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J Clin Endocrinol Metab. 2016 Oct;101(10):3772-3778. Epub 2016 Aug 17.

High Normal Uric Acid Levels Are Associated with an Increased Risk of Diabetes in Lean, Normoglycemic Healthy Women.

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Chief Physician's Office and Department of Family Medicine Central District (M.S., S.V.), Clalit Health Services, Israel; Sackler School of Medicine (M.S., S.V., M.L.), Tel Aviv University, Tel Aviv, Israel; Nephrology and Hypertension Institute (D.D., E.J.H., A.L.), Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Ramat Gan, Israel 52653; Department of Medicine B, The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Israel Defense Forces Medical Corps, Military Track of Medicine, The Hebrew University Faculty of Medicine (G.T., A.L.), Ein Kerem Campus, Jerusalem, Israel; and Department of Medicine and Medical Education (A.L.), Mt Auburn Hospital, Harvard Medical School, Cambridge, Massachusetts 02115.



The risk associated with serum uric acid (SUA) levels within the normal range is unknown, especially among lean and apparently healthy adults.


Evaluating whether high-normal SUA levels, 6.8 mg/dL and below, are associated with an increased diabetes risk, compared with low-normal SUA.


This was a cohort study with 10 years of followup involving all clinics of the largest nationally distributed Health Maintenance Organization in Israel.


Participants included 469,947 examinees, 40-70 years old at baseline, who had their SUA measured during 2002. We excluded examinees who had hyperuricemia (SUA > 6.8 mg/dL), impaired fasting glucose, overweight or obesity and chronic cardiovascular or renal disorders. The final cohort was composed of 30 302 participants.


Participants were followed up to a new diagnosis of diabetes during the study period.


Odds ratio of developing diabetes among participants with high-normal baseline SUA were compared with low-normal (2 ≤ uric acid < 3 and 3 ≤ uric acid < 4 in women and men, respectively).


In a logistic regression model adjusted for age, body mass index, socioeconomic status, smoking, baseline estimated glomerular filtration rate, and baseline glucose, SUA levels of 4-5 mg/dL for women were associated with 61% increased risk for incident diabetes (95% confidence interval, 1.1-2.3). At the highest normal levels for women (SUA, 5-6 mg/dL) the odds ratio was 2.7 (1.8-4.0), whereas men had comparable diabetes risk at values of 6-6.8 mg/dL (hazard ratio, 1.35; 95% confidence interval, 0.9-2.1).


SUA levels within the normal range are associated with an increased risk for new-onset diabetes among healthy lean women when compared with those with low-normal values.

[Indexed for MEDLINE]

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