Serum Uric Acid as a Harbinger of Metabolic Outcome in Subjects With Impaired Glucose Tolerance

Serum uric acid is the major product of purine metabolism (1). In cross-sectional studies, uric acid correlates with components of the metabolic syndrome: hypertension, obesity, low HDL cholesterol, hypertriglyceridemia, hyperinsulinemia, and insulin resistance (2–4). Although determination of uric acid is widely available and inexpensive, it has been overlooked as a marker of disturbed glucose metabolism. We studied its role in predicting changes in glucose tolerance and insulin levels and in the development of type 2 diabetes in the Finnish Diabetes Prevention Study. The design of the Finnish Diabetes Prevention Study has been previously described in detail (5). Briefly, 40- to 65-year-old overweight or obese individuals with impaired glucose tolerance were eligible. Impaired glucose tolerance was defined as a 2-h plasma glucose at 7.8–11.0 mmol/l after oral glucose (75 g) with a fasting glucose <7.8 mmol/l (6). The protocol was approved by the ethics committee of the National Public Health Institute (Helsinki, Finland). All participants gave written informed consent. In all, 522 individuals from five study centers were randomly assigned to the intervention ( n = 265) or control ( n = 257) groups. Serum uric acid concentrations were measured at baseline and at least once during the follow-up in 475 of the 522 participants, and these 475 are included in the present study. The original trial ended after an average follow-up of 3.2 years. In this study, follow-up …