Inverse associations between serum urate and glycemic status in a general population and in persons with diabetes mellitus

Abstract

Background: Results of previous studies regarding the relationship between blood urate level and diabetes are conflicting. The aim of this study was to clarify the relations of urate with glycemic status and metabolic syndrome in a general population and in patients with diabetes.

Methods: The participants were 12,528 men receiving health-checkup examinations (29-70 years old) and they were divided into four quartile groups for serum urate levels. Relationships of urate with metabolic syndrome and its components were investigated after adjustment for age and lifestyle factors such as smoking, alcohol drinking and regular exercise.

Results: In the overall participants and the participants with diabetes (n = 802), hemoglobin A1c levels were significantly lower in the 2nd, 3rd and 4th quartiles for urate than in the 1st quartile and the levels tended to be lower with an increase in the quartile. In the overall participants, the adjusted odds ratios for diabetes vs. the 1st quartile of urate were significantly lower in the 2nd quartile (0.71 [0.59-0.87])), 3rd quartile (0.51 [0.41-0.63]) and 4th quartile [0.35 (0.28-0.44)) than the reference level and the odds ratio tended to be lower with an increase in the quartile. A high urate level was positively associated with visceral obesity, hypertension, dyslipidemia (high triglycerides and/or low HDL cholesterol) and metabolic syndrome, and these associations were less prominent in the diabetes group than in the overall participants.

Conclusions: Blood urate level is inversely associated with glycemic status in both a general population and patients with diabetes. Positive associations of urate with metabolic syndrome and its components except for diabetes are confounded in the presence of diabetes.

Keywords: Cardiovascular risk factor; Diabetes; Hemoglobin A1c; Metabolic syndrome; Urate.