Is Serum Uric Acid Level a Predictor of Development of Type 2 Diabetes Mellitus? A Meta-Analysis
Abstract Number: 1002-P
Authors: SATORU KODAMA, KAZUMI SAITO, MIHOKO ASUMI, AKI SAITO, YOKO YACHI, MIHO MAKI, YUKAKO NISHIGAKI, NOBUHIRO YAMADA, HIROHITO SONE
Institutions: Otsuka Bunkyo-ku, Tokyo, Japan, Tennodai, Ibaraki, Japan
Results: Many epidemiological studies have investigated the association between serum uric acid (UA) and glucose levels. However, it remains controversial whether the serum UA level is a predictor of the onset of type 2 diabetes (T2DM). Therefore, we performed a meta-analysis of cohort studies investigating the dose-response relationship between UA and risk of T2DM. A search of MEDLINE (1966 to February 2008) for observational cohort studies examining the association between serum UA and the risk of T2DM was conducted. In addition, we searched the reference lists of all identified relevant publications. Risk ratios (RRs) of 1 mg/dl increase in UA were pooled with a random-effects model. Eleven articles met the inclusion criteria. In all studies, the estimate was adjusted at least for blood pressure (or presence of hypertension) and body mass index (or presence of obesity). RR of 1 mg/dl increase in UA was 1.14 (95% confidence interval (CI) 1.07-1.22). However, publication bias toward the adverse effect of elevated UA level is suggested (Begg's test: P=0.06; Egger's test: P=0.03). Adjustment for publication bias by using trim and fill methods attenuated the overall estimate (RR=1.08; 95% CI, 1.01-1.17). Current analysis suggested that UA is an independent predictor of T2DM. However, evidence of publication bias and study-variability in adjustment for potential confounders urge caution in interpreting this result.
Figure Overall RRs (with corresponding 95% CIs in parentheses) for risk of T2DM per 1 mg/dl of UA. Area of each square is proportional to study weight. Diamond indicates overall RR; horizontal lines indicate 95% CIs.[figure1]