Division of Epidemiology, Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, La Jolla, California, USA.
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 approximately 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.