title: High serum uric acid and increased risk of type 2 diabetes: a systemic review and meta-analysis of prospective cohort studies.
abstract: OBJECTIVE
  Current evidence suggests high serum uric acid may increase the risk of type 2 diabetes, but the association is still uncertain. The aim of the study was to evaluate the association between serum uric acid and future risk of type 2 diabetes by conducting a meta-analysis of prospective cohort studies.
  
  
  METHODS
  We conducted a systematic literature search of the PubMed database through April 2012. Prospective cohort studies were included in meta-analysis that reported the multivariate adjusted relative risks (RRs) and the corresponding 95% confidence intervals (CIs) for the association between serum uric acid and risk of type 2 diabetes. We used both fix-effects and random-effects models to calculate the overall effect estimate. The heterogeneity across studies was tested by both Q statistic and I(2) statistic. Begg's funnel plot and Egger's regression test were used to assess the potential publication bias.
  
  
  RESULTS
  We retrieved 7 eligible articles derived from 8 prospective cohort studies, involving a total of 32016 participants and 2930 incident type 2 diabetes. The combined RR of developing type 2 diabetes for the highest category of serum uric acid level compared with the lowest was 1.56(95% CI, 1.39-1.76). Dose-response analysis showed the risk of type 2 diabetes was increased by 6% per 1 mg/dl increment in serum uric acid level (RR 1.06, 95% CI: 1.04-1.07). The result from each subgroup showed a significant association between serum uric acid and risk of type 2 diabetes. In sensitive analysis, the combined RR was consistent every time omitting any one study. Little evidence of heterogeneity and publication bias was observed.
  
  
  CONCLUSIONS
  Our meta-analysis of prospective cohort studies provided strong evidence that high level of serum uric acid is independent of other established risk factors, especially metabolic syndrome components, for developing type 2 diabetes in middle-aged and older people.
authors: Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors: Qin
authors: Q
authors: Lv
authors: Xian-Fang
authors: XF
authors: Meng
authors: Fang-Fang
authors: FF
authors: He
authors: Shan
authors: S
authors: Chen
authors: Hua
authors: H
authors: Su
authors: Jing
authors: J
authors: Xiong
authors: Pan
authors: P
authors: Gao
authors: Xiu-Juan
authors: XJ
authors: Tian
authors: Jian-She
authors: JS
authors: Liu
authors: Zhong-Hua
authors: ZH
authors: Zhu
authors: Kai
authors: K
authors: Huang
authors: Chun
authors: C
authors: Zhang
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D004198:Disease Susceptibility; D006801:Humans; D011446:Prospective Studies; D017594:Publication Bias; D012306:Risk; D014527:Uric Acid / Q000097:blood*
chemical_list: D014527:Uric Acid