by Colin Kenny, GP, Dromore
Conditions such as hypertension, obesity, type 2 diabetes and chronic kidney disease may promote hyperuricaemia and in turn may explain the increase in prevalence of gout, which has risen by 63.9% in the UK since 1997 (http://bit.ly/1nyeekI). Alcohol misuse and unhealthy diets have also been recognised as triggers for gout. Not all observational studies, though, have identified elevated uric acid concentration as a risk factor for diabetes.
The authors of this large study examined both the association of uric acid level with incident diabetes and the change in uric acid concentration after a diabetes diagnosis. Specifically, they used data from the ARIC (Atherosclerosis Risk in Communities) study and quantified the independent association between uric acid level and incident diabetes. The also analysed the association between duration of diabetes and change in uric acid level.
The study enrolled 11,134 participants without diagnosed diabetes at baseline. There were 1294 incident cases of diabetes during a median of 9 years of follow-up. Uric acid level was associated with diabetes even after adjustment for other risk factors such as fasting glucose and insulin levels.
In participants with diabetes (n=1510), every additional 5 years’ duration of diabetes was associated, after adjustment, with a uric acid level that was 5.9 µmol/L lower. They concluded that uric acid concentration “rises prior to diagnosis of diabetes and then declines with diabetes duration.”
This study suggests that we should consider the risk of diabetes in individuals who presents with raised uric acid levels, as they are more likely than the general population to develop diabetes.
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