MedWire News: High levels of uric acid are an accurate predictor for Type 2 diabetes, report researchers from the Rancho Bernardo Study.
Increased levels of uric acid, a major urine byproduct, have been previously linked with insulin resistance and established Type 2 diabetes, say Elizabeth Barrett-Connor (University of California, San Diego, USA) and co-workers.
In this study, the team tested whether serum uric acid level at baseline was predictive for incident Type 2 diabetes over a 13-year period by examining glucose tolerance status in a group of 566 participants of the Rancho Bernardo Study aged 63.3 years on average.
At baseline, glucose tolerance status of the participants was defined as normoglycemia, impaired fasting glucose (IFG), or impaired postchallenge glucose tolerance (IGT).
Over the 13-year follow-up period, 55 individuals developed Type 2 diabetes. Of these eight, 25, and 22 were normoglycemic, had IFG, or had IGT at baseline, respectively.
The researchers found that overall high uric acid was significantly predictive for incident Type 2 diabetes. More specifically, for each 1-mg/dl increment in uric acid levels, the risk for incident Type 2 diabetes increased by around 60%.
When the researchers stratified patients who developed diabetes by their initial glucose tolerance status, they found that uric acid levels were only significant independent predictors for incident Type 2 diabetes in participants with IFG at baseline (odds ratio=1.75), but not normoglycemia or IGT.
Current recommendations suggest that clinicians should perform an oral glucose tolerance test in people with IFG to more accurately predict their future risk for developing Type 2 diabetes, but the test is expensive and unpleasant for patients.
Barrett-Connor and co-authors found that in this cohort a uric acid measurement below 5.35 mg/dl was 100% predictive for non-development of Type 2 diabetes in individuals with IFG over a maximum follow-up period of 22 years.
They therefore conclude in the journal Diabetes Care that “adding uric acid to fasting blood glucose may help identify older adults with IFG who are at low risk for diabetes and who do not need a glucose tolerance test.”
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