mechanisms in the development of type 2 diabetes mellitus than late-phase mechanisms.

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Conflict of interest statement

Competing Interests: We have read the journal's policy and the authors of this manuscript have the following competing interests: NvdS has nothing to declare. AD has received consultancy and research support from Metagenics Inc. (outside the scope of submitted work). AB is financially supported by Erasmus Mundus Western Balkans (ERAWEB), a project funded by the European Commission. OHF and KXW work at ErasmusAGE, a center for aging research across the life course funded by Nestlé Nutrition (Nestec Ltd.); Metagenics Inc.; and the AXA Research Fund. This does not alter our adherence to all PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Selection of the study population.
Fig 2
Fig 2. Quartile-specific hazard ratios for serum uric acid in association with incident prediabetes and incident type 2 diabetes mellitus.
See this image and copyright information in PMC

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