lancet-header
Preprints with The Lancet is part of SSRN´s First Look, a place where journals and other research experts identify content of interest prior to publication. These preprint papers are not peer-reviewed. Authors have either opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet, or submitted directly via SSRN. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These papers should not be used for clinical decision making or reporting of research to a lay audience without indicating that this is preliminary research that has not been peer-reviewed. For more information see the Comment published in The Lancet, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com

The Effect of Uric Acid Level, Hyperuricemia and Gout on the Risk of Type 2 Diabetes: A Meta-Analysis of Cohort Studies

33 Pages Posted: 3 Feb 2020

See all articles by Yuchai Huang

Yuchai Huang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - School of Public Health

Yong Gan

Huazhong University of Science and Technology (Formerly Tongi Medical University) - School of Public Health

Wei Xiong

Huazhong University of Science and Technology (Formerly Tongi Medical University) - School of Public Health

Yiling Lou

Huazhong University of Science and Technology (Formerly Tongi Medical University) - School of Public Health

Chuangliang Qiu

Government of the People's Republic of China - Fuyong People's Hospital

Zhengen Luo

Government of the People's Republic of China - Fuyong People's Hospital

Yan He

Zhengzhou University - College of Public Health

Zuxun Lu

Huazhong University of Science and Technology (Formerly Tongi Medical University) - School of Public Health; Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Social Medicine and Health Management; Huazhong University of Science and Technology (Formerly Tongi Medical University) - School of Medicine and Health Management

Shiyi Cao

Huazhong University of Science and Technology (Formerly Tongi Medical University) - School of Public Health

More...

Abstract

Background: Epidemiology evidence on the effect of serum uric acid levels (SUAs), hyperuricemia, and gout on the risk of type 2 diabetes (T2DM) is inconsistent. We conducted a meta-analysis of cohort studies to comprehensively summarize the issue.

Methods: We searched the PubMed and Embase databases to November 2019 for studies conformed to the inclusion criteria. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated with random-effect meta-analysis. We conducted dose-response meta-analysis to investigate the relation between SUA and T2DM risk. Meta-regression analyses, subgroup analyses and sensitivity analyses were performed to identify potential sources of heterogeneity.

Findings: A total of 23 prospective studies involving 737468 participants were identified. A significantly positive association between higher uric acid level, hyperuricemia, gout and T2DM risk was observed, respectively(RR=1.20, 95% CI 1.14, 1.27; RR=1.52, 95% CI 1.21, 1.91; RR=1.35, 95% CI 1.16, 1.57). Piecewise dose-response analysis found a linear trend for SUA higher than 4.5mg/dl, with one mg/dl increase of SUA level associated with 8% increase of T2DM risk (RR=1.08, 95%CI= 1.03, 1.13, P=0.001). Unadjusted for hypertension found a positive association between gout and T2DM risk (RR=1.40, 95% CI 1.22, 1.66), while adjusted for hypertension found the relation to be non-significant (RR=1.31, 95% CI 0.78, 2.21).

Interpretation: The present findings suggest that higher SUA levels, hyperuricemia and gout are risk factors for T2DM. It is necessary for hyperuricemia and gout patients to test blood glucose regularly and prevent T2DM. For general population, lowering serum uric acid might protect from incident T2DM.

Funding Statement: The authors stated that they received no funding for this work.

Declaration of Interests: The authors declare that they have no conflicts of interest.

Ethics Approval Statement: The authors planned and conducted this review under the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses: the PRISMA statement.

Keywords: serum uric acid; hyperuricemia; gout; type 2 diabetes; meta-analysis

Suggested Citation

Huang, Yuchai and Gan, Yong and Xiong, Wei and Lou, Yiling and Qiu, Chuangliang and Luo, Zhengen and He, Yan and Lu, Zuxun and Cao, Shiyi, The Effect of Uric Acid Level, Hyperuricemia and Gout on the Risk of Type 2 Diabetes: A Meta-Analysis of Cohort Studies (January 17, 2020). Available at SSRN: https://ssrn.com/abstract=3521416 or http://dx.doi.org/10.2139/ssrn.3521416

Yuchai Huang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - School of Public Health

1037 Luoyu Rd
Wuhan
China

Yong Gan

Huazhong University of Science and Technology (Formerly Tongi Medical University) - School of Public Health

1037 Luoyu Rd
Wuhan
China

Wei Xiong

Huazhong University of Science and Technology (Formerly Tongi Medical University) - School of Public Health

1037 Luoyu Rd
Wuhan
China

Yiling Lou

Huazhong University of Science and Technology (Formerly Tongi Medical University) - School of Public Health

1037 Luoyu Rd
Wuhan
China

Chuangliang Qiu

Government of the People's Republic of China - Fuyong People's Hospital

China

Zhengen Luo

Government of the People's Republic of China - Fuyong People's Hospital

China

Yan He

Zhengzhou University - College of Public Health

Zhengzhou, Henan
China

Zuxun Lu

Huazhong University of Science and Technology (Formerly Tongi Medical University) - School of Public Health ( email )

1037 Luoyu Rd
Wuhan
China

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Social Medicine and Health Management ( email )

Wuhan
China

Huazhong University of Science and Technology (Formerly Tongi Medical University) - School of Medicine and Health Management

13 Hangkong Road
Qiaokou District
Wuhan, 430030
China

Shiyi Cao (Contact Author)

Huazhong University of Science and Technology (Formerly Tongi Medical University) - School of Public Health ( email )

1037 Luoyu Rd
Wuhan
China

Click here to go to TheLancet.com

Paper statistics

Abstract Views
145
Downloads
19