Diabetes, Metabolic Syndrome and Obesity (Nov 2020)
Sex-Specific Associations of Circulating Uric Acid with Risk of Diabetes Incidence: A Population-Based Cohort Study from Sweden
Abstract
Ning Chen,1,2 Iram Faqir Muhammad,2 Zhibin Li,3 Peter M Nilsson,2,4 Yan Borné2 1Department of Endocrinology, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, People’s Republic of China; 2Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden; 3Epidemiology Research Unit, The First Affiliated Hospital, Xiamen University, Xiamen, People’s Republic of China; 4Department of Internal Medicine, Skåne University Hospital, Malmö, SwedenCorrespondence: Yan Borné; Ning Chen Email [email protected]; [email protected]: To explore the longitudinal, as well as sex-specific, associations between circulating uric acid (UA) and diabetes incidence.Methods: A cohort study of the Malmö Diet Cancer-cardiovascular Cohort (Malmö, Sweden) consisting of 3140 individuals without diabetes at baseline, was followed up until the end of 2018. Incident diabetes cases were identified by linking to local and national diabetes registers. Cox proportional hazard regression was used to assess plasma UA levels in relation to diabetes incidence with adjustment for established confounders.Results: At baseline, with increasing levels of UA, subjects were more likely to be older and have significantly higher body mass index, waist circumference, triglycerides, C-reactive protein, fasting glucose and 2-h plasma glucose postoral glucose tolerance test, and lower levels of high-density lipoprotein. During a mean follow-up period of 8.09± 2.24 years, 315 (10.0%) participants developed diabetes, and diabetes incidence rates were 7.89, 9.48 and 18.11 per 1000 person-years for subjects in the 1st, 2nd, and 3rd tertiles of UA, respectively (log-rank test: p< 0.001). With adjustment for potential confounders, elevated UA levels were significantly associated with increased risks of diabetes incidence, with the adjusted hazard ratio (HR) (95% confidence interval) for per standard deviation increment of UA of 1.22 (1.08– 1.39, p=0.002). Compared with the 1st tertile of UA, the 3rd tertile showed significantly increased risk of diabetes incidence with the adjusted HR of 1.74 (1.24– 2.45, p=0.002), and there was a significant trend between increasing tertiles of UA and diabetes incidence (trend test: p< 0.001). Stratified analyses showed that elevated circulating UA levels were independently associated with increased risks of diabetes incidence in men but not in women, although the interaction between sex and UA was not statistically significant.Conclusion: Elevated circulating UA was independently associated with increased risk of diabetes incidence, especially for men.Keywords: cohort study, diabetes incidence, longitudinal, stratified analysis, uric acid
