Serum uric acid levels and incidence of impaired fasting glucose and type 2 diabetes mellitus: A meta-analysis of cohort studies

Aims: A meta-analysis of cohort studies was conducted to assess the association between serum uric acid (SUA) levels and incidence of impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2DM). Methods: A comprehensive search was conducted to identify eligible studies. The fixed or random effect pooled measure was selected based on between-study heterogeneity. Dose-response relationship was assessed by restricted cubic spline model and multivariate random-effect meta-regression. Results: Twelve studies with fifteen results were included involving 6340 cases and 62,834 participants. The pooled multivariate-adjusted relative risk (RR) (95%CI) of IFG and T2DM for the highest vs. lowest level of SUA was 1.54 (1.41-1.68), I-2 = 42.2%. The association was consistent and significant across subgroup analysis. A nonlinear relationship was found of SUA levels with incidence of IFG and T2DM (P < 0.01), and the multivariate-adjusted RRs (95% CI) of IFG and T2DM were 1.02 (0.95-1.10), 1.04 (0.94-1.15), 1.10 (0.99-1.22), 1.25 (1.16-1.35), 1.43 (1.31-1.55), 1.50 (1.38-1.63) and 1.49 (1.34-1.67) for 2.5, 3.5, 4.5, 5.5, 6.5, 7.5 and 8.5 mg/dl of SUA. The RR (95% CI) of T2DM for the highest vs. lowest level of SUA was 1.67 (1.51-1.86), and a nonlinear relationship was also found between SUA levels and incidence of T2DM. Conclusions: SUA levels are positively associated with incidence of IFG and T2DM, and the association might be nonlinear. (C) 2013 Elsevier Ireland Ltd. All rights reserved.