High Serum Uric Acid and Increased Risk of Type 2 Diabetes: A Systemic Review and Meta-Analysis of Prospective Cohort Studies

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Abstract

Objective

Current evidence suggests high serum uric acid may increase the risk of type 2 diabetes, but the association is still uncertain. The aim of the study was to evaluate the association between serum uric acid and future risk of type 2 diabetes by conducting a meta-analysis of prospective cohort studies.

Design and Methods

We conducted a systematic literature search of the PubMed database through April 2012. Prospective cohort studies were included in meta-analysis that reported the multivariate adjusted relative risks (RRs) and the corresponding 95% confidence intervals (CIs) for the association between serum uric acid and risk of type 2 diabetes. We used both fix-effects and random-effects models to calculate the overall effect estimate. The heterogeneity across studies was tested by both Q statistic and I ² statistic. Begg’s funnel plot and Egger’s regression test were used to assess the potential publication bias.

Results

We retrieved 7 eligible articles derived from 8 prospective cohort studies, involving a total of 32016 participants and 2930 incident type 2 diabetes. The combined RR of developing type 2 diabetes for the highest category of serum uric acid level compared with the lowest was 1.56(95% CI, 1.39–1.76). Dose-response analysis showed the risk of type 2 diabetes was increased by 6% per 1 mg/dl increment in serum uric acid level (RR 1.06, 95% CI: 1.04–1.07). The result from each subgroup showed a significant association between serum uric acid and risk of type 2 diabetes. In sensitive analysis, the combined RR was consistent every time omitting any one study. Little evidence of heterogeneity and publication bias was observed.

Conclusions

Our meta-analysis of prospective cohort studies provided strong evidence that high level of serum uric acid is independent of other established risk factors, especially metabolic syndrome components, for developing type 2 diabetes in middle-aged and older people.

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Author and article information

Contributors

Xiao-Ping Miao: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, USA )

ISSN (Electronic): 1932-6203

Publication date Collection: 2013

Publication date (Electronic): 20 February 2013

Volume: 8

Issue: 2

Electronic Location Identifier: e56864

Affiliations

[1 ]Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

[2 ]Department of Neurobiology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

[3 ]Department of Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China

Author notes

* E-mail: huangkai1@ 123456mail.hust.edu.cn (KH); drzhangchun@ 123456hust.edu.cn (CZ)

Competing Interests: The authors have declared that no competing interests exist.

Conceived and designed the experiments: KH CZ. Performed the experiments: QL XFM. Analyzed the data: QL XFM FFH SC HS JX. Wrote the paper: QL XFM PG XJT JSL ZHZ CZ.

Article

Publisher ID: PONE-D-12-32738

DOI: 10.1371/journal.pone.0056864

PMC ID: 3577701

PubMed ID: 23437258

SO-VID: 75df150a-98bb-4eda-b753-e49a2ea19e21

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 25 October 2012

Date accepted : 15 January 2013

Page count

Pages: 7

Funding

This work was supported by grants from the National Natural Science Foundation of China (no. 81170662, no. 30871174 and no. 31200872), a grant from Natural Science Foundation of Hubei Province (2012FFA038), and a Medicine-Technology Interdisciplinary grant from Huazhong University of Science and Technology (no. 2012-14). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

High Serum Uric Acid and Increased Risk of Type 2 Diabetes: A Systemic Review and Meta-Analysis of Prospective Cohort Studies

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