Serum Uric Acid Levels Improve Prediction of Incident Type 2 Diabetes in Individuals With Impaired Fasting Glucose

Serum Uric Acid Levels Improve Prediction of Incident Type 2 Diabetes in Individuals With Impaired Fasting Glucose The Rancho Bernardo Study Caroline Kaercher Kramer , MD 1 , 2 , Denise von Mühlen , MD, PHD 1 , Simerjot Kaur Jassal , MD 1 and Elizabeth Barrett-Connor , MD 1 1 Division of Epidemiology, Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, La Jolla, California; 2 Division of Endocrinology, Hospital de Clinicas de Porto Alegre, RS, Brazil. Corresponding author: Elizabeth Barrett-Connor, ebarrettconnor{at}ucsd.edu . Abstract OBJECTIVE To determine whether serum uric acid predicts incident type 2 diabetes by glucose tolerance status in older community-dwelling adults. RESEARCH DESIGN AND METHODS Participants without diabetes at baseline were evaluated for incident type 2 diabetes 13 years later. Baseline glucose tolerance status was defined as normoglycemia, impaired fasting glucose, and impaired postchallenge glucose tolerance. RESULTS A total of 566 participants were included (mean age 63.3 ± 8.6 years; 41% men). Regression models adjusted for age, sex, BMI, diuretic use, and estimated glomerular filtration rate showed that for each 1 mg/dl increment in uric acid levels, incident type 2 diabetes risk increased by ∼60%. When analyses were stratified by glucose status, uric acid levels independently predicted incident type 2 diabetes among participants who had impaired fasting glucose (odds ratio 1.75, 95% CI 1.1–2.9, P = 0.02). CONCLUSIONS Uric acid may be a useful predictor of type 2 diabetes in older adults with impaired fasting glucose. Footnotes The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact. Received February 12, 2009. Accepted March 25, 2009. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details. © 2009 by the American Diabetes Association.