title: High Normal Uric Acid Levels Are Associated with an Increased Risk of Diabetes in Lean, Normoglycemic Healthy Women.
abstract: 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.
authors.affiliation: 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.
authors.forename: Michal
authors.initials: M
authors.lastname: Shani
authors.affiliation: 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.
authors.forename: Shlomo
authors.initials: S
authors.lastname: Vinker
authors.affiliation: 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.
authors.forename: Dganit
authors.initials: D
authors.lastname: Dinour
authors.affiliation: 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.
authors.forename: Merav
authors.initials: M
authors.lastname: Leiba
authors.affiliation: 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.
authors.forename: Gilad
authors.initials: G
authors.lastname: Twig
authors.affiliation: 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.
authors.forename: Eliezer J
authors.initials: EJ
authors.lastname: Holtzman
authors.affiliation: 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.
authors.forename: Adi
authors.initials: A
authors.lastname: Leiba
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000097:blood* / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008875:Middle Aged; D012306:Risk; D014527:Uric Acid / Q000097:blood*
chemical_list: D014527:Uric Acid