The Role of Serum Uric Acid in the Prediction of Type 2 Diabetes Mellitus: Tehran Lipid and Glucose Study

BACKGROUND: To investigate the association between serum uric acid (SUA) and incident type 2 diabetes mellitus (T2DM) and its potential role in improving the well-known predictive models of disease. METHODS: The study included 5719 subjects (2588 men) aged ≥ 30 years without T2DM at baseline. Multivariate Cox proportional hazard analyses were applied using SUA as continuous and categorical variables. The added value of SUA was examined by applying Harrell's concordance statistic (C-index) and integrated discrimination improvement (IDI). RESULTS: During a median follow-up of 8.2 years, 778 (376 men) incident T2DM occurred. Each 1-mg/dL increment in SUA was associated with a higher risk of disease in the whole population, men, and women (HR [95% CI]: 1.18 [1.11-1.26], 1.19 [1.09-1.31], and 1.26 [1.14-1.38], respectively). This association in the whole population persisted after adjustment for homeostasis model assessment of insulin resistance and nutritional data (1.15 [1.06-1.25] and 1.19 [1.10-1.30], respectively). A rising risk of incident T2DM was present across quartiles (Q1: reference) in the whole population, reaching 1.82 (1.39-2.37) for Q4 (p-trends < 0.001). Adding SUA to the well-known models did not significantly improve the risk prediction. CONCLUSION: Although SUA has a significant linear association with incident T2DM, its addition to the well-known models will not be accompanied by better risk prediction.